Injury prevention strategies at the FIFA 2014 World Cup: perceptions and practices of the physicians from the 32 participating national teams

Abstract

PurposeThe available scientific research regarding injury prevention practices in international football is sparse. The purpose of this study was to quantify current practice with regard to (1) injury prevention of top-level footballers competing in an international tournament, and (2) determine the main challenges and issues faced by practitioners in these national teams.MethodsA survey was administered to physicians of the 32 competing national teams at the FIFA 2014 World Cup. The survey included 4 sections regarding perceptions and practices concerning non-contact injuries: (1) risk factors, (2) screening tests and monitoring tools, (3) preventative strategies and (4) reflection on their experience at the World Cup.ResultsFollowing responses from all teams (100%), the present study revealed the most important intrinsic (previous injury, accumulated fatigue, agonist:antagonist muscle imbalance) and extrinsic (reduced recovery time, training load prior to and during World Cup, congested fixtures) risk factors during the FIFA 2014 World Cup. The 5 most commonly used tests for risk factors were: flexibility, fitness, joint mobility, balance and strength; monitoring tools commonly used were: medical screen, minutes/matches played, subjective and objective wellness, heart rate and biochemical markers. The 5 most important preventative exercises were: flexibility, core, combined contractions, balance and eccentric.ConclusionsThe present study showed that many of the National football (soccer) teams’ injury prevention perceptions and practices follow a coherent approach. There remains, however, a lack of consistent research findings to support some of these perceptions and practices.

Injury prevention strategies, coach compliance and player adherence of 33 of the UEFA Elite Club Injury Study teams: a survey of teams’ head medical officers

“…The questions were inspired by two previous surveys on injury prevention strategies in professional10 and international football teams 12. The design of the survey took into consideration the authors’ combined knowledge and experience of sports medicine and science in professional elite football, in addition to their work in peer-reviewed research and implementing survey-based research.…”

“…To calculate the overall importance of risk factors, points were awarded on the basis of a Likert scale of perceived levels of importance (‘very important, important, somewhat important, not important, not sure’) developed for previous survey research 10 12. Each time a risk factor was rated ‘very important’, it was awarded 3 points, ‘important’: 2 points, ‘somewhat important’: 1 point, ‘not sure’: 0.5 point and ‘not important’: 0 point.…”

“…Teams were asked to rank in order of importance (1st to 5th) (1) the monitoring tools and (2) the preventative exercises they considered the most important in their injury prevention programme. Points were awarded on the basis of a scale developed for previous survey research10 12; monitoring tools and exercises rated in the 1st position were given 5 points, 2nd: 4 points, 3rd: 3 points, 4th: 2 points and 5th: 1 point. Points for each monitoring tool and exercise were summed and ranked in order from highest to lowest.…”

“…Some reasons have been put forward that may help explain this finding: (1) targeting player-related factors may not be sufficient and external risk factors such as communication between team staff may need to be considered,8 (2) current injury prevention exercises may not be sufficiently specific to the high-speed demands of football,8 (3) there is a lack of scientific studies to provide practitioners with evidence-based prevention strategies9 10 and (4) player adherence (ie, commitment to consistently performing) to injury prevention programmes11 and coaches’ compliance (ie, ‘commitment to complying with individualised player recommendations) with individualised recommendations may not be adequate 12…”

Efficacy of stretching in physiotherapy and sports

“…Stretching was not regarded as a commonly recommended training method. 36 It is thus possible to assume that stretching in sports, especially professional sports, is becoming less trendy, although its influence on injury incidence, especially within ligaments and muscle-tendon units, should be taken into account and analysed in further research. In a study comprising 1538 American recruits the incidence of injuries was significantly lower in a group practicing stretching than in the control group, and muscle tears were noted 5 times less frequently.…”