The official magazine of the Football Medicine & Performance Association
football medicine & performance
Issue 31 Winter 2019/20
Feature
Karen Carney A Pioneer for the Womens’ Game In this issue Injuries in Football: It’s Time to Stop Chasing the Training Load Unicorn Cautious Return to Play Could Prevent Muscle Injuries FMPA Conference 2020 Neurodegenerative Disease Among Former Footballers
Legal Ţ Education Ţ Recruitment Ţ Wellbeing
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CONTENTS FEATURES
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Injury Mitigation in Team Sports. Part-2: The risk management approach Colin W. Fuller
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What to do and When to do it? The Tricky Question of Specialisation in Youth Football Laura Finnegan
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Injuries in Football: It’s Time to Stop Chasing the Training Load Unicorn Franco M. Impellizzeri, Aaron J. Coutts, Maurizio Fanchini, Alan McCall
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Training the Semi-Professional Footballer Daniel Bernardin, Dylan Mernagh
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Karen Carney A Pioneer for the Women’s Game Sean Carmody
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Wrist Injuries in Goalkeepers Raj Bhatia, Adam Esa, Sam Haines
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Neurodegenerative Disease Mortality Among Former Professional Soccer Players – Summary Emma Russell
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Job Insecurity: Reducing Its Negative Effect on Your Wellbeing Caroline Marlowe
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FMPA Register
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ABOUT
Cautious Return to Play Could Prevent Muscle Injuries in Professional Football Håkan Bengtsson, Jan Ekstrand, Markus Waldén, Martin Hägglund
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Generalised Joint Hypermobility – Why should it be screened for within a football setting? Adam Johnson
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FMPA Conference 2020
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Understanding and Developing Relationships in the Modern Football Hierarchy Dr Daniel Parnell, Professor Barry Drust
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 FMPA_Official Officialfmpa fmpa_official LinkedIn: Football Medicine & Performance Association FMPA_Register FMPARegister fmpa_register 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
Project Manager Angela Walton angela.walton@fmpa.co.uk
Contributors Colin W. Fuller, Franco M. Impellizzeri, Aaron J. Coutts, Maurizio Fanchini, Alan McCall, Håkan Bengtsson, Jan Ekstrand, Markus Waldén, Martin Hägglund, Adam Johnson, Dr Daniel Parnell, Professor Barry Drust, Laura Finnegan, Daniel Bernardin, Dylan Mernagh, Raj Bhatia, Adam Esa, Sam Haines, Emma Russell, Caroline Marlowe
Marketing/Advertising Charles Whitney 0845 004 1040
Print Media Village www.media-village.co.uk
Administration Assistant Amie Hodgson amie.hodgson@fmpa.co.uk
COVER IMAGE England’s Karen Carney during the FIFA Women’s World Cup Third Place Play-Off at the Stade de Nice, Nice. Richard Sellers/PA Wire/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
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football medicine & performance
WHAT TO DO AND WHEN TO DO IT? THE TRICKY QUESTION OF SPECIALISATION IN YOUTH FOOTBALL FEATURE / LAURA FINNEGAN What is specialisation? Consensus at the American Orthopaedic Society for Sports Medicine (AOSSM) was that early sports specialization, or early single-sport specialization, be defined by the following 3 criteria: (1) Participation in intensive training and/or competition in organized sports greater than 8 months per year (essentially year round) (2) Participation in one sport to the exclusion of participation in other sports (limited free play overall) (3) Involving prepubertal (seventh grade, US, Year 8-England, S1Scotland or roughly age 12 years) children (LaPrade et al., 2016). Vealey and Chase (2016) suggest that specialisation involves an investment in a single sport through systematic training and competition, typically including yearround participation in that sport, to pursue proficiency and enjoyment in a signature activity. The opposite of specialization is diversification, which is an investment in a broad range of sports and activities. Although we tend to view specialization and diversification dualistically, as categorical opposites, in reality they are on a continuum representing the degree to
which athletes specialize or diversify (see figure 1). Research has shown that a common development pattern for elite athletes was to narrow their number of activities to focus on their main sport in the specializing years but remained involved in a couple of other sporting activities for relaxation and cross-training during the off-season (Baker et al., 2003).
Diversification
A growing trend across youth sport has been a push for exclusive specialisation, in which athletes discontinue all other sports and most other extracurricular activities, to train and compete in one sport.
Specialization
Overspecialization
Narrowing of focus and investment
Figure 1 Specialisation continuum (Vealey & Chase, 2016)
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feature When and why is it an issue? Overspecialization occurs when children, often controlled by parents or coaches, pursue expertise and extrinsic rewards in one sport through year-round systematic training and competition, and sacrifice their psychological development and well-being as well as participation in most all other activities typical of kids their age (Vealey & Chase, 2016). The consensus statement of the American Medical Society for Sports Medicine (DiFiori et al. 2014) on overuse injuries and burnout in youth sports contends that a variety of physical and mental health concerns can be attributed to early sports specialization. It can isolate the young athlete from their peers (i.e. removal from school teams) and can increase the potential for burnout as a result of stress (Wiersma, 2000). Athletes who began training at a younger age and invested more hours per year training at ages 12 and 13 were more likely to drop out of sport (Wall &Côté, 2007). Athletes who specialize before the age of 12 may also have a greater risk of physical injury (LaPrade et al., 2018). Merits of early diversification Advocates of achieving elite performance through sampling more sports and activities through an athletes’ early development stage (early diversification), claim that it may lead to the same senior skill level without these negative consequences (Côté & Hancock, 2015). Footballers can diversify early and still attain elite status as an adult Elite athletes in a variety of sports have achieved elite sport status after engaging in early diversification (or sampling) in their childhood years (typically until around age 12) (Côté, 1999; Baker et al., 2003; Gulbin et al., 2010). A study of German footballers found that the German National Team players differed from amateurs in more nonorganised leisure football in childhood, more engagement in other sports in adolescence, later specialisation, and in more organised football only at age 22+ years (Hornig, Aust & Güllich, 2016). Retain a broader sense of identify Exclusive specialization at a young age can restrict children to a unidimensional selfconcept, which has been linked to burnout and psychological dysfunction (Coakley, 1992). Christensen and Sørensen identified how players struggled to balance the competing demands of school and sport. The perceived necessity to dedicate “100 percent” to football meant that players experienced a premature identity closure, in favour of sport. Research has shown that a strong athletic identity is associated with higher commitment and achievement in sport, but can also be problematic when coping with an injury or managing the transition out of sport (Clarke et al., 2018). Jones, Glintmeyer and McKenzie (2005) have recommended that coaches should help to develop athletes with multiple identities by encouragement to remain engaged with extracurricular activities, thus reducing this reliance on solely a footballing identity (figure 2).
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Finnegan et al., (2020) found that in a long term developmental study of youth footballers, the availability of switching between football codes (Gaelic football v association football) and teams (e.g. club v school) allowed for a greater sense of confidence building by allowing the players to go back into another team with less expectations and pressure. These enhanced perceptions of self-worth and increased motivation were then brought back into their academy environment to advance their development. Recommendations: Try and reverse the ‘race to the bottom’ Minimal ages to compete in competitions and tournaments produce a trickle-down effect on youth sport. Younger competitive structures often fuels the pressure on kids to specialise early (e.g. ‘international elite under
9’ competitions, Müller, et al., 2018) and can lead to a footballing ‘fear of missing out’ on the next superstar. Brian Jones (former Aston Villa academy manager) notes “Aston Villa spend a fortune looking at boys from six onwards – with the best will in the world I wouldn’t know if a six, seven, eight-year-old is going to play in the Premier League in 10 or 12 years’ time. It’s ludicrous.” (Green, 2009). An outdated belief in reaching a mythical 10,000 hours combined with the competitiveness between clubs can often fuel this drive for earlier specialisation. Parental pressure can also enhance the drive for earlier specialisation, as intuitively it seems to make sense that the more hours their child spends purely playing football the better for their development, but as we’ve seen above that isn’t always the case. Education for parents can be key in this regard.
Figure 2 Multidimensional Identity versus Unidimensional Identity (Vealey & Chase, 2016)
School, achivement, particularly art and science
Drawing
Hip-Hop dance
Tennis
Camping with family
Multidimensional identity
Tennis
Unidimensional identity
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football medicine & performance Figure 3 Qualified Education and Training Support (Myer et al. 2015)
Baker, J. (2003). Early Specialization in Youth Sport: a requirement for adult expertise? High Ability Studies, Vol. 14, No. 1, 85-94, DOI: 10.1080/13032000093526.
Mastery of Fundamental Movements
Psychosocial
Clarke, N.J., Cushion, C.J. & Harwood, C. (2018). Players’ understanding of talent identification in early specialisation of youth football. Soccer and Society, DOI: 10.1080/14660970.2018.1432388. Coakley, J. (1992). Burnout among adolescent athletes: A personal failure or social problem? Sociology of sport Journal, 9(3). 271-285. DOI: 10.1123/ssj.9.3.271
Neuromuscular
Program Variation
Progressive Exercises
Visual Motor
Neurocognitive
Conclusion There are athletes who choose to narrowly specialize in one sport because it is their passion, they enjoy it, and they choose to spend their time focusing on that sport. Professional Golfers’ Association (PGA) star Rickie Fowler’s mother recalls her son’s devotion to golf: “When he was 7, he told me, ‘Mom, I don’t want to play baseball or do gymnastics anymore. Just golf. I want to be a pro.’ And he worked on it every day. He sacrificed his social
Côté, J. (1999). The influence of the family in the development of sport, The Sport Psychologist, 13,395 – 416 DiFiori, J.P., Benjamin, H.J., Brenner, J, et al. (2014). Overuse injuries and burnout in youth sports: a position statement from the American Medical Society for Sports Medicine. Br J Sports Med. 48:287–288. Doi: 10.1136/bjsports-2013-093299 Finnegan, L., McArdle, J. Littlewood, M. & Richardson, D. (2020). “The Talent Is Out There” Talent Development In Irish Football: A Study Of Organizational Structure And Practice. PhD (submission 2020). Liverpool John Moores University.
Structured Recovery
Player welfare Children who participate in more hours per week than their age, for more than 16 hours per week in intense training, and who are specialized in sport activities should be closely monitored for indicators of burnout, overuse injury, or potential decrements in performance due to overtraining (Jayanthi, 2011). Youth who specialize in a single sport should plan periods of time to enhance diverse motor skill development and reduce injury risk factors (Myer, 2016) (figure 3). Des Ryan (Head of Sport Medicine and Athletic Development, Arsenal FC Academy) notes that “categorically the research has shown that early specialisation is bad, in terms of participation later on and injuries…but excellence takes time and we need that time with them and that will lean towards specialising early” (2018). Arsenal encourage multi-sport participation from younger age groups, progressively becoming narrower until 16 when the players specialise. They provide encouragement to engage in other sports, have a physical literacy programme, programme of cooperative games and provide sessions of multi-sport activities (periodised over the year, varied and often linked to coach goals i.e. session on finding space may utilise sports that emphasise that skill). With players from the U9 to U11 age groups mainly focusing on functional competence, fundamental movement skills, and multisport content (Ryan et al., 2018).
Côté J. & Hancock D. J. (2015). Evidence-based policies for youth sport programmes. Int. J. Sport Policy Polit. 8 51–65. 10.1080/19406940.2014.919338
life. No parties. No vacations. Didn’t go to football games. I was a little worried back then. He actually allows himself a little bit more fun now. But either way, he loved it” (Diaz, 2014, p. 108). An issue can arise when adults see these examples and assume that early, exclusive specialization is the pathway for all kids to take (the ‘Tiger effect’). We forget that the passion and commitment must be inside of the young athletes, and the choice to specialize and train to the exclusion of most other pursuits is theirs (Vealey & Chase, 2016). Côté and Erickson (2015) emphasise that one can specialise in a single sport-specific domain and sample through different experiences of the same sport domain (e.g., in case of football: playing and practising with your club, playing beach soccer with friends, playing in a park, school, and playing on your own). Ford found that still elite football players had twice as many average hours per year in soccer play activity between 6-12 years of age compared with the ex elite. For every elite performer that specialised early in football there is 100x the number who were not successful doing exactly the same thing. We should be more aware of the existence of a survivorship bias when designing youth development pathways. Various pathways can lead to expertise in football (i.e. early specialisation, early diversification and early engagement) with key recommendations being to derive an appropriate balance between domain-specific deliberate practices (i.e. team practice), participation in domain specific play (e.g. fun football activities that foster motivation, decision-making skills, enhance movement patterns) and external activities to enhance perceptions of identity (Jones et al., 2005; Ford et al., 2009; Finnegan et al. 2020) all while being cognisant of player agency, choice and well-being.
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Ford, P.R., Ward, P. Hodges, N.J. & Williams, M.(2009) The role of deliberate practice and play in career progression in sport: the early engagement hypothesis, High Ability Studies, 20:1, 65-75, DOI: 10.1080/13598130902860721 Green, C. (2009). Every Boy’s Dream. London; A&C Black Publishers. Gulbin, Oldenziel, K.E., Weissensteiner, J.R. & Gagne, F. (2010). A look through the rear view mirror: Developmental experiences and insights of high performance athletes. Talent Development and Excellence, 2(2):149-164. Hornig, M., Aust, F. & Güllich, A. (2016). Practice and play in the development of German top-level professional football players. European Journal of Sport Science, 16, 96-105. Doi: 10.1080/17461391.2014.982204. Jayanthi N, Dechert A, Durazo R, Luke A. (2011). Training and specialization risks in junior elite tennis players. J Med Sci Tennis. 16:14–20. Jones, R. L., Glintmeyer, N., and McKenzie, A. (2005). “Slim Bodies, Eating Disorders and the Coach-athlete Relationship.” International Review for the Sociology of Sport, 40(3): 377-391. doi:10.1177/1012690205060231 LaPrade, R. F., Agel, J., Baker, J., Brenner, J. S., Cordasco, F. A., Côté, J., … Provencher, M. T. (2016). AOSSM Early Sport Specialization Consensus Statement. Orthopaedic journal of sports medicine, 4(4), 2325967116644241. doi:10.1177/2325967116644241 Müller, L., Gehmaier, J., Gonaus, C., Rascher, C. & Müller, E. (2018). Maturity Status Strongly Influences the Relative Age Effect in International Elite Under-9 Soccer. Journal of Sports Science and Medicine, 17, 216-222. Myer, G.D., Jayanthi, N., DiFiori, J.P., et al. (2016). Sports specialization, part II: alternative solutions to early sport specialization in youth athletes. Sports Health. 8:65–73. Ryan, D. (2018). ASCA Podcast #22. Retrieved from: https://soundcloud.com/user-183248915/asca-podcast22-des-ryan Ryan, D., Lewin, C., Forsythe, S. & McCall, A. (2018). Developing World-Class Soccer Players: An Example of the Academy Physical Development Program From an English Premier League Team. National Strength and Conditioning Association, 40(3), 2-11. Vealey, R. & Chase, M. (2016). Best Practice for Youth Sport. Champaign, Il.: Human Kinetics. Wall, M. & Côté, J. (2007). Developmental activities that lead to dropout and investment in sport. Physical Education and Sport Pedagogy. 12, pp. 77–87. doi: DOI: 10.1080/17408980601060358 Wiersma L. (2000) Risks and benefits of youth sport specialization: perspectives and recommendations. Pediatr Exerc Sci. 12:13–22.
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