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      Time before return to play for the most common injuries in professional football: a 16-year follow-up of the UEFA Elite Club Injury Study

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          Abstract

          Objectives

          The objective was to describe the typical duration of absence following the most common injury diagnoses in professional football.

          Methods

          Injuries were registered by medical staff members of football clubs participating in the Union of European Football Association Elite Club Injury Study. Duration of absence due to an injury was defined by the number of days that passed between the date of the injury occurrence and the date when the medical team allowed the player to return to full participation. In total, 22 942 injuries registered during 494 team-seasons were included in the study.

          Results

          The 31 most common injury diagnoses constituted a total of 78 % of all reported injuries. Most of these injuries were either mild (leading to a median absence of 7 days or less, 6440 cases = 42%) or moderate (median absence: 7–28 days, 56% = 8518 cases) while only few (2% = 311 cases) were severe (median absence of >28 days). The mean duration of absence from training and competition was significantly different (p < 0.05) between index injuries and re-injuries for six diagnoses (Achilles tendon pain, calf muscle injury, groin adductor pain, hamstring muscle injuries and quadriceps muscle injury) with longer absence following re-injuries for all six diagnoses

          Conclusions

          The majority of all time loss due to injuries in professional football stems from injuries with an individual absence of up to 4 weeks. This article can provide guidelines for expected time away from training and competition for the most common injury types as well as for its realistic range.

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          Most cited references19

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          Hamstring injuries have increased by 4% annually in men's professional football, since 2001: a 13-year longitudinal analysis of the UEFA Elite Club injury study.

          There are limited data on hamstring injury rates over time in football.
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            Methods for epidemiological study of injuries to professional football players: developing the UEFA model.

            A problem with epidemiological studies of football injuries is the inconsistent manner in which injury is defined and data are collected. Projects have been initiated to study the incidence and causes of injury in football, but there is no uniformly accepted reporting system. In this report, some common pitfalls encountered in the recording of injury are addressed, and practical guidelines for epidemiological studies are provided. An injury reporting system developed for the UEFA Football Safety Project for studies on professional footballers is used as a starting point for a general discussion on injury registration and compared with other existing reporting systems. The recording definition of injury may vary between studies depending on its purpose. A time loss injury definition is practical for all playing levels, and, as a minimum, results on time loss injuries should therefore always be reported separately to allow direct comparisons between studies. There is a need to agree on a uniform sports injury classification system with corresponding diagnostic criteria, as well as standardised return to play criteria after injury.
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              Hamstring muscle injuries in professional football: the correlation of MRI findings with return to play.

              Hamstring injury is the single most common injury in professional football. MRI is commonly used to confirm the diagnosis and provide a prognosis of lay-off time. To evaluate the use of MRI as a prognostic tool for lay-off after hamstring injuries in professional football players and to study the association between MRI findings and injury circumstances. Prospective cohort study where 23 European professional teams, were followed between 2007 and 2011. Team medical staffs recorded individual player exposure and time-loss injuries. Radiological grading was performed using a modified Peetrons classification into four grades where grades 2 and 3 represent fibre disruption. In total, 516 hamstring injuries occurred and 58% of these were examined by MRI. Thirteen per cent were grade 0 injuries, 57% grade 1, 27% of grade 2 and 3% of grade 3. Grade 0 and 1 injuries accounted for 56% (2141/3830 days) of the total lay-off. The lay-off time differed between all four radiological grades of injury (8±3, 17±10, 22±11 and 73±60 days, p<0.0001). Eighty-three per cent of injuries affected the biceps femoris while 11% and 5% occurred to the semimembranosus and semitendinosus, respectively. Re-injuries (N=34/207) constituted 16% of injuries. All re-injuries occurred to the biceps femoris. MRI can be helpful in verifying the diagnosis of a hamstring injury and to prognosticate lay-off time. Radiological grading is associated with lay-off times after injury. Seventy per cent of hamstring injuries seen in professional football are of radiological grade 0 or 1, meaning no signs of fibre disruption on MRI, but still cause the majority of absence days.
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                Author and article information

                Journal
                Br J Sports Med
                Br J Sports Med
                bjsports
                bjsm
                British Journal of Sports Medicine
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                0306-3674
                1473-0480
                April 2020
                10 June 2019
                : 54
                : 7
                : 421-426
                Affiliations
                [1 ] departmentDepartment of Medical and Health Sciences , Linköping University , Linköping, Sweden
                [2 ] Aspetar Orthopaedic and Sports Medicine Hospital , Doha, Ad Dawhah, Qatar
                [3 ] departmentDepartment of Trauma Surgery , Universitatsklinikum Regensburg , Regensburg, Germany
                [4 ] departmentDepartment of Medical and Health Sciences, Athletics Research Centre , Linköping University , Linköping, Sweden
                [5 ] departmentDepartment of Orthopaedic Surgery , St Anna Hospital , Eindhoven, The Netherlands
                [6 ] AFC Bournemouth , Bournemouth, Bournemouth, UK
                [7 ] departmentInstitute of Sports and Preventive Medicine , University of Saarland , Saarbrücken, Germany
                Author notes
                [Correspondence to ] Professor Jan Ekstrand, Department of Medical and Health Sciences, Linköping University, Linköping S-582 21, Sweden; jan.ekstrand@ 123456telia.com
                Author information
                http://orcid.org/0000-0002-6092-266X
                http://orcid.org/0000-0003-3809-5909
                Article
                bjsports-2019-100666
                10.1136/bjsports-2019-100666
                7146935
                31182429
                b892ebe9-a269-48c8-9e78-e21230c5e079
                © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 26 May 2019
                Funding
                Funded by: UEFA;
                Categories
                Original Research
                1506
                2314
                Custom metadata
                unlocked

                Sports medicine
                soccer,injuries,return to play,epidemiology
                Sports medicine
                soccer, injuries, return to play, epidemiology

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