Posted on April 09, 2018

A recent study from Aspetar, Qatar’s orthopaedic and sports medicine hospital, suggests that caution should be applied in using muscle strength to predict injury risk in football. Such an approach is regularly performed in the pre-season screening of football players around the world.

Injuries and particularly those affecting players’ lower extremities are common in professional football, posing a considerable risk of morbidity and potentially negative long-term health consequences for players. It is to identify and possibly prevent such potential risks as well as diseases or disorders among athletes that sports clinicians widely practice a periodic health evaluation (PHE) or screening examination. Yet despite the widespread use of such approaches, the findings from Aspetar suggest that there is limited evidence such tests can succeed in predicting future injuries. To test their reliability, experts from Aspetar teamed up to assess the relationship between strength testing and lower extremity injuries.

The resulting study was published in the American Journal of Sports Medicine and based on data obtained from 369 professional football players drawn from 14 Qatar Stars League teams and gathered during 514 match appearances in total over a two-year assessment period. Testing focused on the hips and legs, and comprised concentric and eccentric quadriceps and hamstring isokinetic peak torques, eccentric hip adduction and abduction forces, and bilateral isometric adductor force. Lower extremity injuries and exposure during training and matches were recorded by the local club’s medical staff each season.

The researchers did not record any significant correlation between muscle strength and injury risk prediction. Whilst the findings do not completely rule out the use of muscle strength testing in football screening, the authors recommend that it should be part of a wider screening process that takes various elements into consideration. One suggested approach is to monitor a player’s strength throughout the sporting season. This matters because a player’s susceptibility to injury is dynamic and subject to change over the course of time due to a range of external factors (e.g. heavy training load, congested playing schedule, or psychological factors).

The research team at Aspetar consisted of Arnhild Bakken, Stephen Targett, Tone Bere, Cristiano Eirale, Abdulaziz Farooq, Andrea B. Mosler, Johannes L. Tol, Rod Whiteley, Karim M. Khan and Roald Bahr. The research is the latest to be produced by Aspetar within the framework of the Aspetar Sports Injury and Illness Prevention Programme (ASPREV), which was launched in 2012 and is led by Professor Roald Bahr. ASPREV’s research on epidemiology, risk factors and injury mechanisms for football injuries is based on data routinely collected from Aspetar’s numerous clinical departments. Their research – including the Athlete Screening Department’s annual Periodic Health Examination (PHE) – targets key groups of athletes to look for any risk factors for injury or illness.

All Qatar Stars League (now called QNB Stars League) players are required to complete a PHE, which includes an extensive range of additional examinations covering musculoskeletal, cardiac, pulmonary and dental health, amongst others. PHE data has been captured on 559 players since its implementation in 2013, offering ASPREV a very significant insight into a large group of athletes.