scholarly journals Return-to-Play after Concussion in American versus European Professional Soccer Players: A Comparative Short-Term Analysis of Performance and Longevity

2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0034
Author(s):  
Prem N. Ramkumar ◽  
Sergio M. Navarro ◽  
Heather S. Haeberle ◽  
Albert S. Jang ◽  
Salvatore Joseph Frangiamore ◽  
...  

Objectives: Many studies have focused on the long-term impact of concussions in professional sports, but few have investigated short-term effects. This study examines concussion effects on individual players in the Major League Soccer (MLS) and English Premier League (EPL) by assessing 1) return-to-play (RTP) time, 2) career length, and 3) performance. Methods: Contracts, transactions, injury reports, and performance statistics from 2008-17 were obtained from the official MLS and EPL online publications. Players who sustained a concussion were compared with the 2008-17 non-concussed player pool. Career length was analyzed using Kaplan-Meier survival curves and athletes were stratified by player age, experience, and longevity. Player performance changes were evaluated between the years before versus after concussion. RTP and games missed were analyzed and compared. Results: Of the 1,784 eligible MLS and 2,001 eligible EPL players evaluated over the 10-year period, 102 MLS players sustained 165 concussions and 124 EPL players sustained 142 concussions resulting in injury protocol initiation. MLS players on average missed 7.5 games after a concussion, with 33.5 days missed, whereas EPL players on average missed 0.5 games after a concussion with 9.5 days missed, which was statistically different (p<0.001, p<0.0001). Performance was reduced at all non-goalie positions for goals and assists post-concussion for players in the MLS and in the EPL (p < 0.01). Concussed MLS players playing non-goalie positions scored 2.5 points/year less following a concussion and played in 20 fewer games/year on average. Concussed EPL players playing non-goalie positions scored 3.1 points/year less following a concussion and started in 5.8 fewer games/year on average. Concussed MLS and EPL goalies saw no significant change in performance, although EPL goalies played 3.2 additional games/year on average (p <0.05). The probability of playing a full season post-concussion was not significantly decreased compared with the non-concussed pool (p > 0.05) in both leagues Conclusion: This study investigating the short-term effects of concussion on professional soccer players demonstrates that performance is reduced for non-goalie players, without a significant difference in career longevity between concussed and non-concussed controls.

2019 ◽  
Vol 47 (10) ◽  
pp. 2287-2293 ◽  
Author(s):  
Prem N. Ramkumar ◽  
Sergio M. Navarro ◽  
Heather S. Haeberle ◽  
Bryan C. Luu ◽  
Albert Jang ◽  
...  

Background: The incidence and effect of sports-related concussions (SRCs) within the global sport of professional soccer is poorly described. Purpose: To comparatively examine the effects of SRC on athletes in Major League Soccer (MLS) and the English Premier League (EPL) in terms of incidence, return to play (RTP), performance, and career longevity. Study Design: Cohort study; Level of evidence, 3. Methods: Contracts, transactions, injury reports, and performance statistics from 2008 to 2017 were obtained and cross-referenced across 6 publicly available websites detailing MLS and EPL data, including official league publications. For each league, players who sustained a concussion were compared with the 2008-2017 uninjured player pool. RTP and games missed were analyzed and compared. Career length was analyzed with Kaplan-Meier survival curves. Player performance changes were evaluated before and after concussion. Results: Of the 1784 eligible MLS and 2001 eligible EPL players evaluated over the 10-year period, the incidence of publicly reported concussions per 1000 athlete-exposures was 20.22 and 18.68, respectively ( P = .53). The incidence of reported concussions steadily increased in both leagues. MLS players missed a mean 7.3 games after concussion (37.0 days missed); EPL players missed a mean 0.6 games after concussion (10.9 days missed) ( P < .0001, P < .0001). Statistical performance in terms of games started, assists, shots on goal, and total shots after concussion was significantly reduced at all nongoalie positions for players in the EPL; however, MLS nongoalie positions with concussion had no significant decreases in these categories. Goalies in both leagues had no significant change in performance or games started. The probability of playing a full season after concussion was not significantly decreased when compared with the uninjured pool in both leagues. Conclusion: This study established the SRC incidence among elite soccer players in 2 international professional leagues and identified major RTP and performance differences between EPL and MLS players. While career longevity was unaffected, the approach to managing concussion as in MLS may better promote player safety and preserve on-field performance.


2017 ◽  
Vol 23 ◽  
pp. 121
Author(s):  
D. Trofa ◽  
P. Noback ◽  
C. Ahmad ◽  
J. Greisberg ◽  
J. Turner Vosseller

2018 ◽  
Vol 6 (11) ◽  
pp. 232596711881077 ◽  
Author(s):  
David P. Trofa ◽  
Peter C. Noback ◽  
Jon-Michael E. Caldwell ◽  
J. Chance Miller ◽  
Justin K. Greisberg ◽  
...  

Background: The majority of Achilles tendon ruptures are sports related; however, no investigation has examined the impact of surgical repair for complete ruptures on professional soccer players. Purpose: To examine the return to play, playing time, and performance of professional soccer players following Achilles tendon repair. Study Design: Cohort study; Level of evidence, 3. Methods: Union of European Football Associations (UEFA) and Major League Soccer (MLS) athletes who sustained a primary complete Achilles tendon rupture and were treated surgically between 1988 and 2014 were identified via public injury reports. Demographic information and performance-related statistics for the identified athletes were recorded for the season before surgery and 2 seasons after surgery and were compared with information for matched controls. Statistical analyses were used to assess differences in recorded metrics. Results: A total of 24 athletes with Achilles ruptures met inclusion criteria, 17 (70.8%) of whom were able to return to play. On average, players had 8.3 years of professional-level experience prior to sustaining an Achilles rupture. Among athletes who returned to play, no differences were found in the number of games played or started, minutes played, or goals scored 1 year postoperatively compared with the year prior to injury. However, 2 years postoperatively, these athletes played 28.3% ( P = .028) fewer minutes compared with their preoperative season, despite starting and playing in an equivalent number of games. Matched controls had baseline playing time and performance statistics similar to those of players. However, controls played and started in significantly more games and played more minutes at 1 and 2 years compared with players ( P < .05). No differences were found in goals scored at any time point. Conclusion: This is the first investigation examining the effect of an Achilles repair on the career of professional soccer players. This is a difficult injury that most commonly occurs in veteran players and prevents 29.2% of players from returning to play despite surgical management. Additionally, athletes able to return to play were found to play fewer minutes 2 years postoperatively compared with their baseline as well as playing less at 1 and 2 years postoperatively compared with uninjured matched controls. The reduction in playing time following an Achilles repair has significant implications for professional players and teams.


2018 ◽  
Vol 6 (12) ◽  
pp. 232596711881423 ◽  
Author(s):  
Prem N. Ramkumar ◽  
Sergio M. Navarro ◽  
Heather S. Haeberle ◽  
Rowland W. Pettit ◽  
Travis J. Miles ◽  
...  

Background: The short-term outcomes of concussions within Major League Baseball (MLB) warrant further consideration beyond a medical standpoint given that performance, career, and financial data remain unknown. The perception of this injury directly affects decision making from the perspective of both player and franchise. Purpose: To evaluate the effect of concussion on MLB players by (1) establishing return-to-play (RTP) time after concussion; (2) comparing the career length and performance of players with concussion versus those who took nonmedical leave; and (3) analyzing player financial impact after concussion. Study Design: Cohort study; Level of evidence, 3. Methods: Contracts, transactions, injury reports, and performance statistics from 2005 to 2017 were analyzed by comparing matched players who sustained a concussion versus those who took nonmedical leave. Of the 4186 eligible MLB players, 145 sustained concussions resulting in the activation of concussion protocol and 538 took nonmedical leave. RTP time was recorded. Career length was analyzed in reference to an experience-based stratification of full seasons remaining after the concussion. Changes in player performance and salary before and after concussion were compared with the same parameters for players who took nonmedical leave. Results: The mean RTP time was 26 days (95% CI, 20-32 days) for athletes with concussion and 8 days (95% CI, 6-10 days) for those who took nonmedical leave. Athletes with concussion had a mean of 2.8 full seasons remaining, whereas athletes who took nonmedical leave had 3.1 seasons remaining ( P = .493). The probability of playing in the MLB after concussion compared with the nonmedical leave pool was not significantly lower ( P = .534, log-rank test; hazard ratio, 1.108). Postconcussion performance decreased significantly in position players, including a lower batting average and decreased on-base percentage in the players with concussion compared with those returning from nonmedical leave. Players who sustained a concussion lost a mean of US$654,990 annually compared with players who took nonmedical leave. Conclusion: This study of the short-term outcomes after concussion in limited-contact MLB athletes demonstrates that concussions may not decrease career spans but may result in decreased performance in addition to financial loss when compared with matched controls who took nonmedical leave. In sports such as baseball that are not subject to repetitive head trauma, career spans may not decrease after a single concussive event. However, sentinel concussions have deleterious short-term effects on performance and compensation among MLB players.


2021 ◽  
Vol 9 (9) ◽  
pp. 232596712110242
Author(s):  
Ophelie Lavoie-Gagne ◽  
Matthew F. Gong ◽  
Sumit Patel ◽  
Matthew R. Cohn ◽  
Avinaash Korrapati ◽  
...  

Background: The average professional soccer team experiences 1 to 2 traumatic leg fractures per season, with unknown effects on player performance. Purpose: To (1) determine the rate and time to return to play (RTP) following leg fracture, (2) investigate the rate of reinjury following RTP, and (3) investigate long-term effects that lower extremity (LE) fracture may have on elite soccer player performance. Study Design: Cohort study; Level of evidence, 3. Methods: Using publicly available records, we identified athletes sustaining a traumatic leg fracture across the 5 major European soccer leagues (English Premier League, Bundesliga, La Liga, Ligue 1, and Serie A) between 2000 and 2016. Athletes with leg fracture (femur, tibia, and/or fibula) were matched 1:2 to controls by demographic characteristics and performance metrics 1 season before the index timepoint. Investigations included the RTP rate, reinjury rate, player characteristics associated with RTP within 2 seasons, long-term player retention, performance metrics during the 4 following seasons, and subgroup analysis by player position. Results: A total of 112 players with LE fracture and 224 controls were identified. Players with LE fractures were absent for a mean of 157 days (range, 24-601 days) and 21 games (range, 2-68 games). The rate of RTP within 1 season was 80%, with 4% experiencing subsequent refracture. Injured players remained active in the league at a higher rate than their uninjured counterparts. As compared with controls, injured athletes played 309 fewer total minutes ( P < .05), scored 0.09 more assists per game ( P < .01) 1 season after injury, and scored 0.12 more points per game 4 seasons after injury ( P < .01). Defenders were most affected by an LE fracture, playing 5.24 fewer games ( P < .05), 603 fewer total minutes ( P < .01), and recording 0.19 more assists per 90 minutes of play as compared with controls 1 season after injury ( P < .001). Attackers and midfielders demonstrated no significant difference in metrics after RTP when compared with controls. Conclusion: Most players sustaining an LE fracture returned to elite soccer at the same level after a significant loss of playing time, with a 4% rate of refracture. Player retention was higher for those sustaining an LE fracture versus uninjured controls. Overall, injured players did not experience a decline in performance after recovery from an LE fracture.


2021 ◽  
pp. 194173812097366
Author(s):  
André Orlandi Bento ◽  
Guilherme Falótico ◽  
Keelan Enseki ◽  
Ronaldo Alves Cunha ◽  
Benno Ejnisman ◽  
...  

Background: Morphological changes characteristic of femoroacetabular impingement (FAI) are common in soccer players. However, the clinical relevance of such anatomical variations is still not well-defined. Hypothesis: We hypothesized that high alpha angle values and/or acetabular retroversion index (ARI) are correlated with rotational range of motion (ROM) of the hip and that there are clinical-radiological diferences between the dominant lower limb (DLL) and nondominant lower limb (NDLL) in professional soccer players. Study Design: Cross-sectional. Level of Evidence: Level 3. Methods: A total of 59 male professional soccer players (average age 25.5 years, range 18-38 years) were evaluated in the preseason. As main outcome measures, we evaluated the alpha angle and the ARI and hip IR and ER ROM with radiographic analysis. Results: The measurements taken on DLL and NDLL were compared and a significant difference was found between the sides in the ER ( P = 0.027), where the DLL measures were 1.54° (95% CI, 0.18-2.89) greater than the NDLL. There were no significant differences between the sides in the measures of IR ( P > 0.99), total ROM ( P = 0.07), alpha angle ( P = 0.250), and ARI ( P = 0.079). The correlations between the rotation measurements and the alpha angle in each limb were evaluated and the coefficient values showed no correlation; so also between the ARI and rotation measures. Conclusion: Morphological changes of the femur or acetabulum are not correlated with hip IR and ER ROM in male professional soccer players. ER on the dominant side was greater than on the nondominant side. There was no significant difference in the other measurements between sides. Clinical Relevance: In clinical practice, it is common to attribute loss of hip rotational movement to the presence of FAI. This study shows that anatomical FAI may not have a very strong influence on available hip rotational movement in professional soccer athletes.


Retos ◽  
2020 ◽  
Author(s):  
Wilson Arroyo Moya

  Se ha comprobado y establecido que alrededor del 66% de los componentes del rendimiento y estado del atleta se explican por los factores hereditarios. Dos de los polimorfismos genéticos mas estudiados con relación al rendimiento deportivo en la ultima década, son el ACTN3 R577X y el ACE I/D. El objetivo de este estudio fue resumir las posibles asociaciones de ambos polimorfismos y el rendimiento en jugadores de fútbol, determinando la combinación alélica y genotípica que más destaca en esta población y, además, observar las relaciones de estos a nivel físico y fisiológico. Para la realización de este estudio se llevaron a cabo dos fases, una primera de revisión bibliográfica y una segunda fase de clasificación y análisis de la información. Los estudios evidencian una mayor influencia de los alelos ACE-D y ACTN-R, y de los genotipos ACE-ID y ACTN-RR. Se observó que los sujetos con estas combinaciones tenían mejores rendimientos es pruebas de velocidad y fuerza. Por otro lado, el polimorfismo ACTN3 está directamente relacionado con las lesiones musculares. En conclusión, se pudo observar una relación entre los polimorfismos genéticos y el rendimiento en jugadores de fútbol. Los componentes genéticos se pueden integrar como un nuevo componente dentro de la caracterización del deporte y como una herramienta dentro de un modelo de identificacción y detección de talentos en el fútbol juvenil. Además, los biomarcadores genéticos podrían ser responsables en un futuro, del estudio del riesgo de lesiones para que se optimice mucho más el rendimiento en el fútbol profesional. Abstract. It has been verified and established that around 66% of the components of the athlete's performance and state are explained by hereditary factors. Two of the most studied genetic polymorphisms in relation to sports performance in the last decade are ACTN3 R577X and ACE I/D. The aim of this study was to summarize the possible associations of both polymorphisms and the performance in soccer players, determining the allelic and genotypic combination that stands out the most in this population and, also, to observe their relationships at the physical and physiological level. In order to complete this study, two phases were carried out, the first one of literature review and, the second one which covered the information classification and analysis. The studies show a greater influence of the ACE-D and ACTN-R alleles, and higher presence of the ACE-ID and ACTN-RR genotypes. Subjects with these combinations were found to perform better on speed and strength tests. On the other hand, the ACTN3 polymorphism is directly related to muscle injuries. In conclusion, a relationship between genetic polymorphisms and performance in soccer players could be observed. Genetic components can be integrated as a new component within the characterization of sport and as a tool within a model of identification and detection of talents in youth soccer. In addition, genetic biomarkers could be responsible, in the future, for the study of the risk of injury so that performance in professional soccer is much more optimized.


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