medicine & performance Issue 27 Winter 2018/19
The official magazine of the Football Medicine & Performance Association
Feature
Testing & Training
output across an 8-week training cycle amongst elite level soccer players
In this issue The Effect of Sleep Nutritionists in Academy Football Life After Football Gilmore’s Groin
Legal Education Recruitment Wellbeing
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CONTENTS WELCOME
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Updates
FEATURES
9
Research & Development
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FMPA Conference and Awards
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The effect of sleep on high speed running during a weekly micro-cycle in elite female soccer players Wiseman, A Stebbings, G.K
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Gilmore’s Groin Revisited Simon Marsh Rachel Rolph
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Neurogenic hamstring and calf pain in football When is a tear not a tear? Dr Simon Petrides
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The association between physical testing and training output across an 8-week training cycle amongst elite level soccer players Adam L. Owen Leo Djaoui Bruno Mendes Shane Malone Osman Ates
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FMPA Register
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The temporal pattern of recovery in eccentric hamstring strength postsoccer specific fatigue David Rhodes Lars McNaughton Matt Greig
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Life After Football – Simon Maltby
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ABOUT
The Officiating Team Modern care of football referees Carlo Castagna Mario Rizzini
Nutritionists in Academy football: A recipe for success? Mark Russell
Football Medicine & Performance Association 6A Cromwell Terrace, Gisburn Road, Barrowford, Lancashire, BB9 8PT T: 0333 456 7897 E: info@fmpa.co.uk W: www.fmpa.co.uk Chief Executive Officer Eamonn Salmon eamonn.salmon@fmpa.co.uk
Design Oporto Sports www.oportosports.com
Executive Administrator Lindsay Butler admin@fmpa.co.uk
Photography PA Images, FMPA, Dan Gold, Nathan Rogers, RawPixel
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Contributors Wiseman.A, Stebbings.G.K, Mark Russell, Simon Marsh, Rachel Rolph, Dr Simon Petrides, Adam L. Owen, Leo Djaoui, Bruno Mendes, Shane Malone, Osman Ates, Carlo Castagna, Mario Rizzini, David Rhodes, Lars McNaughton, Matt Greig
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COVER IMAGE Leicester City’s Harry Maguire receives treatment for an injury. Nigel French/EMPICS Sport/ PA Images Football Medicine & Performance Association. All rights reserved. The views and opinions of contributors expressed in Football Medicine & Performance are their own and not necessarily of the FMPA Members, FMPA employees or of the association. No part of this publication may be reproduced or transmitted in any form or by any means, or stored in a retrieval system without prior permission except as permitted under the Copyright Designs Patents Act 1988. Application for permission for use of copyright material shall be made to FMPA. For permissions contact admin@fmpa.co.uk
feature
football medicine & performance
NUTRITIONISTS IN ACADEMY FOOTBALL: A RECIPE FOR SUCCESS? FEATURE / MARK RUSSELL – SCHOOL OF SOCIAL & HEALTH SCIENCES, LEEDS TRINITY UNIVERSITY
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o create a world leading Academy system that serves to provide more and better home grown players, the English Premier League initiated the Elite Player Performance Plan (EPPP) in 2012 [1,2]. This initiative sought to increase the coaching hours of English youth soccer players to better align to the amount delivered by European clubs and other British youth development programmes outside of football. Accordingly, when progressing from under 9 to under 21 age groups in the highest standards of classification, coaching hours rose from 3-12 to 4-16 h·player-1·week-1. Alongside such changes, the EPPP also introduced mandatory requirements for ‘interdisciplinary specialists in the sports science and medicine team’ in various classifications of football Academy, including those associated with sports science, medical services, psychology, match analysis, physiotherapy etc. but not nutrition.
Surprisingly, such data appears to have increased from before the EPPP’s introduction (1999-2001), where 0.40 injuries·player-1·season-1 were reported[3]. Published and empirical evidence highlights that the nutritional practices of youth soccer players may be less than optimal; specifically, with regards to achieving overall energy balance, consuming adequate amounts of micronutrients, adhering to authoritative nutritional guidelines, and optimising the balance of macronutrient intake over the waking day[6,7]. Although some methodological limitations in these studies exist, in order to maintain energy balance (i.e., to be neither in a state of energy deficit or surplus), the energy intake of adolescents should meet both the demands of activity-related energy expenditure and their growth and development needs[6]. However, until specific ages, developing players may be involved in multiple sporting and recreational activities and structured
As injury reduction is quite rightly considered a priority area by the English Football Association[3], published and empirical evidence highlights that staff outside of the immediate medical team such as sports scientists and strength and conditioning coaches often contribute to injury risk screening and prevention strategies[4]. However, the extent to which Academy nutritionists positively influence performance via illness and injury prevention strategies and rehabilitation practices is unclear; a statement which may reflect the limited number of Academy nutritionists in English professional football. Notably, the injury incidence of youth football players increases with chronological age, exposure to training and match time, and during peak height velocity and adolescence. Indeed, a loss in player availability of ~22 days·injury-1 has been observed from six clubs engaged in the EPPP during the 2014/15 season with 1.32 injuries·player-1·season-1 reported[5].
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competitive and training encounters each week that contribute to increases in overall energy cost when compared to the general population. Knowledge of, and therefore matching to, such energy expenditures with appropriate energy intake is necessary to prevent the detrimental effects of chronic energy deficit; for example, impaired bone health has been reported in both male and female youths in energy deficit[8]. Likewise, the intake of specific micronutrients, such as iron, vitamin D and calcium, also influence skeletal health and have specific recommendations associated with their intake for active adolescent populations[6]. Accepting that published findings may not reflect the practices of all clubs and players, and that longer term studies are lacking, chronic exposure to inadequate energy intake, and deficiencies of specific macro- and micro- nutrients, while undertaking high training volumes and competitive loads, may impair short and long-term performance and predispose
feature a susceptible population to injury due to incomplete musculoskeletal development. Furthermore, although a food-first approach is always preferable, clubs may also wish to consider whether anyone has responsibility for performing structured appraisals of each Academy age group’s specific dietary needs and (where applicable) what assessment of the need, risk, and consequences of supplement use (as per UK Anti-doping recommendations[9]) has been made. Questioning whether a strong rationale exists for the use of specific supplements across all age groups or identifying if they are merely provided to Academy players from an overspill of the first team sponsorship products is also an important consideration. From a quality control perspective, are food and supplement stores openly accessible, and are staff able to call upon information relating to who has access to such areas if required? Does the service provided by the on-site kitchen/canteen align to the ethos and recommendations of the club or is it possible that those watching the senior squad games in hospitality suites are being fed better food than the competing and developing players are? Unfortunately, minimal mention of terms such as “nutrition” and/or “diet” exist in the original EPPP guidance documentation[1,2] and nutritionists at all categories of Academy are not a mandatory requirement of any classification of Academy and are typically considered at the discretion of the Academy manager[1,2]. Therefore, to enhance the development of their youth players, Academy managers may wish to employ the services of appropriately qualified (and/or mentored) individuals with demonstrable and qualityassured qualifications and experiences who also adhere to codes of conduct and ethical practice guidelines (e.g., those on authoritative registers such as the Association for Nutrition’s UK Voluntary Register of Nutritionists, and/or the British Dietetic Association’s Sports and Exercise Nutrition register). Likewise, research programmes such as the collaborative PhD studentship scheme delivered by Leeds Trinity University can facilitate links between universities, academics, and professional football clubs which may help to bridge the gap between science and application. Whether it’s a more focused and evidence-based approach to the education structures provided to players and their parents/guardians, an upskilling of host families looking to accommodate young players for the season ahead, or a more pragmatic approach to club kitchens providing players and staff with appropriate nutritional intake over the course of the competitive/training week, a move towards those responsible for the nutritional
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football medicine & performance “assess then address” approach may provide a framework for: 1) auditing current practices, and 2) rationalising specific interventions thereafter. For instance, investigation into the estimated energy intake and expenditure status of Academy football players (i.e., assess) may yield insight into subsequent dietary modification(s) required to support maximised performance preparation and/or improved athlete health across the season and Academy career (i.e., address).
practices of youth football players being mandatory requirements of the EPPP’s stipulated staff teams will likely confer positive effects. Researchers, practitioners, Academy management staff, policy makers, and auditors are therefore encouraged to consider the role for nutritionists within the structure of Academy football, both within the English system and further afield. An
AUTHOR BIO Professor Mark Russell is based at Leeds Trinity University and focuses his research on topics allied to performance nutrition and applied exercise physiology for team sport athletes. As a result of this research, Mark has published over 75 peer-reviewed articles, presented at international conferences and led multiple industry-funded contract research projects from inception to completion. Professor Russell presently supervises a number of Doctoral candidates at Leeds Trinity University which includes leading projects related to profiling the performance and physiological responses of soccer goalkeepers and team sport substitutes, optimising half-time strategies, and facilitating recovery in Rugby League players. Professor Russell also works with a range of professional rugby and football teams and has consulted to a number of English Premier League football clubs and National and International Rugby squads. Professor Russell was also the National Lead for Applied Exercise Physiology with UK Deaf Sport between 2010 and 2017 and was responsible for the co-ordination of the sports science support services for DeaflympicsGB at the 2013 Summer Deaflympics held in Sofia, Bulgaria.
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It must be highlighted that this correspondence does not serve to undermine the EPPP or current injury prevention strategies presently being employed, but it does serve as an opportunity to increase the awareness and possible impact that nutrition and nutritionists may have on the complex and multifaceted problem of maximising performance while promoting long term player health. Not only are the performance consequences of days missed through injury and illness critical to performance outcomes, but as the majority of Academy recruits fail to play professionally, encouraging life-long principles for healthy living, which encompass responsible eating and nutritional education, likely represents “a recipe for success.”
1. Elite Player Performance Plan 2011 [Available from: https://www.goalreports.com/ EPLPlan.pdf] accessed 1st October 2018. 2. Elite Player Performance Plan [Available from: http://docs.wixstatic.com/ugd/01c e7c_97ea72e28e114f5688e27e5bb7eb8 01c.pdf] accessed 1st October 2018. 3. Price RJ, Hawkins RD, Hulse MA, et al. The Football Association medical research programme: an audit of injuries in academy youth football. Br J Sports Med 2004;38(4):466-71. 4. Read PJ, Jimenez P, Oliver JL, et al. Injury prevention in male youth soccer: Current practices and perceptions of practitioners working at elite English academies. J Sports Sci In press:1-9 5. Read PJ, Oliver JL, De Ste Croix MBA, et al. An audit of injuries in six English professional soccer academies. J Sports Sci In press:1-7. 6. Desbrow B, McCormack J, Burke LM, et al. Sports Dietitians Australia position statement: sports nutrition for the adolescent athlete. Int J Sport Nutr Exerc Metab 2014;24(5):570-84. 7. Russell M, Pennock A. Dietary analysis of young professional soccer players for 1 week during the competitive season. J Strength Cond Res 2011;25(7):1816-23. 8. Tenforde AS, Barrack MT, Nattiv A, et al. Parallels with the Female Athlete Triad in male athletes. Sports Med 2016;46(2):171-82. 9. UK Anti-doping Supplements [Available from: https://www.ukad. org.uk/medications-and-substances/ supplements/] accessed 1st October 2018
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REGISTER Following the launch of the FMPA Register, we have received incredible feedback and seen an increase in registrants who are keen to promote themselves within professional football, to the grassroots community and fans. Analytics have shown an increase in traffic to the FMPA site on the Register pages with a 43.8% increase, which proves that more people are accessing the Register, including grassroots and professional clubs. We have been extremely busy highlighting members to their chosen audience and on average a member has been put in front of approximately 45,000 potential clients! This is a fantastic figure and so soon after the launch! We have further initiatives in place to increase our reach even further. Watch this space!
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FMPA REGISTER TO REACH 500,000 FAN BASE The FMPA Register has been in recent talks with various organisations to help create a greater awareness of the support our members offer to fans and grassroots players. One of those we have connected with is the Football Supporters’ Federation (FSF). The Football Supporters’ Federation is an organisation representing football fans in England and Wales. It campaigns across a range of issues and supports fan representation.
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