Periodic Health Examination and Injury Prediction in Professional Football (Soccer): Theoretically, the Prognosis is Good

Abstract

In professional soccer and other elite sports, medical and performance screening of athletes (also termed periodic health examination or PHE) is common practice. The purposes of this are: (1) to assist in identifying prevalent conditions that may be a threat to safe participation, (2) to assist in setting benchmark targets for rehabilitation or performance purposes and (3) to assist clinicians in determining which athletes may be at risk of future injury and selecting appropriate injury prevention strategies to reduce the perceived risk. However, when using PHE as an injury prevention tool, are clinicians seeking to identify potential causes of injury or to predict future injury? This Current Opinion aims to examine the conceptual differences between aetiology and prediction of injury while relating these areas to the capabilities of PHE in practice. We also introduce the concept of prognosis—a broader approach that is closely related to prediction—and why this may have greater applicability to PHE of professional athletes.

The Value of Preseason Screening for Injury Prediction: The Development and Internal Validation of a Multivariable Prognostic Model to Predict Indirect Muscle Injury Risk in Elite Football (Soccer) Players

“…Specifically, in elite football, PHE is used by 94% of teams and consists of medical, musculoskeletal, functional and performance tests that are typically evaluated during preseason and in-season periods [11]. PHE has a rehabilitation and performance monitoring function [12] and is also used to detect musculoskeletal or medical conditions that may be dangerous or performance limiting [13]. Another perceived role of PHE is to recognise and manage factors that may increase, or predict, an athlete's future injury risk [10], although this function is currently unsubstantiated [13].…”

“…PHE-derived variables associated with particular injury outcomes (such as IMIs) are called prognostic factors [14], which can be used to identify risk differences between players within a team [12]. Single prognostic factors are unlikely to satisfactorily predict an individual's injury risk if used independently [15].…”

Lesions of the Lumbar Region in Asymptomatic Young Soccer Players: A Cross-Sectional Study

“…Chronic lesions formed through overuse occur via repetitive microtrauma to a tissue that exceeds the capacity to be repaired. This can lead to an increase in pressure at this articulation [17,19]. In addition, during the fastest growth period of adolescents (i.e., growth spurts during puberty) can lead to locally imbalanced bone tissue and musculature-this may cause an increased risk of lesions especially on growth plates [14,15].…”

Pre-season screening currently has no value for injury prediction: The development and internal validation of a multivariable prognostic model to predict indirect muscle injury risk in elite football (soccer) players

“…PHE is used by 94% of elite football teams and consists of medical, musculoskeletal, functional and performance tests, performed during preseason and in-season periods [11]. PHE has a rehabilitation and performance monitoring function [12] and is also used to detect musculoskeletal or medical conditions that may be dangerous or performance limiting [13]. Another perceived role of PHE is to recognise and manage factors that may increase, or predict, an athlete's future injury risk [10], although this function is currently unsubstantiated [13].…”

“…Another perceived role of PHE is to recognise and manage factors that may increase, or predict, an athlete's future injury risk [10], although this function is currently unsubstantiated [13]. PHE-derived variables associated with particular injury outcomes (such as IMIs) are called prognostic factors [14], which can be used to identify risk differences between players within a team [12]. Single prognostic factors are unlikely to satisfactorily predict an individual's injury risk if used independently [15].…”