{"id":14929,"date":"2019-03-18T12:13:19","date_gmt":"2019-03-18T15:13:19","guid":{"rendered":"https:\/\/barcainnovationhub.com\/?p=14929"},"modified":"2021-11-24T12:31:50","modified_gmt":"2021-11-24T15:31:50","slug":"muscle-injury-guide-preventing-and-treating-muscle-injuries-in-football","status":"publish","type":"post","link":"https:\/\/barcainnovationhub.com\/ca\/muscle-injury-guide-preventing-and-treating-muscle-injuries-in-football\/","title":{"rendered":"MUSCLE INJURY GUIDE \u2013 PREVENTING AND TREATING MUSCLE INJURIES IN FOOTBALL"},"content":{"rendered":"","protected":false},"excerpt":{"rendered":"<p>There are many physical and mental health benefits to training and playing football, however, there is also, unfortunately, one key adverse effect; an increased risk of injury, with muscle injuries being one of the most common injuries we see in elite football.<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[222,31],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v16.6.1 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<meta name=\"description\" content=\"There are many physical and mental health benefits to training and playing football, however, there is also, unfortunately, one key adverse effect; 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an increased risk of injury, with muscle injuries being one of the most common injuries we see in elite football. Due to the negative effects that we know injuries have on performance, club finances and long-term player health, their prevention and optimal treatment (when they do occur) is an essential part of the football medicine and performance department. In particular, at FC Barcelona (and I am sure in many of the football clubs around the world) we see the role of the football medicine and performance department and staff as three-fold;<\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li><b>Protect our players\u2019 health<\/b><\/li>\n<\/ul>\n<ul>\n<li>Maximize player and team performance<\/li>\n<\/ul>\n<ul>\n<li>Ensure the scientific integrity of medical and performance programs delivered in FC Barcelona<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>At FC Barcelona we believe that the creation, integration, and delivery of an effective and efficient medical and performance program requires an evidence-led approach, using the best of research knowledge combined with our many years of practical experience. We also believe strongly in sharing our knowledge and experiences among the football and sports community globally.<\/p>\n<p>In 2009, we published the first FC Barcelona Muscle Injury Guide with the aim of providing an insight into our philosophy and methods of preventing and treating muscle injuries. Then in 2015, we released our second Muscle Injury Guide. With each Guide, we strive to progress on the last. We now have the great pleasure of launching our 2018 FC Barcelona Muscle Injury Guide: \u2018Preventing and Treating Muscle Injuries in Footballers\u2019. We see this Guide not as a progression on the previous two, but rather as a new concept and with a new direction. In the true spirit of FC Barcelona, we are \u2018mes que un club\u2019 (more than a club) and have welcomed into our football family, a number of internationally renowned sports medicine and performance practitioners and researchers to contribute with us on the practical recommendations that follow. We are truly grateful for the partnerships we have formed in the production of this Guide including; the Oslo Sports Trauma Research Centre and the Science and Medicine in Football Journal. Our aim is to provide you, the reader\/practitioner with the most up to date knowledge and experiences from 60+ worldwide experts combined with the \u2018Bar\u00e7a Way\u2019.<\/p>\n<p>Our Muscle Injury Guide is not intended to be a \u2018must follow recipe\u2019, but rather provide some key ingredients that you can adapt and integrate appropriately into your own practice. We hope you enjoy reading the combined knowledge and experiences of the many valued contributors included throughout.<\/p>\n<p><b>Dr Ricard Pruna<\/b><\/p>\n<p><b>Head of Medical Services, FC Barcelona<\/b><\/p>\n<p>&nbsp;<\/p>\n<p><b>1- AN INTRODUCTION TO PREVENTING MUSCLE INJURIES<\/b><\/p>\n<p>The objective of football is to win games. There are many factors (i.e. tactical, technical, physical and mental) interacting to achieve this objective. However, one key, contributing factor that the medical and performance team can influence is player availability i.e. through a lower impact of injuries (incidence and severity).<\/p>\n<p>\u2014 With Alan McCall and Ricard Pruna<\/p>\n<p>&nbsp;<\/p>\n<p><b>A NEW MODEL FOR INJURY PREVENTION IN TEAM SPORTS:\u00a0<\/b>THE TEAM-SPORT INJURY PREVENTION (TIP) CYCLE<\/p>\n<p>Recently there has been growing interest in injury prevention for football and other team sports, including the development of models and frameworks to guide injury prevention efforts, and improve understanding of injury aetiology.<\/p>\n<p>\u2014 With James O\u2019Brien, Caroline Finch, Ricard Pruna, and Alan McCall<\/p>\n<p><b>EVALUATING THE MUSCLE INJURY SITUATION<\/b>(EPIDEMIOLOGY)<\/p>\n<p>Muscle injuries are one of the biggest medical problems in modern football, regardless of the playing level. Specifically, muscle injuries represent almost one third of time-loss injuries and account for more than one-quarter of the overall injury burden as it was shown in the largest available study involving more than 9,000 injuries in men\u2019s professional football players in Europe. Numbers from this investigation also revealed that on average, an individual player will sustain a muscle injury every other season.<\/p>\n<p>\u2014 With Markus Wald\u00e9n, Tim Meyer, Matilda Lundblad, Martin H\u00e4gglund<\/p>\n<p><b>EVALUATING THE MUSCLE INJURY SITUATION IN YOUR OWN TEAM<\/b><\/p>\n<p>\u2014 With Alan McCall, Markus Wald\u00e9n, Martin H\u00e4gglund, and Ricard Pruna<\/p>\n<p><b>RISK FACTORS AND MECHANISMS FOR MUSCLE INJURY IN FOOTBALL<\/b><\/p>\n<p>\u2014 With Markus Wald\u00e9n, Khatija Bahdur, Matilda Lundblad, Martin H\u00e4gglund<\/p>\n<p><b>THE COMPLEX, MULTIFACTORIAL AND DYNAMIC NATURE OF MUSCLE INJURY<\/b><\/p>\n<p>While risk factor identification is important, athletic injuries do not occur because of any single risk factor. Rather, injuries (muscle injuries included) occur as several risk factors interact at the time of an inciting event during training or competition. In other words, athletic injury etiology is complex, dynamic, multifactorial, and context dependent.<\/p>\n<p>\u2014 With Natalia Bittencourt, Mario Bizzini, Johann Windt, and Alan McCall<\/p>\n<p><b>MUSCULOSKELETAL SCREENING IN FOOTBALL<\/b><\/p>\n<p>It is common practice in professional sport to perform some manner of periodic health evaluation (PHE), commonly referred to as \u201cscreening\u201d. In elite football, 90% of the teams do some form of screening throughout the season. Professional teams and football governing bodies aim to protect the health of the player through screening and monitoring to identify potential risk of injury, which, if possible, could positively impact performance, economical aspects at the club, and the health of players.<\/p>\n<p>\u2014 With Nicol van Dyk, Robert McCunn, Phil Coles, Roald Bahr<\/p>\n<p><b>BARRIERS AND FACILITATORS TO DELIVERING INJURY PREVENTION STRATEGIES<\/b><\/p>\n<p>Published information on barriers and facilitators to delivering injury prevention strategies is scarce, but initial research on injury prevention exercise programs has identified a wide range of factors, relating either to the content and nature of the program itself, or how the program is delivered and supported by players, coaches and team staff members.<\/p>\n<p>\u2014 With James O\u2019Brien and Caroline Finch<\/p>\n<p><b>STRATEGIES TO PREVENT MUSCLE INJURY<\/b><\/p>\n<p>When we think of prevention strategies for muscle injuries, we typically think of exercises targeted at strengthening the muscles and related modifiable risk factors that exercise can influence. However, in contemporary professional football, we are moving away from the thought that preventing muscle injury means implementing specific exercises and looking at it as a more holistic strategy that is multifaceted.<\/p>\n<p>\u2014 With Alan McCall and Ricard Pruna<\/p>\n<p><b>CONTROLLING TRAINING LOAD<\/b><\/p>\n<p>Athlete monitoring is now common practice in high-performance football. Fundamentally, athlete monitoring involves quantifying the players training load and their responses to that training. The main reasons for monitoring athletes are that it can provide information to refine the training process, increase athlete performance readiness and reduce risks of injury and illness. Through a systematic approach to data collection and analysis an improved understanding of the complex relationships between training, performance and injury can be obtained.<\/p>\n<p>\u2014 With Aaron J Coutts<\/p>\n<p><b>RECOVERY STRATEGIES<\/b><\/p>\n<p>Our Delphi survey revealed recovery as an effective strategy to prevent muscle injury in elite footballers. Although fatigue has been highlighted by football practitioners as one of the most important non-contact injury risk factors in elite players, \u00a0it is surprising that the actual scientific level of evidence for fatigue and injury is currently weak.<\/p>\n<p>\u2014 With Abd-Elbasset Abaidia, Gregory Dupont, Antonia Lizarraga, and Shona Halson<\/p>\n<p><b>EXERCISE-BASED STRATEGIES TO PREVENT MUSCLE INJURIES<\/b><\/p>\n<p>Exercise is one of the most common preventative strategies implemented by football teams to prevent muscle injury. The following summary and recommendations are a combination of relevant scientific research findings with current best practice.<\/p>\n<p>\u2014 With Maurizio Fanchini, Eduard Pons, Franco Impellizzeri, Gregory Dupont, Martin Buchheit, and Alan McCall<\/p>\n<p><i>*Special contribution from Nick van der Horst, Ida Bo Steendhal and the EBMIP Delphi Group<\/i><\/p>\n<p><b>COMMUNICATION<\/b><\/p>\n<p>Another of the most important injury prevention strategies as highlighted by elite football practitioners from the \u2018Big 5\u2019 Leagues in our Delphi Survey was \u2018communication\u2019. A common opinion among football practitioners is that to maximize the preventative effects of strategies such as controlling load and implementing exercise and recovery strategies, we must be able to communicate effectively with key stakeholders such as players and coaching staff, as well as among ourselves.<\/p>\n<p>\u2014 With Mike Davison and Ricard Pruna<\/p>\n<p><b>CONTINUOUS (RE) EVALUATION AND MODIFICATION OF PREVENTION STRATEGIES<\/b><\/p>\n<p>A key phase of the Team Sport Injury Prevention (TIP) cycle is ongoing (re) evaluation of the injury situation to find out whether prevention strategies are actually having an impact. Are any new or different injury patterns emerging? This information is essential to allow the medical and performance team to adapt to a constantly changing injury landscape and ensure maximum prevention effectiveness over time.<\/p>\n<p>\u2014 Alan McCall, Ben Clarsen, James O\u2019Brien and Robert McCunn<\/p>\n<p>&nbsp;<\/p>\n<p><b>2- RETURN TO PLAY FROM MUSCLE INJURY:\u00a0<\/b>AN INTRODUCTION<\/p>\n<p>The previous section on preventing muscle injury in football has outlined various strategies and tools that can be adopted to minimize the risk of players incurring a muscle injury. While in an ideal world we would be able to prevent all muscle injuries from occurring this is, unfortunately, impossible. As outlined in our \u2018Injury Landscape\u2019 article a professional football can expect around 16 muscle injuries in a season.<\/p>\n<p>\u2014 With Ricard Pruna, Alan McCall and Thor Einar Andersen<\/p>\n<p><b>RETURN TO PLAY IN FOOTBALL:\u00a0<\/b>A DYNAMIC MODEL<\/p>\n<p>There is a paradigm shift occurring in the way we think about return to play.<\/p>\n<p>Instead of return to play being the highly anticipated event occurring at the end of a rehabilitation program, we now consider that return to play starts the moment the injury occurs and continues beyond the point where the player making his or her return to unrestricted match play. This type of progression is individual and malleable, allowing for faster and slower individual progressions throughout the return to play plan.<\/p>\n<p>\u2014 With Clare Ardern and Ricard Pruna<\/p>\n<p><b>RETURN TO PLAY IN FOOTBALL:\u00a0<\/b>A DYNAMIC MODEL<\/p>\n<p>When a footballer sustains a muscle injury, their first question is invariably: \u201chow long will this take to recover?\u201d Answering this is not easy, but in elite-level football, it is vital to make an educated guess. As previously discussed, the RTP continuum begins with the anticipated date of return to optimal performance in mind and works backward, defining the milestones necessary to achieve that goal. This approach motivates the player, allows the manager to plan effectively, and facilitates good communication and realistic expectations from all involved.<\/p>\n<p>\u2014 With Ricard Pruna and Ben Clarsen<\/p>\n<p><b>MAKING AN ACCURATE DIAGNOSIS<\/b><\/p>\n<p>When an injury occurs during training or match play, the essential questions to answer as clinician on-field are: where is the localization of the muscle injury, what type is the injury and, can the player continue to play? In most cases, the player should be taken off the field for further assessments and acute injury management according to the PRICE principle (protection, rest, ice, compression, elevation).<\/p>\n<p>\u2014 With Thor Einar Andersen, Arnlaug Wangensteen, Justin Lee, Noel Pollock, Xavier Valle<\/p>\n<p><b>EXERCISE PRESCRIPTION FOR MUSCLE INJURY<\/b><\/p>\n<p>When a player sustains a muscle injury, the chances of it recurring are high. In fact, epidemiological research consistently identifies previous injury as the most powerful risk factor for muscle injuries.<\/p>\n<p>Fortunately, the risk of recurrence can be reduced through careful management of the return to play process, including appropriate prescription of therapeutic and football-specific exercises.<\/p>\n<p>\u2014 With Phil Glasgow, Thor Einar Andersen and Ben Clarsen<\/p>\n<p><b>RESTORING PLAYERS\u2019 SPECIFIC FITNESS AND PERFORMANCE CAPACITY IN RELATION TO MATCH PHYSICAL AND TECHNICAL DEMANDS.<\/b><\/p>\n<p>Restoring the players\u2019 specific fitness and performance capacity before joining the team for collective training sessions and competitions is essential<\/p>\n<p>\u2014 With Martin Buchheit and Nicolas Mayer<\/p>\n<p><b>REGENERATIVE AND BIOLOGICAL TREATMENTS FOR MUSCLE INJURY<\/b><\/p>\n<p>Despite the substantial regenerative potential that skeletal muscle possesses in the form of its own stem cells, injured skeletal muscle still heals, like most of our tissues, by a repair process, not by complete regeneration. Thus, the healing will result in the formation of non-functional scar tissue. The outcome of this repair process is that the ruptured skeletal muscle fibers remain terminally separated by the scar tissue that has formed at the site of the injury, i.e. inside the injured skeletal muscle.<\/p>\n<p>\u2014 With Tero AH J\u00e4rvinen, Haiko Pas and Jordi Puigdellivol<\/p>\n<p><b>SURGERY FOR MUSCLE INJURIES<\/b><\/p>\n<p>When dealing with muscle injuries, the main principles of non-operative treatment should be used as a common guideline. There are, however, more severe muscle injuries in which surgical treatment should be considered. Especially in athletes, but also in other physically active people, if misdiagnosed and\/ or improperly treated, a complete or even a partial muscle rupture can cause considerable morbidity and lead to decreased performance.<\/p>\n<p>\u2014 Lasse Lempainen and Janne Sarimo<\/p>\n<p>&nbsp;<\/p>\n<p><b>3- RETURN TO PLAY FOLLOWING HAMSTRING MUSCLE INJURY<\/b><\/p>\n<p>In this section, we build upon the general principles described earlier in the guide, with specific reference to hamstring muscle injuries.<\/p>\n<p>\u2014 With Thor Einar Andersen, Arnlaug Wangensteen, Nicol van Dyk and Ricard Pruna<\/p>\n<p><b>SURGICAL TREATMENT OF HAMSTRING INJURIES<\/b><\/p>\n<p>Most hamstring injuries do not require surgery. However, in some cases, surgery should be performed immediately after the injury occurs. Surgery may also be necessary if conservative treatment fails to achieve a satisfactory result \u2013 for example, if the player has chronic symptoms or recurrent injuries.<\/p>\n<p>\u2014 With Lasse Lempainen, Sakari Orava and Janne Sarimo<\/p>\n<p><b>RETURN TO PLAY FOLLOWING QUADRICEPS MUSCLE INJURY<\/b><\/p>\n<p>In this section, we build upon the general principles described earlier in the guide, with specific reference to quadriceps muscle injuries.<\/p>\n<p>\u2014 With Phil Glasgow, Mario Bizzini and Andreas Serner<\/p>\n<p><b>SURGERY FOR RECTUS FEMORIS MUSCLE INJURIES<\/b><\/p>\n<p>Rectus femoris muscle injuries are common in sports. Most of these injuries are strains or direct contusions which are treated by conservative means with good results. There are, however, also more severe rectus femoris injuries which can result in impaired athletic performance and long rehabilitation times. In these severe rectus femoris injuries, the decision of optimal treatment method is not always so evident.<\/p>\n<p>\u2014 With Lasse Lempainen, Sakari Orava and Janne Sarimo<\/p>\n<p><b>RETURN TO PLAY FOLLOWING GROIN MUSCLE INJURY<\/b><\/p>\n<p>In this section, we build upon the general principles described earlier in the guide, with reference to acute groin muscle injuries, specifically, injuries to the adductor, hip flexor, and abdominal muscle groups.<\/p>\n<p>\u2014 With Andrea Mosler, Andreas Serner, Joar Har\u00f8y, Jonas Werner and Adam Weir<\/p>\n<p><b>RETURN TO PLAY FOLLOWING CALF MUSCLE INJURY<\/b><\/p>\n<p>In this section, we build upon the general principles described earlier in the guide, with specific reference to calf muscle injuries.<\/p>\n<p>\u2014 With Tania Pizzari, Brady Green, Karin Silbernagel, and Anthony Schache<\/p>\n<p><b>SURGERY FOR CALF MUSCLE INJURIES<\/b><\/p>\n<p>The vast majority of calf muscle injuries can be successfully managed conservatively. In some cases, however, surgical intervention is warranted. Given the high pressure on players and medical and performance staff to return to the pre-injury level as fast as possible, it is paramount to recognize these cases as early as possible. Failure to do so could potentially result in suboptimal outcome, persistence or worsening of dysfunction and complaints, or recurrent injury.<\/p>\n<p>In this section, we review the specific injuries for which surgical intervention should be considered, surgical technique, and prognosis.<\/p>\n<p>\u2014 \u00d6zg\u00fcr Kilic, Anne van der Made and Gino Kerkhoffs<\/p>\n<p>&nbsp;<\/p>\n<div id=\"tw-target-text-container\" class=\"gsrt tw-ta-container tw-nfl\">\n<h3 class=\"tw-data-text tw-ta tw-text-large\" dir=\"ltr\" data-placeholder=\"Traducci\u00f3n\"><a href=\"https:\/\/barcainnovationhub.com\/ca\/update-center\/\" target=\"_blank\" rel=\"noopener\"><span lang=\"ca\" tabindex=\"0\">Apr\u00e8n m\u00e9s: <\/span>Professional Update Center<\/a><\/h3>\n<pre class=\"tw-data-text tw-ta tw-text-large\" lang=\"ca\"><\/pre>\n<\/div>\n"}],"activar_banner_2":false,"banner_2":false,"activar_banner_3":false,"banner_3":false,"id_magento":"","colaboradores":false,"cta_titulo_top":"","cta_boton_top":"","cta_url_top":"","cta_titulo_footer":"","cta_subtitulo_footer":"","cta_boton_footer":"","cta_url_footer":"","banner_1":[{"activar_imagen_unica_para_banner":true,"imagen_unica_para_banner":"https:\/\/static.capabiliaserver.com\/frontend\/clients\/barca\/wp_prod\/wp-content\/uploads\/2021\/03\/4f764ad5-fondo-03-3.png","activar_titulo_banner":true,"titulo_banner":"APUNTA\u2019T AL FISIOTER\u00c0PIA I READAPTACI\u00d3 EN LESIONS MUSCULARS AL FUTBOL","activar_subtitulo_banner":false,"subtitulo_banner":"","activar_cta_banner":true,"cta_texto_banner":"UNIR-SE ARA","cta_url_banner":"https:\/\/barcainnovationhub.com\/ca\/product\/readaptacio-lesions-musculars-futbol\/?utm_source=ads_banner&utm_medium=content&utm_campaign=notas","color_fondo_banner":"","imagen_fondo_banner":false,"activar_imagen_izquierda_banner":false,"imagen_izquierda_banner":false}],"activar_nuevos_banners":true,"activar_banner_1":false,"mostrar_banner_1":true,"crear_banner_1":{"utilizar_imagen_unica_para_banner":true,"asignar_imagen_unica_para_banner":"https:\/\/barcainnovationhub.com\/wp-content\/uploads\/2021\/11\/e205b909-fondo-02-7.png","mostrar_titulo_banner":true,"titulo_para_banner":"APUNTA\u2019T AL FISIOTER\u00c0PIA I READAPTACI\u00d3 EN LESIONS MUSCULARS AL FUTBOL","mostrar_subtitulo_banner":false,"subtitulo_del_banner":"","mostrar_cta_banner":true,"texto_cta_banner":"UNIR-SE ARA","url_cta_banner":"https:\/\/barcainnovationhub.com\/ca\/product\/readaptacio-lesions-musculars-futbol\/?utm_source=ads_banner&utm_medium=content&utm_campaign=notas","fondo_de_color_banner":"","fondo_de_imagen_banner":false,"mostrar_imagen_izquierda_banner":false,"asignar_imagen_izquierda_banner":false},"mostrar_banner_2":false,"crear_banner_2":{"utilizar_imagen_unica_para_banner":false,"asignar_imagen_unica_para_banner":false,"mostrar_titulo_banner":false,"titulo_para_banner":"","mostrar_subtitulo_banner":false,"subtitulo_del_banner":"","mostrar_cta_banner":false,"texto_cta_banner":"","url_cta_banner":"","fondo_de_color_banner":"","fondo_de_imagen_banner":false,"mostrar_imagen_izquierda_banner":false,"asignar_imagen_izquierda_banner":false},"mostrar_banner_3":false,"crear_banner_3":{"utilizar_imagen_unica_para_banner":false,"asignar_imagen_unica_para_banner":false,"mostrar_titulo_banner":false,"titulo_para_banner":"","mostrar_subtitulo_banner":false,"subtitulo_del_banner":"","mostrar_cta_banner":false,"texto_cta_banner":"","url_cta_banner":"","fondo_de_color_banner":"","fondo_de_imagen_banner":false,"mostrar_imagen_izquierda_banner":false,"asignar_imagen_izquierda_banner":false},"alineacion_vertical_header":"center"},"_links":{"self":[{"href":"https:\/\/barcainnovationhub.com\/ca\/wp-json\/wp\/v2\/posts\/14929"}],"collection":[{"href":"https:\/\/barcainnovationhub.com\/ca\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/barcainnovationhub.com\/ca\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/barcainnovationhub.com\/ca\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/barcainnovationhub.com\/ca\/wp-json\/wp\/v2\/comments?post=14929"}],"version-history":[{"count":5,"href":"https:\/\/barcainnovationhub.com\/ca\/wp-json\/wp\/v2\/posts\/14929\/revisions"}],"predecessor-version":[{"id":110077,"href":"https:\/\/barcainnovationhub.com\/ca\/wp-json\/wp\/v2\/posts\/14929\/revisions\/110077"}],"wp:attachment":[{"href":"https:\/\/barcainnovationhub.com\/ca\/wp-json\/wp\/v2\/media?parent=14929"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/barcainnovationhub.com\/ca\/wp-json\/wp\/v2\/categories?post=14929"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/barcainnovationhub.com\/ca\/wp-json\/wp\/v2\/tags?post=14929"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}