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      Injuries During Return to Sport After the COVID-19 Lockdown: An Epidemiologic Study of Italian Professional Soccer Players

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          Abstract

          Background:

          The injury rate in professional soccer players may be influenced by match frequency.

          Purpose:

          To assess how changes in match frequency that occurred because of coronavirus disease 2019 (COVID-19) influenced training and match injuries in the Italian Serie A league.

          Study Design:

          Descriptive epidemiology study .

          Methods:

          Three phases in the Serie A league, each 41 days long, were evaluated: phase A was the beginning of the 2019-2020 season; phase B was a period after the COVID-19 lockdown was lifted, when the remaining matches of the season were played with greater frequency; and phase C was the beginning of the 2020-2021 season. All male professional soccer players who were injured during the 3 phases were included. Player age, height, position, injury history, and return to play (RTP) were retrieved from a publicly available website. Training- and match-related injuries during each of the 3 phases were collected and compared. Moreover, match injuries that occurred after the lockdown phase (phase B), in which there were 12 days designated for playing matches (“match-days”), were compared with injuries in the first 12 match-days of phases A and C.

          Results:

          When comparing 41-day periods, we observed the injury burden (per 1000 exposure-hours) was significantly lower in phase B (278.99 days absent) than in phase A (425.4 days absent; P < .05) and phase C (484.76 days absent; P < .05). A longer mean RTP period was recorded in phase A than in phase B (44.6 vs 23.1 days; P < .05). Regarding 12–match day periods (81 days in phase A, 41 days in phase B, and 89 days in phase C), there was a significantly higher match injury rate (0.56 vs 0.39 injuries/1000 exposure-hours; P < .05) and incidence (11.8% vs 9.3%; P < .05) in phase B than in phase A and a longer mean RTP period in phase A than in phase B (41.8 vs 23.1 days; P < .05). Finally, the rate and incidence of training-related injuries were significantly higher in phase B (4.6 injuries/1000 exposure-hours and 6.5, respectively) than in phase A (1.41 injuries/1000 exposure-hours and 2.04, respectively) ( P < .05).

          Conclusion:

          Both training- and match-related injuries were greater during the abbreviated period after the COVID-19 lockdown. These may be linked to the greater match frequency of that period.

          Related collections

          Most cited references15

          • Record: found
          • Abstract: found
          • Article: not found

          Injuries affect team performance negatively in professional football: an 11-year follow-up of the UEFA Champions League injury study.

          The influence of injuries on team performance in football has only been scarcely investigated.
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            • Article: not found

            Injury incidence and injury patterns in professional football: the UEFA injury study.

            To study the injury characteristics in professional football and to follow the variation of injury incidence during a match, during a season and over consecutive seasons. Prospective cohort study where teams were followed for seven consecutive seasons. Team medical staff recorded individual player exposure and time-loss injuries from 2001 to 2008. European professional men's football. The first team squads of 23 teams selected by the Union of European Football Associations as belonging to the 50 best European teams. Injury incidence. 4483 injuries occurred during 566 000 h of exposure, giving an injury incidence of 8.0 injuries/1000 h. The injury incidence during matches was higher than in training (27.5 vs 4.1, p<0.0001). A player sustained on average 2.0 injuries per season, and a team with typically 25 players can thus expect about 50 injuries each season. The single most common injury subtype was thigh strain, representing 17% of all injuries. Re-injuries constituted 12% of all injuries, and they caused longer absences than non re-injuries (24 vs 18 days, p<0.0001). The incidence of match injuries showed an increasing injury tendency over time in both the first and second halves (p<0.0001). Traumatic injuries and hamstring strains were more frequent during the competitive season, while overuse injuries were common during the preseason. Training and match injury incidences were stable over the period with no significant differences between seasons. The training and match injury incidences were stable over seven seasons. The risk of injury increased with time in each half of matches.
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              • Record: found
              • Abstract: found
              • Article: not found

              Effect of 2 soccer matches in a week on physical performance and injury rate.

              Recovery duration may be too short during the congested fixtures of professional soccer players with regard to maintaining physical performance and a low injury rate. To analyze the effects of 2 matches per week on physical performance and injury rate in male elite soccer players. Cohort study; Level of evidence, 3. Match results, match-related physical performance, and injuries were monitored during 2 seasons (2007-2008 and 2008-2009) for 32 professional soccer players in a top-level team participating in the UEFA (Union of European Football Associations) Champions League. Total distance, high-intensity distance, sprint distance, and number of sprints were collected for 52 home matches. Injuries and player participation in matches and training were recorded throughout the full season. Physical performance, as characterized by total distance covered, high-intensity distance, sprint distance, and number of sprints, was not significantly affected by the number of matches per week (1 versus 2), whereas the injury rate was significantly higher when players played 2 matches per week versus 1 match per week (25.6 versus 4.1 injuries per 1000 hours of exposure; P < .001). The recovery time between 2 matches, 72 to 96 hours, appears sufficient to maintain the level of physical performance tested but is not long enough to maintain a low injury rate. The present data highlight the need for player rotation and for improved recovery strategies to maintain a low injury rate among athletes during periods with congested match fixtures.
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                Author and article information

                Journal
                Orthop J Sports Med
                Orthop J Sports Med
                OJS
                spojs
                Orthopaedic Journal of Sports Medicine
                SAGE Publications (Sage CA: Los Angeles, CA )
                2325-9671
                14 June 2022
                June 2022
                : 10
                : 6
                : 23259671221101612
                Affiliations
                [* ]Orthopedic Unit and “Kirk Kilgour” Sports Injury Centre, S. Andrea Hospital, University of Rome “Sapienza,” Rome, Italy.
                []Italian Football Research Group, Orthopedic Unit and “Kirk Kilgour” Sports Injury Centre, S. Andrea Hospital, University of Rome “Sapienza,” Rome, Italy.
                [3-23259671221101612] Investigation performed at the Orthopedic Unit and “Kirk Kilgour” Sports Injury Centre, S. Andrea Hospital, University of Rome “Sapienza,” Rome, Italy
                Author notes
                [*] []Alessandro Annibaldi, MD, Italian Football Research Group, Orthopedic Unit and “Kirk Kilgour” Sports Injury Centre, S. Andrea Hospital, University of Rome “Sapienza,” Via di Grottarossa 1035, Rome, Italy (email: alessandro.annibaldi91@ 123456gmail.com ).
                Article
                10.1177_23259671221101612
                10.1177/23259671221101612
                9201316
                35722177
                df9be724-fb94-4281-b493-c5014fc2ac3e
                © The Author(s) 2022

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License ( https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 16 March 2022
                : 22 March 2022
                Categories
                Article
                Custom metadata
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                football,injuries,epidemiology,sports trauma
                football, injuries, epidemiology, sports trauma

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