Prevention of non-contact anterior cruciate ligament injuries in soccer players. Part 1: Mechanisms of injury and underlying risk factors

Alentorn-Geli, Eduard; Myer, Gregory D.; Silvers, Holly J.; Samitier, Gonzalo; Romero, Daniel; Lázaro-Haro, Cristina; Cugat, Ramón

doi:10.1007/s00167-009-0813-1

Cited by 710 publications

(761 citation statements)

References 183 publications

(332 reference statements)

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“…A full appraisal of these topics is beyond the scope of this review and in some instances has already been conducted [71][72][73][74][75][76]. However, the importance of these variables to female soccer players and the potential impact on training, performance and injury risk should not be underestimated.…”

Section: ) Female Differencesmentioning

confidence: 99%

“…Internal risk factors include anatomical, neuromuscular, biomechanical and hormonal variables [74,75]. Studies often concentrate on intrinsic risk factors as they can provide differentiation between the sexes.Evidence suggests the anatomy of the female knee, specifically a smaller intercondylar notch width and ACL, are contributing factors to an increased risk of ACL injury [74,75]. A link has been established between hypermobile individuals and higher risk of ACL injuries in female soccer and basketball players [122].…”

mentioning

confidence: 99%

“…Evidence suggests the anatomy of the female knee, specifically a smaller intercondylar notch width and ACL, are contributing factors to an increased risk of ACL injury [74,75]. A link has been established between hypermobile individuals and higher risk of ACL injuries in female soccer and basketball players [122].…”

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Applied Physiology of Female Soccer: An Update

et al. 2014

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The popularity and professionalism of female soccer has increased markedly in recent years, with elite players now employed on either a professional or semi-professional basis. The previous review of the physiological demands of female soccer was undertaken two decades ago when the sport was in its relative infancy. Increased research coupled with greater training and competition demands warrants an updated review to consider the effect on physical performance and injury patterns.The physical demands of match-play along with the influence of factors such as the standard of competition, playing position and fatigue have been explored. Total distance covered for elite female players is approximately 10 km, with 1.7 km completed at high-speed (>18 km.h -1 ). Elite players complete 28% more high-speed running and 24% more sprinting than moderate level players. Decrements in high-speed running distance have been reported between and within halves, which may indicate an inability to maintain highintensity activity. Although physical capacity of female players is the most thoroughly researched area comparisons are difficult due to differing protocols. Elite players exhibit maximal oxygen uptake (VO2max) values of 49.4 -57.6 ml.kg -1 .min -1 , Yo Yo Intermittent Endurance test level 2 (YYIE2) scores of 1774 ± 532 m (mean ± SD) and 20 m sprint times of 3.17 ± 0.03 s (mean ± SD). Reasons for the increased prevalence of anterior cruciate ligament injuries in females (2-6 times greater than males) are discussed with anatomical, biomechanical loading and neuromuscular activation differences being cited in the literature. This review presents an in-depth contemporary examination of the applied physiology of the female soccer player.Applied Physiology of Female Soccer 2 1) Introduction The last review of the physiological demands of female soccer was undertaken two decades ago [1] . At the time of that review, women's soccer was in its relative infancy with the inaugural Women's World Cup having taken place in 1991. The popularity of women's soccer has increased markedly in recent years with 29 million participants recorded in 2011, an increase of 34% from 2000 [2]. The 2015 Women's World Cup will have 24 participating nations, an increase of eight from the previous tournament.Since the previous review, increasing attention in the scientific literature has focused on women's soccer with over two thousand scientific articles published. There has been a drive towards professionalism in the sport with players at the highest level now employed on a professional or semi-professional basis. Current elite players are exposed to greater training volumes and competition demands than ever before, consequently these increased physical demands may have implications for both physical performance levels and injury patterns. Inline with these changes, advances in technology available for monitoring athletes has led to greater opportunities to scientifically support players and thus information regarding the modern elite female player...

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Section: ) Female Differencesmentioning

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Applied Physiology of Female Soccer: An Update

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“…Increased leg stiffness is suggested to enhance rate of force development, locomotor kinematics and energy storage and utilisation (Brughelli and Cronin 2008), providing performance benefits of increased force output, movement speed and running economy (Butler et al 2003;Wilson and Flanagan 2008). Furthermore, it has been suggested that lower limb stiffness is an important injury protection mechanism (Alentorn-Geli et al 2009), with low levels of stiffness associated with soft tissue injuries (Hobara et al 2008). …”

Section: Introductionmentioning

confidence: 99%

Altered neuromuscular control of leg stiffness following soccer-specific exercise

et al. 2014

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2 AbstractPurpose: To examine changes to neuromuscular control of leg stiffness following 42-min of soccer-specific exercise. Methods: Ten youth soccer players aged 15.8  0.4 hopped on a force plate at a self selected frequency before and after simulated soccer exercise performed on a non-motorised treadmill. During hopping muscle activity was measured using surface EMG from four lower limb muscles and analysed to determine feedforward and feedback mediated activity, as well as co-contraction. Results: There was no change in stiffness following the soccer-specific exercise (26.6  10.6 versus 24.0  7.0 kN·m -1 , p > 0.05), with half the group increasing and half decreasing their stiffness. Changes in stiffness were significantly related to changes in CoM displacement (r = 0.90, p < 0.01) but not changes in peak GRF (r = 0.58, p > 0.05). A number of significant relationships were observed between changes in stiffness and CoM displacement with changes in feedforward, feedback and eccentric muscle activity of the soleus and vastus lateralis muscles following the soccer exercise (r = 0.64-0.98, p < 0.05), but not with changes in co-contraction around the knee and ankle (r = 0.11-0.55, p > 0.05). Conclusions:Following soccer-specific exercise individual changes in extensor muscle activity modulate changes in CoM displacement and leg stiffness. Individuals who reduce preactivation, braking activity and consequently leg stiffness with fatigue may be at a greater risk of injury.

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“…It was not within the scope of this review to discuss the causes of any gender-related difference, since this has been done previously [3,38,41].…”

Section: Introductionmentioning

confidence: 99%

The epidemiology of anterior cruciate ligament injury in football (soccer): a review of the literature from a gender-related perspective

Waldén

Hägglund

Werner

et al. 2010

Knee Surg Sports Traumatol Arthrosc

243

208

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Football (soccer), the most popular sport worldwide, is associated with a high injury risk and the knee joint is often affected. Several studies have found female players to be more susceptible to knee injury, anterior cruciate ligament (ACL) injury in particular, compared to their male counterparts. There is, however, some controversy regarding the magnitude of this risk increase and a few studies have found no differences. The influence of age and activity type on genderrelated differences in injury risk is only scarcely investigated. In this paper, the literature reporting gender-specific ACL injury risk in football is reviewed. A literature search yielded 33 relevant articles that were included for review. These show that female players have a 2-3 times higher ACL injury risk compared to their male counterparts. Females also tend to sustain their ACL injury at a younger age than males and a limiting factor in the existing literature is that age is not adjusted for in comparisons of ACL injury risk between genders. Furthermore, the risk increase in females is primarily evident during match play, but type of exposure is also rarely adjusted for. Finally, the studies included in this review share important methodological limitations that are discussed as a starting point for future research in the field.

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Prevention of non-contact anterior cruciate ligament injuries in soccer players. Part 1: Mechanisms of injury and underlying risk factors

Cited by 710 publications

References 183 publications

Applied Physiology of Female Soccer: An Update

Applied Physiology of Female Soccer: An Update

Altered neuromuscular control of leg stiffness following soccer-specific exercise

The epidemiology of anterior cruciate ligament injury in football (soccer): a review of the literature from a gender-related perspective

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