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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feature
football medicine & performance
TRAINING THE SEMI-PROFESSIONAL FOOTBALLER FEATURE / DANIEL BERNARDIN & DYLAN MERNAGH Outside of elite football, players feel that “nobody cares about them” and there is “a lack of professional support”. They “want to play at the highest level they can” and to do this, they “want to train like a pro”.
At the professional level people care about you and look after you, at the semi-professional level, no one seems to care.”
FSCR (Football Strength Conditioning & Rehabilitation) is a dedicated team of practitioners working within professional football. Our story started when a player who was at a professional academy as an 18-year old dropped down into non-league and wanted to find a way to continue to train like a professional. Our research found limited options except for expensive personal trainers with no elite football experience. This is when we realised that the semi-professional footballer was getting limited or poor support to help them be the best they can be, and FSCR was established to fulfil this need. Football is the world’s game with many players aspiring to reach the highest levels, with the Premier League now being a coveted destination. Unfortunately for the vast majority of those participating in football, they are more likely to be hit by a meteorite than make it as a professional footballer. It is estimated
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that less than 0.02% of those players playing within an academy setting will go on to have a full-time career in the game, with the numbers even lower for those outside of the academy set up. As a company our mission is to provide elite Strength, Conditioning and Physiotherapy support to all players’ in a results driven environment that allows every player to train like a pro. Strength & Conditioning (S&C) Our Strength & Conditioning programme aims to cover all the basics of athletic development and injury prevention. We know there are a myriad of physical factors that influence football performance and no single attribute is going to make the difference. However, by providing a well-rounded strength and conditioning programme to these players we hope to help bridge the gap to the physical qualities seen at the professional level. Currently we deliver one strength and conditioning (S&C) session per week and that session is on a Wednesday as most semi-pro clubs will train Monday, Tuesday and Thursday. If they have a mid-week game (Tuesday)
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feature the players have the option of coming in for an active recovery session which will include light aerobic work on the bike, upper body (stimulates growth hormone to aid recovery), soft tissue mobilization (foam rolling/mobility or sports massage) and contrast therapy. Due to the players’ training schedule and the fact most players have a full-time or part-time job alongside football, we only recommend one S&C session per week. Due to the financial constraints of working with this target market we provide group strength and conditioning sessions which reduces the cost for each player. We provide one coach to every six players and each programme or phase lasts six weeks. Players are only progressed onto the next phase when they have completed their current programme. We spend time teaching the players how to read their programmes correctly (exercise order, rest periods and exercise tempo), how to select their loads appropriately, how to progressively increase load weekly or reduce load if they are tired. They are expected to record all their weights and their rating of perceived exertion (RPE) for each session. With a very limited amount of contact time we had to build a programme that covered a lot of bases but was focused on achieving results. We know that there are certain key characteristics and key factors that can distinguish between successful and less successful players and teams. For example, a key characteristic for footballers is speed, which includes acceleration, maximal speed and agility. Research shows speed is a key physical requirement during the more crucial moments of the game including winning possession, scoring or preventing an opposition goal1. Similarly, a key factor in the success of a player or team regardless of level, is injury2. From an individual’s perspective decreasing the risk of injury is of paramount importance especially for the semi-professional as injury can often bring their career to a crossroads which may result in them leaving the game or not being paid, the harsh reality of their situation. For these reasons our strength and conditioning programme incorporates multiple factors that cover key characteristics and factors identified. All our S&C sessions are 60 minutes in length and include the following categories in sequential order; mobility, movement skills, speed and power, strength and muscle robustness. Mobility (10mins): One area that is severely avoided by most footballers regardless of their level is mobility. We know mobility is a key factor in reducing the risk of injury and we have a three-step process that begins with isolated mobility and progresses through to dynamic mobility. 1.
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Soft Tissue Mobilization: Includes both myofascial release (foam rollers, hockey balls) and a dynamic stretching routine led by our coaches. This includes all the key muscle groups of the lower limb and thoracic spine.
2.
Joint Mobilization: Here we focus on mobilizing the hip and knee joints which are often stiff in most footballers. We utilise mobilization with movement techniques that incorporate elastic bands and focus on ankle dorsi-flexion, hip extension, hip flexion and hip internal rotation.
3.
Global Mobilization with a Constraints Led Approach: This aims to create a situation where the player must complete a task that requires mobility to achieve it. Here we use hurdle circuits that challenge the players mobility and coordination that are progressed in difficulty with each training phase.
Movement Skills (10 mins): As mentioned earlier high-speed actions; acceleration, maximal speed and agility are key physical requirements for success in football. Therefore, developing a players’ movement skills is paramount to improving their football performance. Our aim is to build a foundation of
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general movement patterns that are specific to football that with time become stable and automated allowing players to be more effective, efficient and reactive with their movements in game situations. Our movement skills are broken down into three movement classifications as described by Ian Jefferies3 and six key movement patterns. We typically focus on two key movement patterns per phase. Movement Classification 1. 2. 3.
Initiation: Movements that are used to start or change direction Transition: Movements that are used as preparation for subsequent actions Actualization: Movements that decide the success of the action or moving to a given position as quickly as possible
football medicine & performance Key Movement Patterns 1. 2.
3. 4. 5. 6.
Athletic start position (front, side, back, acceleration and change of direction) Running gait: (acceleration and max velocity) Deceleration (stopping) Side shuffling and cross-stepping Cutting (direction change) Backpedalling and drop-stepping
Speed & Power (10mins): Alongside the development of movement skills it is important to improve speed & power. We improve speed and power through the utilisation of plyometrics. Our plyometric process is built upon three categories: the plyometric contraction, the direction of force and the plyometric movement. Players are progressed from basic level plyometrics to more advanced methods over time. We typically programme two plyometric exercises per phase and include one linear and one lateral or rotational exercise. Plyometric Pathway 1) A. B. C. D. E.
Plyometric Contraction: Non-counter movement Unloaded counter movement Counter movement Continuous Drop jump
2) A. B. C.
Direction of Force: Linear Lateral Rotational
3) A. B. C.
Plyometric Movement: Jump Bound Hop
Strength (20 mins): Strength is the foundation to all physical qualities in football and is required to improve agility, speed and power. Our aim is to build a foundation of general strength through compound movements typically split between five key exercises and their variations. This is further broken down into kettle bell, dumbbell, barbell, cable, special bars and alternative resistance variations. This provides several years of strength training progressions for the semi-pro player. We typically programme two strength exercises, one knee dominant (Split Squat and Step Up) and one hip dominant (Deadlift and Romanian Deadlift) exercise per phase.
2) A. B. C. D.
Deadlift Trap Bar Deadlift Sumo Deadlift Traditional Deadlift Snatch Grip Deadlift
3) A. B. C. D.
Step Up Controlled Step Up Controlled Triple Jumpers Step Up Pistol Squat Dynamic Step Up
4) A. B. C. D.
Romanian Deadlift Bilateral RDL Unilateral RDL Landmine RDL Snatch Grip RDL
5) A. B. C.
Pull Ups Supinated Grip Pull Ups Pronated Grip Pull Ups Wide Grip Pull Ups
Muscle Robustness (10 mins): Our muscle robustness programme focuses on the three most frequently injured muscle groups in football, the hamstrings, quadriceps and the adductors4. Our aim is to alter the angle at which peak-torque is produced, improve isolated endurance capacity, and reduce the risk of delayed onset of muscle soreness (DOMS) via isometrics held at long muscle lengths for 15-30 seconds5. Avoiding the risk of DOMS is important when you don’t have any input into the semi-pro players’ training and game schedule. We utilise many different variations of Hamstring Bridges, Reverse Nordics and Adductor Bridges and will programme one exercise for each muscle group in a tri-set with no rest between exercises. We have been providing S&C sessions for semi-pro players for 18 months now and have seen the positive impact it has had on the players. We have expanded our services to include physiotherapy
By building a team of practitioners that believe in the FSCR mission we have been able to provide footballers of all levels, in this instance semi-professional, with invaluable knowledge and experience from a range of different professional clubs. Having first-hand knowledge into the day to day requirements of the players at the highest levels allows our team to provide meaningful support to those semi-professional players trying to play at the highest level they can. For more information, check out FSCR’s social media account on Instagram @footballscr_ or get in touch via email info@footballscr.com
1. Little, T., & Williams, A.G. (2005). Specificity of acceleration, maximum speed, and agility in professional soccer players. Journal of Strength and Conditioning Science, 19 (1), 76-78. 2. Hägglund, M., Waldén, M., Magnusson, H., Kristenson, K., Bengtsson, H., Ekstrand, J. (2013). Injuries affect team performance negatively in professional football: an 11-year follow-up of the UEFA Champions League injury study. British Journal of Sports Medicine, 47 (12), 738-742. 3. Jefferies, I. (2008). Movement training for football. UKSCA Journal, 14-23. 4. Ekstrand, J., Hägglund, M., Waldén, M. (2011). Injury incidence and injury patterns in professional football: the UEFA injury study. British Journal of Sports Medicine, 45 (7), 553-558.
Key Exercises 1) A. B. C. D.
and rehabilitation for the semi-pro player. Where we believe we can make the biggest difference is in accurate diagnosis and reducing injury recurrence. Our rehabilitation strategies also include pitch re-integration and clear return to play criteria.
5. Philippou, A., Bogdanis,G., Nevil, A., Maridaki, M. (2004). Changes in the angle-force curve of human elbow flexors following eccentric and isometric exercise. European Journal of Applied Physiology, 93, 237-244.
Split Squat Front Foot Elevated Split Squat Neutral Split Squat Rear Foot Elevated Split Squat Bulgarian Split Squat
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feature
football medicine & performance
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