Autumn 2023 - Issue 44 by Football Medicine & Performance Association

The official magazine of the Football Medicine & Performance Association

football medicine & performance

Issue 44 Autumn 2023

In this issue Wellbeing & Challenges of a Playing & Coaching Career Tactical Periodisation in Football: Load Monitoring in Football Breaking the Silence: Ending the Stigma of Mental Health in Football Relational Performance: A Model & Tool for the Team Behind the Team From Scotty Dogs to Bird Dogs & More: Rehabbing Pars Injuries Back to the Pitch

Legal • Education • Recruitment • Wellbeing

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ONLINE COURSE

MPA DIPLOMA PREPARATION FOR WORK IN PROFESSIONAL FOOTBALL ✓ Health and safety ✓ Safeguarding ✓ Equality/Diversity ✓ Mental Health/wellbeing ✓ Confidentiality ✓ Record keeping ✓ Media TV ✓ Social Media ✓ Expectations of behaviour/general professionalism ✓ Integration within the MDT environment ✓ Insight into the working week ✓ Awareness of un-clinical skills ✓ From `Theory to Practice’ ✓ How the science sits in the working environment ✓ What an employer is looking for – Employability, CPD, Reflective Practice, CV ✓ Portfolio design

Includes FREE FMPA membership access for 6 months: • FMPA resources • FMPA publication • Free access to BJSM

• Sports Scientists • Physiotherapists • Doctors • Analysts • Sports Therapists • S & C Coaches • Fitness Coaches • Soft Tissue Therapists • Sports Rehabilitators • Sports Psychologists • Nutritionists • Podiatrists

• FMPA podcasts • FMPA education • Latest Jobs

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CEO MESSAGE As the academic year gets under way the FMPA has entered the educational arena with the launch of the ‘MPA Diploma; Preparing for work in professional football.’ This is an exciting development for the association and is the conclusion of several months of work in pulling the course material together with the online education platform that has been built specifically to host and deliver educational content. This unique course is designed for new graduates and those entering into a professional sporting arena for the first time. The course is designed to prepare prospective employees in those areas that are specific to a Club environment. Multiple modules cover vital elements such as health and safety, inclusion, diversity and safeguarding, amongst others, but also unique topics such as media management and integrating within the MDT which are much more specific to the professional sports department. The course also encourages personal growth through reflective practice and CV portfolio design. The MPA Diploma is open to Sports Scientists, Physiotherapists, Doctors, Analysts, Sports Therapists, Strength and Conditioning Coaches, Fitness Coaches, Soft Tissue Therapists, and Sports Rehabilitators, as well as service providers to clubs such as Sports Psychologists, Nutritionists and Podiatrists. “Within the evolutionary world of elite sport, it is key for support staff to understand the everchanging environment in which they operate. Irrespective of qualifications and experience, staff need to enter the landscape and be skilled in aspects of emotional intelligence and self-awareness. The MPA diploma will be invaluable for practitioners in preparing for the pressures and expectations they will face when working in high performance.” Ross Burbeary, Head of Football Development & Performance, Derby County FC “I applaud FMPA and the Course Development team for producing an educational programme that is appropriate, realistic and necessary for any therapist or performance practitioner hoping to work in professional sport, and especially football. It is a Course that covers so much of the vital environmental and “industry” information required, but never fully addressed in their preregistration programmes. It is, therefore, a Course that I would unequivocally recommend to any graduate considering a career in professional sport as it will prepare them for facing and understanding the realities of the hard and unforgiving world that they are about to enter.” Professor Graham Smith, Rehabilitation and Sports Injury Consultant It is worth noting that many of the job listings request candidates to have ‘kept up to date’ in many of the areas covered by the MPA Diploma, making this the perfect resource for new graduates and those seeking a professional career in football. A certificated MPA Diploma illustrates that Clubs have engaged with and prepared their staff for the environment they are entering in to and clearly this is for the betterment of employers and employees alike. Find out more: www.fmpa.co.uk/courses/mpa-diploma/

Eamonn S almon

Chief Executive Officer Football Medicine & Performance Association

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FROM THE EDITORS In this upcoming edition of the FMP Magazine, we delve into the intricate world of football from a myriad of perspectives. Our featured articles provide insight into various aspects of the sport, ranging from tactical methodologies to the well-being of players and those who support them. Often the topic of staff wellbeing is not visited, and we felt it was important to highlight this and offer insight on the challenges staff face through their roles within football as well as in their life after football, particularly those that find themselves redundant for non-performance related reasons. In “Tactical Periodisation in Football (Part II): Load Monitoring in Football,” Rainer Van Gaal Appelhof takes us deeper into the fascinating realm of tactical periodisation, shedding light on how load monitoring plays a pivotal role in modern football coaching. Continuing the theme of load management and monitoring, Ed Clarke discusses the crucial rehabilitation process for players recovering from Pars injuries and the innovations in this field. David Clancy presents “Relational Performance: A Model & Tool for the Team Behind the Team,” emphasising the significance of teamwork off the pitch and its impact on the overall success of a football club. As well as caring for the backroom staff, Professor David Lavallee shares valuable insights in “Wellbeing Support for Goalkeepers in Football Academies Is Improving,” highlighting the evolving care and attention given to these critical players in football academies. Furthermore and on the same topic Dr.Gary Souter discusses and advocates for open conversations about mental health and well-being in the world of football in his article titled “Breaking the Silence: Ending the Stigma of Mental Health in Football”. Finally, Dr Andrew Shafik delves into the wellbeing challenges of a coaching and playing career with Steven Reid in an interview that offers an inside look into the experience of those who have navigated both sides of the game. We hope you find these articles both informative and thought-provoking, as they encapsulate the diverse and evolving landscape of football. From tactical intricacies to player and staff well-being, our aim is to provide a comprehensive view of this beautiful game that continues to captivate hearts around the world. Enjoy the read, and may the beautiful game continue to inspire and unite us all.

Sean Carmody Dr Sean Carmody Editor, FMPA Magazine

Fadi Hassan Dr Fadi Hassan Editor, FMPA Magazine

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Andrew Shafik Dr. Andrew Shafik Editor, FMPA Magazine

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football medicine & performance

ASSOCIATE EDITORS

Ian Horsley Lead Physiotherapist

Dr Jon Power Director of Sport & Exercise Medicine

REVIEWERS

Matthew Brown Academy Sports Scientist

Mike Brown Head of Physical Performance

Dr Andrew Butterworth Senior Lecturer

Dr Avinash Chandran Director

Lisa Edwards Sports Therapist

Jake Heath Elite Sports Specialist Podiatrist

Frankie Hunter Lead Sports Scientist

Callum Innes Medical Doctor

Dr Danyaal Khan Academy Doctor

Dr Daniela Mifsud GP Trainee

Dr Jose Padilla MD Sports Medicine Specialist

Kevin Paxton Strength & Conditioning Coach

Dr Dáire Rooney Doctor

ABOUT

Dr Manroy Sahni Medical Doctor

Eleanor Trezise Medical Student

Football Medicine & Performance Association 43a Moor Lane, Clitheroe, Lancs, BB7 1BE 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 Commercial Manager Angela Walton angela.walton@fmpa.co.uk

Photography Alamy, FMPA, Unsplash Cover Image Liverppol’s Head of Fitness & Conditioning, Andreas Kornmayer, cheers on the team while warming up Photo: Alamy

Design Oporto Sports www.oportosports.com

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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

CONTENTS FEATURES

Wellbeing and Challenges of a Playing and Coaching Career Interview with Steven Reid

Tactical Periodisation in Football (Part II): Load Monitoring in Football Rainer van Gaal Appelhof

Exploring the Role of Differential Learning in the Development & Coaching of Footballers Dr. David Turner

Relational Performance: A Model and Tool for the Team Behind the Team David Clancy

Wellbeing Support for Goalkeepers in Football Academies is Improving Calum Brodie, Jonny Glen, and Professor David Lavallee

From Scotty Dogs to Bird Dogs and More: Rehabbing Pars Injuries Back to the Pitch Ed Clarke

The Influence of Physical Performance on Technical and Tactical Outcomes in the UEFA Champions League Dr. James J. Malone

Breaking the Silence: Ending the Stigma of Mental Health in Football Dr. Gary Souter

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news

INTRODUCING FMPA BUSINESS PARTNERS FOR THE 2023/24 SEASON FMPA Lead Sponsor ProMOTION The FMPA is delighted to announce that ProMOTION has renewed its sponsorship as Lead Sponsor for a fourth season! In our three seasons of working together, this exciting partnership has helped ProMOTION to amplify their brand and inform our members of the many benefits that ProMOTION EV1 offers. We’re looking forward to continue supporting ProMOTION in the 2023-2024 season and hope our members take this opportunity to try out the EV1 and take advantage of the exclusive FMPA member deals that ProMOTION has kindly provided. Quote FMPA20 at the Checkout on purchases or FMPA40 on rentals. Don’t forget ProMOTION EV1 is also approved to be considered as a suitable discretionary claim item (alongside with other treatment modalities) via The FA Premier League Medical Care Scheme.

2023-24 football season and continue to support FMPA members to add the versatile ProMOTION EV1 to their toolkits.

Jonathan Smith, Managing Director at ProMOTION, commented:

“We’re looking forward to working with members to gain further data and research into new and innovative applications for targeted contrast and heat therapies, in addition to the better-known cryotherapy applications.

“We’re delighted to confirm our ongoing partnership with FMPA as we head into the

“After meeting with so many members at the conference this summer we’re

really excited to support even more clubs and professionals to share best practices around applications, therapy protocols and outcomes in the year ahead.” https://promotion.fitness/exclusive-fmpamembers-offers/ For more information about ways to get your ProMOTION EV1 or to get a free no obligation demonstration, contact our customer services team on customerservices@swellaway.com or call us on 01925 751027.

The FMPA is excited to announce that SwimEx are continuing their partnership for a 6th season! “SwimEx are very proud to once again support the FMPA who serve and deliver so much support for the Medical and Performance professionals across all levels from grass roots to the elite level. We feel privileged to be able to call Eamonn, Lindsey, Angela and the whole team at FMPA dear friends – Good luck to everyone in the 2023/4 season and most of all enjoy the journey” Richard Bishop. M.I.S.P.E. Aqua Thermae is an aquatic sports and hydrotherapy specialist company who represent SwimEx pools in the UK, Ireland and across Europe. We have also supported SwimEx pools by project managing several installations across the Middle East. Our clients include the British Ministry of Defence, British embassy abroad, Stoke City FC, Wolverhampton Wanderers FC, Reading Football Club. We recently installed two SwimEx pools at Queens Park Rangers FC including a recovery deep water cold plunge pool with an energy efficient heat pump chilling system. We are also working with the UK Sports Institute updating their water treatment and filtration system on their recovery pool at Bisham Abbey to support Team GB in the build up to the 2024 Paris Olympics. We also installed the SwimEx 600T with automated underwater treadmill at the Strive Elite sports academy in Jersey who have hosted the British And Irish Lions, England rugby, Leicester Tigers, Bath rugby and Sale rugby clubs on training camps.

The success of premium hydrotherapy is founded on premium quality equipment and design specifications that seek to exceed industry guidance wherever possible. Richard Bishop, Technical Director, has been in the industry for 36 years and composed the award winning technical paper for the Institute of Swimming Pool Engineers and recently gave a talk on sports hydrotherapy to the Institute. You can contact Richard Bishop MISPE direct if you would like to discuss a health check on your existing facilities or considering a future hydrotherapy project. Email richard@aquathermae.co.uk or telephone 07484 070765 Or visit www.aquathermae.co.uk

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football medicine & performance

Compex UK is delighted to announce the renewal of our business partnership with the FMPA for the 23/24 season.

ScribePro is delighted to announce our affiliation with FMPA for the 2023-2024 season.

For over 30 years, Compex has been providing high quality muscle stimulators to the international sporting community. Our state-ofthe-art Muscle Stimulators are backed up by clinical trials proving their effectiveness. Compex’s flagship muscle stimulation technology is widely used to assist with physical preparation, muscular recovery, injury prevention and pain treatment in the sporting field.

Delivering the very best digital medical records system, ScribePro is the go-to tool for all club clinicians who provide care to players across all leagues and divisions.

Our range has now expanded to include additional recovery products including our Fixx range of Massagers and Ayre Wireless Compression Boots. To view our full product range please visit www.compex.com/uk Free Compex Muscle Stimulation Training: We are pleased to be able to offer free online Compex muscle stimulation training to all FMPA members.

CEO and Medical Director of ScribePro Dr Jonny Gordon said; “We are really looking forward to next season! We are excited about the number of national associations and top flight clubs using ScribePro already, and working together with FMPA will allow us to broaden our reach and raise awareness of our fantastic system with clinicians at clubs across the UK. Getting in front of clinicians can be challenging but we know the reach and impact that FMPA has and we cannot wait to start working together with them”. FMPA MEMBER BENEFIT 10% discount on the first year of contract, using code FMPA10.

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The FMPA is delighted to welcome Sporting Edge as a new FMPA Business Partner for the 2023/24 season!

GNG Group design and manufacture a wide range of foam based contract, domestic and medical grade healthcare mattresses and have renewed their contract as FMPA Business Supplier for the 23/24 season.

Sporting Edge is a UK based manufacturing company with an expanding global reputation as the leader in the design and provision of Altitude & Environmental Facilities. Sporting Edge systems deliver measurable fitness and performance improvements in as little as three weeks, with the added benefit of allowing fitness levels to be retained during injury repair – speeding up return to play. Since 2005, Sporting Edge has consistently set the benchmark for performance, safety, reliability and control for Simulated Altitude, Temperature & Relative Humidity, supported by a number of patents and innovations. Endorsed by the UK Sports Institute (EIS) and with a client list including many UK Universities, Olympic facilities, Professional Sports Teams and Commercial Physical Performance Centres. Visit www.sportingedgeuk.com and take a look at the research library section to see how you could benefit from a class leading, Altitude and/ or Environmental chamber. Contact info@sportingedgeuk.com or +44 (0)7879 494279. FMPA MEMBER DISCOUNT - RECEIVE 5% OFF BY QUOTING FMPA

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feature

WELLBEING & CHALLENGES OF A PLAYING & COACHING CAREER FEATURE / STEVEN REID INTERVIEW BY DR ANDREW SHAFIK This is a transcript of the FMPA Podcast episode of the same name that was released in February 2023. It has been edited for clarity and to improve readability by Dr Elle Trezise, a member of the FMPA Education Team. If you’d prefer to listen, episodes can be found on the FMPA website, Apple Podcasts, SoundCloud and Spotify.

Steven Reid

Dr Andrew Shafik

In this podcast episode host Dr Andrew Shafik, a medical doctor working in professional football and a Senior Editor in the FMPA Education Team, speaks to Steven Reid, a former professional football player who has played for Millwall, Blackburn Rovers, Burnley and West Bromwich Albion. He then moved into coaching, starting at Reading FC. He has also coached at Crystal Palace, Nottingham Forest and for the Scotland National Team. Steven is now pursuing a career in counselling and also wellbeing, confidence and leadership coaching.

Andrew Welcome to this Football Medicine and Performance Podcast. Today I am delighted to be joined by Steven Reid. Steven began his playing career at Millwall before a move to the Premier League with Blackburn Rovers. He then went on to play five more seasons in the Premier League with West Bromwich Albion and Burnley. Steven’s coaching career began at Reading with Steve Clarke, helping them to a playoff final before moving on to Crystal Palace alongside Roy Hodgson. He then helped the Scotland National Team

to their first tournament in twenty-two years at the 2021 Euros. Steven left his role to concentrate on club duties at Nottingham Forest, helping them return to the Premier League after twentythree years. After promotion, Steven decided to pursue a different career in wellbeing, confidence and leadership coaching alongside counselling studies. Today we’re going to discuss Steven’s journey, experiences and find out a little bit more about his journey as a player, coach and his life after coaching. Welcome, Steven.

Steven Evening. Good to see you, Andrew. Andrew Thanks for joining us, Steven. That intro - really some career as a player and as a coach and obviously life after, but it would be interesting to start off by learning a bit about your journey as a player and some of the key challenges that you faced. Steven I started my playing career coming through the ranks at Millwall. During that time, it was kind of a centre of excellence and then you progressed into the Youth Training Scheme (YTS). Before the scholarships you did your two-year YTS. I signed my first professional contract on my 17th birthday and, pretty quickly, there was a little group of us who broke into the first team quite early. Had a lot of success at Millwall, obviously: we got a promotion and things progressed well. Then it was that big move to the Premier League in 2003. Spent the remainder of my career in Premier League football but as I’m sure we’ll get to, on the face of it this is success and the perception a lot of the time is seeing all the trappings of what that looks like, but it was a real challenge for many different reasons. Andrew Do you mind just touching on a few of those challenges? Some of the key ones that yourself and, I suppose, players generally experience alongside their playing career?

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football medicine & performance

Steven It started pretty early for me. I mean, even growing up I was a little bit of a worrier. I was slightly anxious probably as a kid growing up and then being involved in the football environment, especially leaving school and then going straight into the YTS scheme at Millwall, I felt different challenges in that: the dressing room banter and playing with a lot of senior pros. I just felt a pressure. I felt a sort of anxiety. That’s a period where I was struggling to adjust to those pressures and dealing with playing in front of bigger crowds and the expectations and all that goes along with becoming a professional footballer. It became a little bit more of an issue when I signed my first professional contract and started playing first team football. It stopped being purely a game that I loved and purely a game that was fun and enjoyable with your mates. It became really serious quite soon in my career. Andrew Are some of the challenges different for different age groups coming through the YTS? Did you find the challenges quite different [when you were younger compared to] when you were a senior pro?

Steven To be honest, when I was playing as a schoolboy at Millwall it was just excitement. It was excitement and anticipation of getting that YTS. I was always one of the, I guess, better players at that time. So, in a confident kind of way back then I expected to get a YTS but even at that time, I do remember the pressures were building around the YTS, around who was going to get one and who was going to get released. Because one of the first major steps in any professional’s career is getting that scholarship, is getting that YTS contract. Because then it’s effectively leaving the structured school life. I know there are other studies if you go into that scholarship programme and YTS. I did a leisure and tourism course when I was at Millwall doing my YTS but it was always around those times when a decision was being made that I really do remember those moments where guys are starting to feel the pressure, starting to get anxious. You’d see parents having these discussions on the sideline and obviously we’ve seen in a few of the programmes quite recently around academy football, seems to me that it’s almost gone up to another level. I think that’s partly

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down to the nature of the world we live in. Think social media - now we’ve got access to everyone’s lives. You can see the trappings. You can see what success brings to a lot of footballers’ lives and celebrities’ lives. I think it’s now become a different landscape because back then I had no idea whatsoever what was going on in certainly other footballers’ lives. It was just living in your own little football bubble. Andrew Tell us a bit about your journey into coaching and some of the challenges you faced during that time. Steven Just to finish off on the playing side, it’s probably right for me to mention after my move from Millwall to Blackburn that brought another layer of - I’ve spoken about it recently - impostor syndrome: “am I good enough to be a Premier League player? Am I going to fit into this dressing room? Can I do it at that level? Am I going to get found out?” So, it took me a good season to a season and a half to believe that I actually belonged at that level. So that’s when the stresses and

feature the pressures and the real mental health issues kicked into another gear for me. It’s also around the same sort of time that the injuries started to rear their ugly head, ranging from ruptured cruciate ligament which led to a chondral defect, had a micro-fracture and an ankle reconstruction bit later on at West Brom. So, alongside the mental health struggles, the physical injuries were also causing me a big problem and I guess that was, in a way why I even thought about going down the coaching route. I wasn’t sure at the time, but I thought, “well, I’m injured. I need to do something.” Because there’s no guarantee that I was going to get back to that level. So, I made good connections when I was playing. I got on well with Steve Clarke and Roy Hodgson when I was at West Brom who were managers. When I was coming to the end of my playing career at Burnley, that’s when I had a discussion with Steve Clarke and I made that decision in probably the December of my last season. That that was going to be it and I was going to pursue that journey into the coaching world. Andrew It’s a really interesting point, I think, especially for medical and performance practitioners to hear that - something we’re probably aware of - but when the mental health side of it was kicking in a little bit more some of the injuries and the physical health manifestations were of a very similar timing and both potentially going hand in hand or exacerbating one another. I don’t know if you want to comment on that. Steven No, absolutely. What was going through my head when you were speaking there was what you become as a medic or a doctor – it’s a more than just that. You’re walking side by side with your players. I was out for three months with my pars defect in my lower back. So, I was out for a period of time. Got back from that. First week back I did my ACL. So, I was out for seven months. Got back from that for twenty games and then I was out for eleven months with a chondral defect and the micro fracture. So, you become as a physio or as a doctor, all things really. Might be a father figure, part-counsellor, a friend. All of these different support networks that you become is so important for that relationship, and I was so lucky during that time that I had unbelievable medical support. I used to challenge them. I’ve got to be honest but I know Dave Fevre has spoken

All of these different support networks that you become is so important for that relationship, and I was so lucky during that time that I had unbelievable medical support

about it in, I think, a podcast he has done. He loved it. He loved players that wanted to be challenged. I remember I grabbed one of the S&C coaches and said, “right, this period of time I’m non weight bearing on my right leg for two months. Me and you are going to be in the gym at nine o’clock every morning for two months working on my left leg.” Because there was that kind of theory that you get a little bit of overflow into your right leg. So, I was quite active in looking for that support and I found that they loved it. The S&C and the medical department really loved being challenged a little bit and being pushed. But, again, it’s psychological skills that you need and what you do to support the players on their own journey. That’s what I’ve personally found. When I had the strong medical departments behind me, it went so far to getting me back to fitness quicker. Andrew I suppose you’ve been at a range of clubs throughout your career and mentioned quite a few injuries there. We’ve already kind of touched on this but what are some of the best practices from medical practitioners that you’ve seen in those moments where you’ve needed them the most – as you mentioned e.g. being the father figure? Are there things specifically that you can pick out that you feel would be really important for players who have experienced similar? Steven From a human point of view, just that empathy. You know, a club doctor that I could speak freely to not just about the injury but just about where I was mentally. So that was always my first port of call when I ended up seeing Steve Peters for a period of time and when I was at Blackburn and that was me going to see Dr Phil Batty and saying, “I really think I need to go and

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see someone.” He had presented this to the squad which is brilliant. So, on the back of that I went to see the doc but had that relationship where I felt comfortable to do that. It was the same when I went to West Brom and had my issues. Mark Gillett was great at 1-to-1s showing empathy and knowing where I was at physically and almost fighting your corner to get you days in the gym. Things like that. But one of the key ones I think during my rehab periods was when the physios mixed it up; it wasn’t just your standard exercises, CV etc. etc. daily. It would be mixed up. Luckily, when I was at Blackburn we had a swimming pool, we had the beautiful countryside and we had facilities there so it might be a triathlon for the day. We might go out on the mountain bikes, get back and we’re in the pool, got the rower side by side with the pool. It might be - at West Brom, where the doc gets in, Richie Woodhall, the former British champion, or maybe even European boxing champion, you know, just something to stimulate you a little bit just to keep things fresh and mixing it up. So, you’re not just on the daily grind but I also noticed that the good ones would know when you were not in a great place and it might be, “right, just take a few days off” or “take a week off.” When I was having my issues with some of my serious injuries, especially the chondral defect, I had my eight to ten weeks non weight bearing and then a couple of my mates were in Thailand at the time. So, Dave Fevre went, “listen, at the end of your period of time doing the CPM machine and eight to ten weeks non weight bearing just off you go and just get away.” You know, just stuff like that when they could tell that you need a little break. It’s not all by the book. A lot of it is just that feel and those relationships.

football medicine & performance Andrew So interesting that a lot of it is that human touch side that you’ve spoken about there. A really key message that, I suppose, I’ve taken out is that it is not only the physical stimulus of different activities, but the new mental stimulus as well. Steven I find it’s the same in coaching. Periodisation of your coaching philosophy usually means in the next day after a game you do the warm down. The guys that don’t play will train but sometimes it just doesn’t work mentally and for the feel of the group. Sometimes actually the best thing is to have a day off away from the training ground, clear the head, then physically it might be a four-day lead in or no days off in the week just to get you fully prepared. But sometimes it’s about the feel, it’s about the atmosphere in the dressing room and what the lads might need just to switch off from the game. Andrew It’d be interesting to get your experience - what did you find were some of the challenges moving from club and international football based on some of the bits we’ve spoken about? It’d interesting to hear from you if you’ve gone through different changes and uncertainty with injury, communication between

medical staff, if you were in constant communication with staff yourself. It’d be interesting to hear that side of things. Steven Yeah, the major challenge with that is the amount you can do and the recovery period because more often than not a meet ahead of a Wednesday or Thursday international would be the Sunday night, but a lot of the time we might have the Celtic boys, might even be the Old Firm derby where you got Ryan Jack from Rangers and you got, John McLaughlin from Rangers and you got the Celtic players playing against each other on the Sunday. You might have Andy Robertson playing for Liverpool on the Sunday. So, they’re recovering Monday and Tuesday. Then you’re at match day minus one. So, can’t do very much before the game on the Wednesday or the Thursday so it’s actually how much you can do with the players. But I always found the dialogue was really good. The clubs were always really open about sharing data around the training loads of the players. We’d like to think we were quite sensible as coaches so we kind of knew about recovery days and how much the players can do. Head of Performance Graeme Jones was fantastic with Scotland. He dealt with a lot of the liaising between the club and

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the international team. He would often go out and visit the players, go into clubs for visits and catch up with the players as well. If players were injured, we might as coaches obviously check in with those players and see how they’re getting on. So, I think the main challenge is they’re not your players so sometimes you’ve just got to be wary of not knowing exactly how they are physically. You’re not seeing them every day. You might not know to the exact detail what their training load or training week looks like. So, there are a lot of challenges with that. A lot of challenges again from a personal point of view and from a coaching point of view, was the gaps between games: you have a November international and then you’ve got to wait until March to see the players again. You hope that they turn back up in one piece. Andrew Now we’ve moved on to the coaching part of your career a little bit more, do you mind telling us a bit about when you were approaching the end and why you decided to leave coaching and set up on your own? Steven Yeah, I’d been thinking about it for a little while. I had quite a brief sort of break when I was at Crystal Palace. I stepped away from Crystal Palace in 2018 to take

feature a break but it didn’t last too long. I was toying with the idea of exploring what I’m doing now back then, but to be totally honest I didn’t really have a plan as to what it was going to look like or what I was going to do. I was still unsure whether I would go back into coaching after that break. I think I got a little bit scared with the uncertainty of going into the unknown, not being sure what it was going to look like. Then the phone rings again and you can quickly be back in it, back on the hamster wheel. Then I ended up being back in coaching for some time and I started to explore courses. I’d already got my level two counselling course by that stage and it’s something that I’ve used personally, something that I believe in, and I’ve always wanted to do. I just felt going out at the top as well after a promotion with Forest was a great way to go out. Although I’d been thinking about it for some time and what I kind of wanted to do and want to get qualified in and you just simply can’t do it when you’re in a full-time coaching role. So, the decision was made to step out of it, get qualified in that but in the meantime, kind of be a mentor, crack on with the coaching that I’m doing with individuals - players and coaches. I’ve gone to a couple of academies to present what the journey could look like – I present in all honesty a lot of factors that the players are likely going to face on the journey whether it be injury, whether it be the form, whether it be family pressures, whether it be living away from home, whether it be performance pressure, whether it is that imposter syndrome when a player gets a move, whether it is about episodes of panic attacks at different stages in my life which other players have shared with me since I shared this openly in the media. It’s just been nice as well to, bottom line, spend some quality time with the family.

The kids are at an age where I’m still kind of just clinging on to them. They’re starting to get older and starting to do their own thing. Spending four out of the last seven years being away from them, I’ve realised that I don’t want to miss out on too much more of that. Andrew You’ve mentioned a bit about the pathway into counselling. Tell us a bit about that part of the journey and a bit more about what you’re doing now in your various roles - you mentioned going into clubs and some of the other bits and pieces. Steven I had counselling from quite a young age. I think probably from 17 I had quite an intense spell for a period of time. Then it sort of dipped into more sports psychology work through my football career. It was only when I left Crystal Palace that I felt like I needed that bit of help again. Forgetting the performance side of things, this was about just some issues that I was kind of going through and dealing with. All of the issues that we spoke about. So, did some work on myself then with a counsellor and it’s just something that I believe in. It’s something that I’ve wanted to pursue for quite a while. I’ve just got this almost dream of just having little set up - a little cabin in the garden that can be that safe space when fully qualified for that side of the work. I think that the counselling side of the work is different to the coaching and the mentoring. The counselling is more about allowing that safe space for players and coaches to just get a lot off their chest that they feel. Because they’re in football, they feel they can’t moan about anything because a lot of people don’t get it. It’s a coaching and mentoring service and it’s one that, along similar lines, players and coaches can come and share some of the

The counselling is more about allowing that safe space for players and coaches to just get a lot off their chest that they feel.

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issues they’re dealing with but it’s also for talking about potential plans. Could be potential life after football. What does that look like? How can we go about finding out what that does look like? Whether it’s the coaching journey, getting your Professional Footballers Association (PFA) number, you investigating when that coaching course might begin, it might be something completely away from football. You know, it might be a coach that is going through similar issues that I’ve been through in my coaching journey, and it’s just allowing that space to talk about it and hopefully provide some of the tools that actually did help me in not only the mental side of it, but physically. Because you often find in coaching that as soon as the results dip, as soon as the pressures on, we can come away from all the stuff that we know makes us feel better and that helps us on that journey. So, it’s been really interesting. The presentations as well I think have been really useful to the academy players that I’ve spoken to. On the back of that there’s been one or two that have sent WhatsApps after just wanting to pick my brains a little bit more because something’s really resonated with them. I think it’s important that what I have said to them is that I never knew any of this stuff existed when I was sixteen to twenty-one years old. I thought I was the only one experiencing all of these sorts of issues that were going on with myself. In football everyone looks like they’re loving it. Everyone looks like they’ve not got a care in the world. I thought I was the only one carrying a lot of stuff. So, I think it just can be quite comforting for a lot of players to hear that I’ve had that journey, I’ve been through these issues. You’re not alone and, by the way, even despite having all these challenges and issues I still played twelve years in the Premier League, played in the World Cup, coached in the Euros, coached in the Premier League and coached international football. So, many think that they can’t do it because of what they’re going through but with the right support and the right help it is possible. Andrew You’ve spoken really openly there but also mentioned a lot of really useful tools. You’ve had a very unique journey in the sense of your playing career, coaching career and going into the wellbeing, confidence and leadership coaching and now obviously the counselling studies as well. Do you have any recommendations for clubs looking to support not only players but support staff as well?

football medicine & performance

Steven Well, that’s a big issue. I think it’s a massive issue because in terms of support networks, I’ve got to take my hat off to the to the PFA. Some of the work they do is incredible around support. With the counselling, obviously got that connection with Sporting Chance that I do some work with. They do all sorts: coaching badges, education support but that’s for PFA members. I always think to myself, if I’m support staff e.g. analyst, physio, masseur or chef in a football club, I’m not sure where they go to, to be honest. Sometimes it’s not really that clear if you’re a player or if you’re a coach, but it’s the support staff that are often doing the hours often not on great money, that are often living away from the family, dealing with all of those pressures in the high pressure world. But I think the number one thing for me is actually being in that good place yourself because I often found as a coach when I was having some struggles, when I was maybe going through a difficult time, you can’t recognise it in others a lot of the time. You’re so caught up in your own little bubble, it’s very difficult to

recognise it in others but I think we need to create these environments where it is safe to effectively talk about this stuff. Need to have people in place that are skilled and can offer that support within the football club across the board. I know it’s about players and it’s about winning games, but it is having that open and transparent support and options for anyone within that football club. Whether it is a meeting at the start of the season to let every employee know: if you have an issue mentally or physically or going through a tough time, these are the processes that we’ve got in place and this is the support network we’ve got in place. But I think one of the key things is that it’s external because of stigma. If someone has to go through a club’s channels, there’s a fear of “how does this look”, a fear of “I’m not going to progress”, a fear of “this might do me harm in my development at the club or on my journey going forward.” But it is just finding that support network for everyone, all employees throughout the club, because I think at times it is all geared around the players, but I’ve seen first-hand that there’s a lot of staff that put in a lot of hours that are going through a lot of issues themselves and almost don’t know what to do.

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Andrew That’s brilliant. Steven, I can only thank you very much for joining us today and sharing a lot of your insight having been on a very unique journey. But there’s also a lot of key take homes, I think, for listeners. I know primarily a lot of our listeners are medicine and performance staff. So, having also worked not only with players but support staff across the board - as you mentioned - there’s certainly a lot more that we can do in this space, something to support players but also to support the support staff by trying to tap into some of our own education and teaching. Also, what can we try to put in place to maximise not just the performance of the players, but to maximise the performance of support staff? Listeners, we’ll put up links for any articles and web links mentioned on the podcast. If you enjoyed today, please subscribe to the FMPA on our Spotify, SoundCloud or Apple Podcast accounts where you can reach all of our podcasts. Alternatively, our podcasts are also available for free via the podcast section of the FMPA website.

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football medicine & performance

EXPLORING THE ROLE OF DIFFERENTIAL LEARNING IN THE DEVELOPMENT & COACHING OF FOOTBALLERS Senior Lecturer in Sports Coaching, Anglia Ruskin University Cambridge Centre for Sport and Exercise Sciences

FEATURE / DR DAVID TURNER

“If we want to have extraordinary performance, we need to train extraordinarily.” Professor Wolfgang Schöllhorn (quoted in Gray, 2021). Introduction Differential learning (DL) is an alternative approach to training design which emphasises the exploration of movement patterns through experiencing extreme variations during practice, rather than through traditional repetition, and without any accompanying coaching corrections provided. Over the last decade several research papers have been published on the effects of DL interventions undertaken in football contexts, highlights of which I provide below. Furthermore, two prominent figures in football coaching have emerged whose professional practice has been influenced by the DL approach, and I will outline these examples later. Finally, I will draw together the theory and the practice to make some recommendations on the

potential role of DL in the development and coaching of footballers. Principles of Differential Learning Schöllhorn proposed DL in 1999 (Tassignon et al., 2021), after his research revealed that even for elite athletes there was a large amount of variability (rather than stability) in their execution of movement patterns, with optimal movement solutions being highly context dependent. Moreover, he additionally found a large amount of between athlete variability, even at top levels of performance, although it also proved possible to identify individual athletes based on their own signature movement patterns – that is by their own unique range of movement solutions. So, elite athletes had developed

their own movement solutions, but these varied across athletes due to individual differences, and even within the same athlete due to altering circumstances. Therefore, a key principle of DL is that there is no one ideal movement pattern for all athletes to target acquiring. Following on from this repetition of the same actions in training becomes a questionable practice, and correction from the coach in relation to some conceived ideal example does not make sense. Instead, repetition and correction are replaced by variation of movements, and the encouragement of a full exploration of the movement space, in order to promote the self-organisation of the athlete in seeking new solutions and remaining adaptable.

Millwall FC follow ballet mistress Doreen Hermitage in a ballet session at The Den, London 1964

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feature Hence, DL reflects a non-linear view of learning, with athletes not following an identical path prescribed by the coach, but creatively coming up with their individualised movement solutions through being compelled via training design to experience random and extreme variations of movement. From this perspective, in a sport such as football it seems absurd to employ repetition to practice particular actions over and over again, when players are unlikely to encounter exactly the same conditions twice in a match – with the game demands changing due to altering external conditions (e.g., weather, surface), and the player having to adapt to their own internal alterations (e.g., fatigue, injury). Thus, in DL players would be exposed via extreme variations in practice conditions to fluctuations that destabilise their existing movement patterns, with the intention of provoking the emergence of new and more effective movement solutions. In this method variation is used for its own sake, such that actions will be completed that appear outlandish, and would be impractical if repeated within matches, such as dribbling with your hands on your head, to deliberately perturb the system with very different movement challenges than are normally encountered to promote further learning. That is, learning through experiencing differences. Research on Differential Learning and Football Schöllhorn, Hegen and Davids (2012) compared a classical linear training approach, featuring repetition and correction, with a differential nonlinear approach featuring variation and no correction, over a 4 week training period, with 8th tier German league footballers, working on the development of ball control and shooting. There were a total of 40 variations in exercises for the differential group, with examples such as – ‘ball reception with the chest, with right eye closed, left arm straight up, right arm straight lateral’; ‘goal shot after a short dribble, rotate arms forward, head to the left’. The differentially trained groups performed significantly better than the classically trained group, in both the acquisition and retention phases of skill acquisition, but the number of participants was very limited (12 in total), making this more of a pilot study. Bozkurt (2018) examined the effects of 4 weeks of differential and traditional training on the technical development of youth footballers in Turkey. In the differential training there were numerous movement variations based on different parts of the body, angles, velocities, and

rhythms, while performing technical football skills. Although participants in the differential group were able to improve their performance in all tests and techniques (juggling, passing, dribbling) compared to the traditional group, there were no statistically significant differences in the development of players’ football techniques, so improvements were small and results could be due to chance. Again, a very small number of participants (12) made this more of a pilot study. Ozuak and Çaglayan (2019) investigated the effect of an 8 week programme of DL exercises on 26 Turkish youth footballer’s skills. An example of what was worked on in the differential training is – ‘Dribbling while keeping up a balloon-tennis ball with the hands (change in surfaces; on artificial-grass surface, on dirt surface, on a slope)’. While both traditional training and differential training improved players’ scores across a battery of skill tests, the differential learning group were statistically superior to the traditional training group for 3 tests specifically related to dribbling ability. The authors speculated that the perturbations associated with the DL exercises compelled players to use their non-dominant leg more often, enabling them in turn to elicit more effective responses to complex movement challenges

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faced in football. Hence, they claim that DL may be considered an important factor in the training of football technical skills. Coutinho et al. (2018) identified the effects of a 10 week complimentary training programme based on the DL approach on attackers in Portuguese youth football. The wide ranging programme worked on developing physical, technical, creative, and positioning performance of the attackers. The differential learning programme featured random variations in physical literacy exercises and small sided games, such as attacking with different numbers of teammates or opponents, attacking from different angles and distances from goal, changing the number and type of targets, and changing the pitch size or shape. Results indicated that the differential training programme was effective for the overall development of the U15 experimental group compared to the U15 control group; however, it was speculated that the U17 players might need a longer programme or more variability to show the same sort of effects since they may have had more previous exposure to more traditional coaching approaches. Nevertheless, although mostly in the U15’s, and with only 9 players in each experimental group, there was evidence that differential training was effective on the overall

football medicine & performance development of youth attacking footballers in a number of parameters. In perhaps the most interesting and substantial study on DL and football to date, Santos et al. (2018) identified the effects of a 5 month differential learning programme embedded in small sided games situations (SSG), on the creative and tactical behaviour of 20 Portuguese youth footballers. The typical SSG group experienced sequential tasks in a predetermined identical progression (1vs1, 2vs2, 3vs3, etc.), undertook ball possession drills to emphasise the pass, performed the pass technique according to specific criteria, and were given instructions and correction. While the differential learning SSG group experienced random consecutive perturbations (4vs4, 2vs1, 5vs5, 5vs3, etc.), performed passes with conditions such as hands tied or one eye covered, constantly improvised new ways of passing, and were provided with no correction. Results indicated that the differential SSG group had greater improvements than the typical SSG group in originality of actions, a decrease in errors during the game, and more regular pitch positioning tactical behaviours. Benefits were greater in the U13 group compared to the U15 group, with the authors speculating that this might be because younger players are more creative. Two intriguing possibilities raised in this paper are that DL approaches

Figure 1: A pitch shape with the corners cut off used by Thomas Tuchel to encourage diagonal passing.

may help players to develop adaptive behaviour that promotes performance in unpredictable games based contexts, and that DL might promote more regular positional behaviour as tactical awareness could be heightened through the exploration of new movement solutions within SSG situations. Coaches in Football Influenced by Differential Learning Paco Seirul·lo (left) is a legendary and celebrated football trainer in Spanish

sport, and the only professional coach to have won a European Cup in two different sports (handball and football) (Transfermarkt, no date). He was fitness coach working under more than a dozen managers of FC Barcelona, including Cruyff and Guardiola, over a 20 year period, before being appointed as Head of Methodology for the club, a role which he stepped down from in 2022 (Transfermarkt, no date). According to Lyttleton (2017) Seirul·lo appreciated the advantages of DL, and applied it in the Barcelona youth academy (La Masia), with more variation incorporated during training, and exercises limited to a maximum of three repetitions, so that diverse players were able to come up with individualised solutions, and the training environment was kept stimulating (Power, 2020). It is also claimed that DL has influenced Jürgen Klopp (Soccer Issue 2013; Soccer Hub, 2019). Although I can find no further corroboration of this, it is certainly plausible since the originator of DL, Professor Schöllhorn, works at University of Mainz, near to the FSV Mainz 05 training ground where Klopp worked when he coached the club. What we do know is that Thomas Tuchel (left) visited Schöllhorn when he led Mainz, and that DL certainly affected his practice and thinking. Tuchel stated, “That influenced me a lot, because it changed my role as a coach completely. With this there is no right and wrong. I’m just responsible for the ideas and principles of how we play. Within those they are free to find their own solutions.” (Lyttleton, 2017, p.72). In this way coaching may be viewed as an act of orchestrating the practice environment,

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feature to promote a more non-linear creative form of learning, rather than directing the players. Having players learn through actively doing, rather than passively being told what to do (Johnson & Honigstein, 2021), and becoming more self-organising in their behaviours (Gray, 2021). Hence, Tuchel tailors practice to continually challenge and stretch his players, with extreme variation in pitch sizes and problem scenarios; all implemented with the intention that training ends up being so testing and demanding, that competitive matches seem comparatively easier to cope with (Honigstein, 2021). For example, he has his players play on pitches with little width or depth, with different size footballs, on pitches with the corners cut off (see Figure 1.), on slippery surfaces, with defenders holding tennis balls so they cannot grab attackers, or where they have to control the ball with their knees before passing (Power, 2020). Recommendations on the Role of Differential Learning in the Development and Coaching of Football In a review of research studies on the effectiveness of DL across a number of sports, Tassignon et al. (2021) concluded that despite large differences between studies, limited studies and sample sizes, low statistical power in results, and a high risk of bias, DL retains the potential to lead to greater improvements in the acquisition and retention phases of motor learning when compared to traditional methods. However, the jury is still out on whether DL is effective generally as an approach, let alone specifically in football, and more research is required. Nevertheless, it does raise a number of interesting alternative ideas about how we might go about developing football players, and signposts to principles that we might use to guide our coaching practice. It is possible that Seirul·lo was influenced by DL, but he also developed his own theoretical ideas on training methodology in team sports, based on complexity and the sportsperson as composed of interacting dynamic systems. Notwithstanding, we can see similarities of his approach with DL, for instance, in an online article on Seirul·lo’s proposal for team sport training organisation, at Barca Innovation Hub (2021), it states “Learning is not about repeating, it is about experiences in changing environments.” He also discusses the need for coaches to structure situations that allow for players

Figure 2: Learning and different amounts of variation associated with various motor learning approaches (taken from The Perception & Action Podcast, 2018, and based on a framework from Schöllhorn, Mayer-Kress, Newell, & Michelbrink, 2009).

to self-improve (Barcelona Innovation Hub, 2019). Similarly, some of Tuchel’s coaching implementations illustrated earlier seem more akin to other non linear approaches, such as contextual interference, or a constraints led approach. But, as Tassignon et al. (2021) asserted, practitioners will often mix up different motor learning approaches in trying to improve those in their charge. What is consistent in Tuchel’s method though is a deliberate intention to expose players to different challenges, to orchestrate training situations so that players can learn by doing rather than simply be told, and to make training more complex and demanding than the game. Schöllhorn himself conceived of a bell curve, with the free play of children at one extreme end, and the traditional repetition of adult practice at the other, each representing non optimal forms of learning, while non-linear approaches occupy intermediate positions towards the upper peak of the curve, signifying superior learning (with DL placed at the peak – see Figure 2). Conclusion It would be a hard sell to football players and coaches to incorporate some of the more extreme variations of DL into training, and it would be difficult to justify a wholesale adoption of the approach into developmental football programmes given the current evidence. Furthermore,

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determining the optimum amount of desirable variability in practice remains a difficult matter, complicated by the maturity of the athlete, and their level of comfort in making mistakes and being constantly challenged to come up with their own solutions. Additionally, the adoption of a DL approach would depend on the philosophy of the coach or football club regards promoting player autonomy – how willing are they to let players self-organise and be creative? Here are my recommendations arising: • DL signals that the most important guiding principles for coaching and training might be individualisation, variation, and self-organisation; rather than one size fits all solutions, repetition, and direction from others. • If we add greater variation to training then we might gain more creativity and innovation from players and teams, in training and competitive action. • If the coach orchestrates practice to regularly challenge players to come up with novel movement solutions, then there is less need for direction and negative feedback, and players might therefore be more secure in their relationship with the coach, confident in their own abilities, and willing to experiment as a result. • Less repetition and more variation might lead to less mindless, passive behaviours, and boring experiences, and more mindful, active behaviours, and stimulating experiences, in the context of football training, better promoting enjoyment, engagement, and learning.

football medicine & performance

DIFFERENTIAL LEARNING IN THE DEVELOPMENT AND COACHING OF FOOTBALLERS

DIFFERENTIAL LEARNING Exploration of movement patterns through extreme variation, rather than repetition, with no coaching corrections provided.

PRINCIPLES Elite athletes develop unique movement solutions, which vary across athletes due to individual differences, and within the same athlete due to altering circumstances. So, there is no one ideal movement pattern for all athletes to target acquiring.

EMPHASIS Repetition and correction, replaced by variation and exploration, promoting selforganisation and adaptability.

RESEARCH DL based programmes may promote better learning and performance of technical football skills (e.g., Bozkurt, 2018). Specific improvements evidenced in dribbling (Ozuak & Çağlayan, 2019) , the development of attacking youth players (Coutinho et al., 2018), and in the creative and tactical behaviour of youth footballers (Santos et al., 2018).

INFLUENCED PRACTITIONERS Jürgen Klopp??

Paco Seirul·lo?

Thomas Tuchel!

RECOMMENDATIONS

Important guiding coaching principles might be individualisation, variation, and self-organisation. Adding more variation to training might result in more creative innovative players. If the coach orchestrates practice to challenge players to come up with novel movement solutions, there is less need for direction and negative feedback, players might be more secure in their relationship with the coach, confident in their own abilities, and willing to experiment. Less repetition and more variation might lead to less mindless, passive behaviours, and boring experiences, and more mindful, active behaviours, and stimulating experiences, in football training.

References Barcelona Innovation Hub (2019). Paco Seirul·lo’s proposal for team sports training: structured training, game spaces and preferential simulation situations. Available at: https://barcainnovationhub. com/paco-seirul%c2%b7los-proposal-for-team-sports-trainingstructured-training-game-spaces-and-preferential-simulationsituations/ Accessed on: 23rd August 2022. Barcelona Innovation Hub (2021). How to organize training in team sports. The Paco Seirul·lo proposal. Available at: https:// barcainnovationhub.com/how-to-organize-training-in-teamsports-the-paco-seirul%c2%b7lo-proposal/ Accessed on: 28th August, 2022. Bozkurt, S. (2018). The effects of differential learning and traditional learning trainings on technical development of football players. Journal of Education and Training Studies, 6(4a), 25-29. Coutinho, D., Santos, S., Gonçalves, B., Travassos, B., Wong, D., Schöllhorn, W.I. & Sampaio, J. (2018). The effects of an enrichment training program for youth football attackers. PLoS ONE, 13(6), 1-18. Gray, R. (2021). How we learn to move: A revolution in the way we coach and practice sports skills. Perception Action Consulting & Education LLC. Johnson, S. & Honigstein, R. (2021). Thomas Tuchel, the innovator who took Chelsea to Champions League glory. The Athletic. Lyttleton, B. (2017). Edge: Leadership secrets from football’s top thinkers. London: HarperCollinsPublishers. Ozuak, A. & Çağlayan, A. (2019). Differential learning as an important factor in the training of football technical skills. Journal of Education and Training Studies, 7(6), 68-76. Power, R. (2020). Coaching youth football: What soccer coaches can learn from the professional game. Oakamoor: Bennion Kearny Limited. Santos, S, Coutinho, D., Gonçalves, B., Schöllhorn, W.I., Sampaio, J. & Leite, N. (2018). Differential learning as a key training approach to improve creative and tactical behavior in soccer. Research Quarterly for Exercise and Sport, 89(1), 11-24. Schöllhorn, W.I., Hegen, P. & Davids, K. (2012). The nonlinear nature of learning – a differential learning approach. The Open Sports Sciences Journal, 5, 100-112. Schöllhorn, W.I., Mayer-Kress, G, Newell, K.M. & Michelbrink (2009). Time scales of adaptive behavior and motor learning in the presence of stochastic perturbations. Human Movement Science, 28(3), 319-333. Soccer Hub (2022). Meet Soccer HUB’s Teacher: Wolfgang I. Schöllhorn. Available at: https://www.facebook.com/ soccerhubonline/posts/3376456815917560 Accessed on: 24th August 2022. Soccer Issue (2013). Everyone is unique. Available at: https://www. soccerissue.com/everyone-is-unique/ Accessed on: 24th August 2022. Tassignon, B., Verschueren, J., Baeyens, J-P, Benjaminse, A., Gokeler, A., Serrien, B. & Clijsen, R. (2021). An exploratory meta-analytic review of the empirical evidence of differential learning as an enhanced motor learning method. Frontiers in Psychology, 12, 1-23. The Perception and Action Podcast (2018). Episode 92 - Differential Learning. Available at: https://perceptionaction.com/92-2/ Accessed on: 29th August 2022. Transfermarkt (no date). Paco Seirul·lo. Available at: https://www. transfermarkt.com/paco-seirul-middot-lo/profil/trainer/5119/ plus/1 Accessed on: 23rd August 2022.

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football medicine & performance

WELLBEING SUPPORT FOR GOALKEEPERS IN FOOTBALL ACADEMIES IS IMPROVING FEATURE / CALUM BRODIE, JONNY GLEN, AND PROFESSOR DAVID LAVALLEE Introduction Football academies world-wide provide people with a pathway to becoming a professional player. In the UK, approximately 12,000 young people aged 9-21 are enrolled within these elite sporting environments at any given time.1 However, less than 0.5% will secure a professional career, with the majority being released during early adolescence.2 These academies are regarded as highpressure environments that are often associated with negative outcomes such as psychological distress, fear of failure and emotional exhaustion. Consequently, academies have a duty of care to support the wellbeing of players.3 Wellbeing Support for Goalkeepers Perhaps no role within football is as demanding of wellbeing support as the goalkeeper due to the unique challenges and pressures associated with the position. The goalkeeper’s role

is inherently isolating, with specific training regimens and responsibilities compared to their outfield counterparts.4 The position requires resilience because when goalkeepers make errors the consequences are more often than not a goal against their team, which can have a direct and visible impact on the result. This can often lead to them receiving more blame and criticism from their teammates, coaches, media and supporters for their mistakes.5 Moreover, poor decision-making can negatively impact a goalkeeper’s performance by reducing self-confidence and attentional focus.6 One could argue that the demands placed on goalkeepers are as great, if not greater, than the demands placed on outfield players, necessitating distinct wellbeing support tailored to their needs. For this reason, we aimed to learn more about the wellbeing support provided to goalkeepers within their academy structures.

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Abertay University

Comparing Current and Former Academy Goalkeepers We collected data in March 2023 from 101 goalkeepers from 14 different countries to compare the support levels being provided to goalkeepers in football academies at the time of the study (n=67; mean age = 18 years) with the support previously provided to former academy goalkeepers (n=34; mean age = 21 years) between 2018-2022. We were interested in the forms of support provided to goalkeepers by their academes, including coaches, teammates and others, that help them cope with the unique challenges and stressors within the academy environment. We collected data on the levels of wellbeing support goalkeepers perceived was available to them while at academies, and also the level of support that they received when they needed it.7, 8 We specifically assessed the four different

feature types of support outlined in Table 1: emotional support, esteem support, informational support, and tangible support.

Results revealed that all areas of wellbeing support for goalkeepers in football academies is improving (Figure 1). Emotional support had the greatest improvement (+10.2%), followed by tangible support (+6.1%), esteem support (+4.5%), and informational support (+3.2%). Overall, the wellbeing support provided to goalkeepers has improved by 6%, when comparing former with current academy goalkeepers.

Table 1. Types of Support for Goalkeepers • Emotional support refers to expressions of care, empathy, and understanding that create a sense of security and belonging for the goalkeeper. • Esteem support involves bolstering the goalkeeper’s self-confidence and feelings of competence by recognising their achievements and abilities. • Informational support consists of providing valuable advice, guidance, and feedback that can help goalkeepers improve their skills and decision-making. • Tangible support represents the practical assistance, such as financial aid or logistical help, that contributes to the goalkeeper’s overall well-being and success.

goalkeepers, given the distress associated with sudden deselection.

Conclusion Duty of care continues to climb the property stack in the minds of everyone who is interested in football in recent years, including academies.3 Our results have several practical implications that can assist academies in further improving their wellbeing support provision.

Providing regular feedback, encouragement, and recognition of progress to goalkeepers through esteem support can help build self-confidence. The provision of emotional support within the context of elite football academies can also help goalkeepers deal more effectively with setbacks and stress. The PFA has a 24/7/365 confidential wellbeing support helpline.11 Mental health first aid courses can also equip coaches with tools and techniques that can help support the wellbeing of players. These supports are especially important for academy goalkeepers who may not yet have fully developed the coping strategies that are necessary due to the unique pressures associated with the position.

Tangible support can be provided by ensuring goalkeepers have access to the practical resources they need to thrive such as equipment, facilities, medical services, and financial information from banks. Informational support could come in the form of advice, guidance to essential services such as the PFA’s youth advisory, and regular insights from coaches and mentors. This is especially important regarding future career planning for

Take Home Messages • Goalkeepers face unique challenges and pressures associated with the position, which requires distinct wellbeing support. • Academies play an important role in fostering a supportive environment for goalkeepers. As academies better understand what goalkeepers need, then they can provide better support. • Wellbeing support for goalkeepers in football academies is improving.

Tangible Support

Information Support

Esteem Support

Emotional Support

Overall Wellbeing Support 0

Figure 1: Percentage Change Increase in Support Between Former and Current Academy Goalkeepers Source: data adapted from Brodie10 - data was collected from 101 goalkeepers

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football medicine & performance

References 1. Blakelock, D., Chen, M., & Prescott, T. (2019). Coping and psychological distress in elite adolescent soccer players following professional academy deselection. Journal of Sport Behavior, 41, 1-26. 2. Blake, M., & Solberg, V.S.H. (2023). Designing elite football programmes that produce quality athletes and future ready adults: Incorporating social emotional learning and career development. Soccer & Society. 3. Burrows, K (2022). An introduction to key issues in footballer welfare. Football Medicine and Performance, 39, 33-37. 4. Villemain, A., & Hauw, D. (2014). A situated analysis of football goalkeepers’ experiences in critical game situations. Perceptual and Motor skills, 119, 811-824. 5. Kristiansen, E., Roberts, G.C., & Sisjord, M.K. (2011). Coping with negative media content: The experiences of professional football goalkeepers. International Journal of Sport and Exercise Psychology, 9, 295-307. 6. West, J. (2018). A review of the key demands for a football goalkeeper. International Journal of Sports Science & Coaching, 13, 1215–1222. 7. Freeman, P., et al. (2011). The perceived available support in sport questionnaire. Journal of Sport & Exercise Psychology, 33, 54-74. 8. Freeman, P., et al. (2014). The athletes’ received support questionnaire. Journal of Sport & Exercise Psychology, 36,189-202. 9. Lavallee, D., Lowder, J., Lowder, J., & Lavallee, R.M. (2020). Success in football is no longer enough. Football Medicine and Performance, 32, 28-29. 10. Brodie, C. (2023). Exploring social support networks: A study on current and former academy goalkeepers [Undergraduate dissertation]. Abertay University: Dundee. 11. https://www.thepfa.com/players/wellbeing

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BREAKING THE SILENCE: ENDING THE STIGMA OF MENTAL HEALTH IN FOOTBALL FEATURE / DR GARY SOUTER Introduction Despite the high prevalence in professional footballers, mental health disorders are rarely reported within elite football (Gouttebarge 2019). Stevenson (2020) believes that the perceived stigma is holding footballers back from discussing and disclosing their mental health issues. Players often fear disclosing mental health issues, due to the possibility of team deselection, the detrimental impact on their market value, and the negative perception amongst their club’s fans (James et al., 2022). In the UK, mental health issues within professional football often generate headlines in the media (Bennett 2020). Although this can be viewed positively, such as raising awareness of mental health issues in elite sport, the intensity of social media platforms can also exacerbate negative societal attitudes towards footballers experiencing issues with their mental health. There has previously been an assumption that professional footballers are immune to mental health issues due to

Head of the Leicester School of Nursing and Midwifery, De Montfort University

their status, wealth, and adulation (FIFA, 2021). However, constant exposure to the public spotlight can leave footballers vulnerable to negativity from the media and fans. This public stigma that is created significantly impacts footballers’ willingness to disclose and seek treatment for mental health related issues (Merz, et al., 2020). Subsequently, the impact of stigma can have a debilitating effect on footballers who are experiencing mental health symptoms. If a footballer struggles with their mental health, they can become labelled as ‘mentally weak’ or ‘not mentally tough’. This paper reports on the key recommendations resulting from a doctoral study exploring the mental health of eighteen first team professional footballers across the English Football League (EFL). Player-centred care Professional football clubs should develop a holistic approach to mental health. Mental health in football is more than just a prioritisation of performance-related goals.

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Clubs should continue to explore the benefits of sport psychology, marginal gains, and the improvement in physical performance. However, they should also develop a playercentred approach. Professional footballers have many identities. In addition to being a footballer, they have other identities that define them and subsequently impact their mental health. A holistic approach should consider all these aspects in order to assess, treat and improve the emotional wellbeing of the player, coach, or relevant support staff affected. To support a holistic approach to the emotional wellbeing of the player, coaches and support staff, professional football clubs should appoint a wellbeing officer. This role should support existing structures in place within the club and should have a particular focus on psychological wellbeing. Mental health champions Professional football clubs should introduce a

football medicine & performance mental health champion scheme and identify volunteers from both the playing staff and support staff to take on the champion role. Identified mental health champions would take action to raise club-wide awareness of mental health and challenge stigma. These individuals would also act as role models for other players to reach out to them to discuss their emotional wellbeing. Thus, the designated champions should also be trained in mental health first aid. Furthermore, support should be provided by the club Wellbeing Officer, through organisation and delivery of the recommended mental health training. Players who have recently been released should also receive mental health support where necessary, and signposted to available services for future needs. The majority of participants within the doctoral study have been released by a professional football club at some point in their career. This process has been shown to trigger feelings of anxiety, depression, and low self-esteem. Green (2009) suggests that 99% of academy players do not make it through the youth development systems. Therefore, there will be a substantial population of young men released from professional football who may then develop signs and symptoms of psychological distress. Professional football clubs should develop an aftercare package for released players to improve access and signposting to appropriate therapeutic support services. Professional clubs should also improve the way in which they communicate the decision to players and their families regarding their release. There are numerous examples of young players being notified of their release and rejection by either text message or email. Clubs should develop a player-centred approach that considers how release and rejection can lead to a deterioration in a young player’s mental health and subsequently develop a strategy that mitigates this risk.

Transition All professional footballers will transition out of playing football at some point in their career. This can happen at any time in their career and players cannot always prepare for it. Players are either released from clubs or naturally come to the end of their contract. These players are not always offered a new contract with their existing club or a new club. Therefore, they may be left with no choice but to leave elite football and seek alternative employment. Similarly, some players may experience a career-ending injury. There are also cases where footballers have a lengthy career and choose to naturally retire at a point at which they are seemingly prepared. However, professional footballers may not fully understand the life implications and adjustments involved after football. Therefore, there needs to be improved access to interactive workshops with a focus on coping with the transition out of football. Professional football clubs should employ qualified counsellors to improve access to psychological support. Currently there is only one professional football club within England that employ a sports psychotherapist. There should be an increase drive for seeking psychotherapeutic support in professional football clubs. The Professional Football Association (PFA) offer a 24-hour helpline with counselling support. However, some players are reluctant to access this support as there is a belief that the coaches and managers would find out and there would be repercussions, such as losing their place in the team. This reinforces the stigma associated with mental health. Clubs should do more to encourage players to access the support that the PFA offer. Ending the stigma Professional football clubs should consider modifying the language and terminology used to reduce stigma and discrimination. There are frequent examples of stereotypical masculine language used within football. This occurs during training and matches but also within team talks prior to playing a match. There can be an over-reliance on use of masculine terms based on strength, toughness and the perception of “being macho”, which may deter players who feel vulnerable when speaking out and seeking help. The concepts of being strong and tough are interwoven within the matchday language of professional football teams. Herzog (2019) suggested that the rules and tactics of football bear similarities to military characteristics and used to be interpreted in categories of battle orders. The military-influenced language is still prevalent within the team talks of football clubs worldwide. Players should be encouraged to express their vulnerabilities and offered appropriate support when they require it.

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Managers and coaches should cease using outdated terms such as ‘man up’ and other negative stigmatising terms. Conclusion The stigma of mental health remains prevalent within professional football. Players who experience symptoms of poor mental health are reluctant to speak out and seek help. Instead, they continue to suffer in silence. The football industry should take the following action to support players who are currently suffering from, or at risk of poor mental health: • Take a holistic approach to supporting the emotional wellbeing of footballers. • Introduce mental health champions and a club wellbeing officer. Players should have increased access to counselling and psychological support, either through the PFA or independently. • Develop or improve existing aftercare packages for released players with a particular focus on effective communication and support. • Break the stigma of mental health by challenging the use of language and introducing a positive and inclusive culture towards mental health.

References Bennett, M. (2020). Understanding the lived experience of mental health within English Professional football. Ph.D. University of East Anglia FIFA.com (2021). Martinez: Mental health is an issue we all face. [Online] [Accessed 29th August 2022] https://www.fifa.com/news/martinezmental-health-is-an-issue-we-all-face Green, C. (2009). Every boy’s dream. London: Bloomsbury Gouttebarge V, Castaldelli-Maia JM, Gorczynski P, et al Occurrence of mental health symptoms and disorders in current and former elite athletes: a systematic review and meta-analysis British Journal of Sports Medicine 2019;53:700706 Herzog, M. (2019). Footballers as Soldiers. Rituals of Masculinity in Twentieth-Century Germany: Physical, Pedagogical, Political, Ethical and Social Aspects. STADION, 43(2) pp. 250-269. James, I., Morris, S., Johnston, A. and Glover, D., (2022). Treating mental stress in elite footballers using a stigma-free psychological approach: the Power Threat Meaning Framework. BJPsych Advances, pp.1-8. Merz, Z., Perry, J., Brauer, A., Montgomery, T.. Shulze, J., and Ross, M. (2020). The Cost of Mental Illness: The Public’s Derogation of Athletes With Psychological Distress. Stigma and Health. Advance online publication. [Online] [Accessed 14th September 2022] http://dx.doi. org/10.1037/sah0000213 Stevenson, D. (2020). Get your head in the game. London: Watkins

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TACTICAL PERIODISATION IN FOOTBALL (PART II): LOAD MONITORING IN FOOTBALL FEATURE / RAINER VAN GAAL APPELHOF Introduction The physical, technical, tactical and cognitive demands of professional football are growing on the backdrop of an even more congested fixture schedule. This makes managing player load even more challenging. It demands the need for practitioners to create a consistent detailed analysis of information collected during both training and matches. This information, in turn, is then used to inform and assist the coaching staff in terms of future planning of the training process to maximize player availability and performance, whilst minimizing the risk of injury. Training harder but smarter Modern analysis methods (e.g., GPS or optical tracking) are used to enable players to meet the demands of one or more matches every week. To gain insight into the (physical) profile of players, data is collected in both training and matches. This results in a large

number of data points that are used to search for the optimal load per player. Much research has been done into the intensity and volume of training in relation to injuries. This phenomenon is known as the traininginjury paradox1 Players who are accustomed to a high(er) load over a longer period of time have a smaller chance of suffering an injury than players who are accustomed to a low(er) load. This chronic strain therefore has a protective effect. Therefore, it is very important to choose variables that you can influence in order to positively alter the training process. Considering that each of these variables can be expressed in both absolute (volume) and relative (intensity) terms, the potential number of available variables and the complexity increases. Previous research has recorded an average of 7 ± 2 variables (excluding training duration) when monitoring training.2 Therefore,

Head of Sport Science and Strength & Conditioning), FC Utrecht

the effectiveness of the monitoring is determined by the quality of the resulting decisions. According to current literature, these variables are generally reported separately, without association to the physical demands of a match.3 In an attempt to capture the complexity of the training process, the chosen KPIs are analysed in the context of match-play. For this purpose, we use a so-called multimodal mechanical approach.3 For each player the individual maximum match load is used as a benchmark. The absolute data of a training session (or match) is then displayed per KPI as a percentage of the player’s maximum capacity and physical potential. The weighted average of all individual scores then gives one total score for the volume of training (see Figures 1 and 2). This method makes it possible to combine variables with different units into one score for the volume in relation to the match load.

Photos: FC Utrecht

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football medicine & performance Figure 1: Calculation for the total volume of a training (or match)3

Figure 2: Total volume scores during the training week leading up to a match3

Based on this score, training goals and the required recovery time for a given training load are determined. By monitoring each variable separately, the contribution to the total score is made clear (see Figure 3). This ensures a targeted focus on specific variables and greater specificity of the individual training load. We do that by spreading the total volume of load over the training week. Depending on the match schedule, it is determined on which of the KPI’s the focus is (see Table 1 from part I of the article). For example, the total volume on a typical MD-3 training will be influenced mainly by the total distance and VHID due to larger relative playing areas. The other variables contribute less on this day, but are of course still trained and included in the analysis. Together with subjective scores and the principles of the periodisation model, this method of monitoring allows for data-driven decisions to be taken as to whether or not specific parameters can be over- or underloaded. The data provides important insight, but the player’s subjective wellness scores also play a big role. The effect of the same training load can, for each player, be influenced by numerous additional contextual factors, such as the perceived degree of recovery, sleep quality, stress, mood and/or possible muscle soreness. Practice shows that these factors differ on an individual basis, resulting in a different approach for each player.

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feature Figure 3: Volume scores per KPI during the training week leading up to a match3

Figure 4: Inter-match variability for 1-minute peak intensity and 90-minute absolute values7 Key Performance Indicators (KPI’s); football load • Total Distance (m): The total distance covered in all speed zones. • High-Intensity Distance (HID) (m): the distance covered between 14.4-19.7 km/h. • Very High-Intensity Distance (VHID) (m): the distance covered between 19.8-25.1 km/h. • Sprint Distance (SD) (m): the distance covered > 25.1 km/h. • Accelerations (no): the number of (explosive) accelerations > 3 m/s2. • Decelerations (no): the number of (explosive) decelerations < -3 m/s2. • Explosive Distance (EXP-D) (m): the distance covered during (explosive) acceleration or deceleration > 2 m/s2 Recently, a study4 was published in which the validity of this method is questioned. According to Weaving & Read, a statistical problem arises when variables are treated as completely independent and the possible overlap between them is not considered. However, the speed with which decisions are made on a daily basis means that there is a constant trade-off between statistically correct analyses and communicating meaningful data to coaches and players. In conclusion, future research should investigate the effect of this potential overlap on the total score. Also the relationship with subjective measures of recovery needs further attention.

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football medicine & performance Train the way you play Not only is the volume of the training week determined by the context of match-play, it is also used in designing training formats to effectively prepare players for the intensity of a match. By reproducing the match intensity, we assume that the training provides a sufficient stimulus to produce physiological outcomes that support match performance.5 Previous studies have mainly analysed total and/or average load.5,6 Furthermore, comparisons were often made between fixed time periods (e.g., m/min per 5-15 min).5 Although useful to express the tempo and speed of the game, averages have been shown to underestimate actual peak intensity by as much as 20-25%. Using averages in the planning of training may therefore lead to an increased risk of injury as players are not regularly exposed to actual match intensity.5 Since the analysis of competitive demands

has increased knowledge about match demands, it seems important to also quantify the peak intensity of varies sized games often used in training. Empirical research conducted on our own players showed that peak values for sprint distance during the most demanding minute of small-sided games was almost 9 times (!) higher than the average value. Considering this knowledge may help coaches and practitioners to design, implement, and apply conditioning drills integrating football-specific and tactical aspects (e.g., small-sided games, tactical and positional drills, transition games, etc.) and prescribe optimal stimuli to develop or maintain adaptations without exceeding the limits of physiological tolerance of the players. Taking into account the intermittent course of the game, intensity is constantly changing. For example, an increase in the duration or intensity of the actions will lead to a higher load.

Conversely, a decrease in the duration (or increase in intensity) of the intervals can also lead to a higher intensity. Because these intervals are unpredictable, the use of averages over fixed periods is likely to underestimate the actual intensity. In contrast to averages, a so-called Max Intensity Period (MIP) comprises a moving average (e.g., 1, 3 or 5 minutes). These intervals are chosen to correspond to the typical duration of training exercises. When determining a MIP, there is no predetermined start and end point over which the average is calculated. The set of points moves with time, allowing the maximum output for a selected variable to be calculated. This information provides a valuable contribution to the creation of position-specific player profiles. In this way, for the various KPIs (e.g., m/min, VHID/min, ACC/min, etc.) threshold values are determined according to the objective of the training drill. When utilised effectively MIP’s can

Figure 5: Distribution of the intensity in relation to the peak load over 1 minute8

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football medicine & performance

be an effective training and drill planning tool as it allows coaches and practitioners to run drills that accurately replicate match demands for the specified drill time. Research in the Italian Serie A has shown that the 1-minute peak intensity varies on average by 13% across different matches. This is comparable to the variability of absolute values for total distance, HID, VHID, accelerations and decelerations. For sprint distance, a significantly lower variability was found (see Figure 4). In conclusion, the results for the MIPs are therefore only slightly affected by variability and can be interpreted with confidence to set training goals.7 Theoretically, the maximum intensity during a match occurs only once or at most a few times. Recent research in the Australian football and rugby league has shown that the intensity in relation to the peak load over 1 minute follows a normal distribution. The greatest volume of intense activity during a match is around 60% of the maximum intensity (see Figure 5). This distribution of physical activity relative to the maximum intensity helps to more accurately prescribe the optimal training load rather than simply using the maximum values as a guideline. Thus, with respect to the different training days, training for the worst-case scenario is only a part of the entire programme. The highest intensity is generally found on MD-4, MD-3 and MD+1 (for the substitutes to mimic the match load)9. This way, players have enough time to recover before the next match. Conclusion The importance of training monitoring

in professional football cannot be understated, and is a prerequisite to high performance, injury prevention and increasing overall player availability. Training monitoring is a complex process that requires practitioners to factor in many variables such as its ability to reliably and accurately quantify the training dose of each player. There are a variety of ways in which teams can monitor their players, with advantages and disadvantages to each. Understanding what needs to be achieved to positively alter the training process and inform key stakeholders will assist in deciding what approach suits your club most. Therefore, the effectiveness of the monitoring is determined by the quality of the resulting decisions. Where possible, applying a more individualised approach to monitoring is considered advantageous. It is recommended that an evidence-based approach, combined with craft knowledge and an understanding of training be used to formulate best practice monitoring approaches.

Rainer van Gaal Appelhof is the current head of sport science and strength & conditioning at FC Utrecht. He has spent over six years with the 1st team and is responsible for overseeing the football performance elements of the first team. Optimal planning and delivery of evidence-based S&C, both on and off the field, translating data and making objective decisions about players and training combined with a strong connection to the coaching staff are key roles of his current position. Rainer obtained a master’s in human movement sciences (majoring in training & coaching football) from the Catholic University of Leuven whilst holding accreditation with the Australian Strength and Conditioning Association (ASCA), and a UEFA A Elite Youth Coaching licence. Questions or comments? Email to r.vangaalappelhof@fcutrecht.nl

References 1. Gabbett TJ (2016). The training-injury prevention paradox: should athletes be training smarter and harder? British Journal of Sports Medicine, 50 (5), 273-280. 2. Akenhead R & Nassis GP (2016). Training load and player monitoring in high-level football: current practice and perceptions. International Journal of Sports Physiology and Performance, 11, 587-593. 3. Owen AL et al. (2017). A contemporary multi-modal mechanical approach to training monitoring in elite professional soccer. Science and Medicine in Football, 1 (3), 216-221. 4. Weaving D & Read DB (2021). Re: A contemporary multi-modal mechanical approach to training monitoring in elite professional soccer: A statistical problem? Science and Medicine in Football, in press, doi: 10.1080/24733938.2017.1334958. 5. Novak AR et al. (2021). Analysis of the worst-case scenarios in an elite football team: Towards a better understanding and application. Journal of Sport Sciences, 39 (16), 1850-1859. 6. Wonwoo J et al. (2022). Contextualised peak periods of play in English Premier League matches. Biology of Sport, 39 (4), 973-983. 7. Riboli A et al. (2021). Effect of formation, ball in play and ball possession on peak demands in elite soccer. Biology of Sport, 38 (2), 195-205. 8. Johnston RD et al. (2020). The distribution of match activities relative to the maximal mean intensities in professional rugby league and Australian football. Journal of Strength and Conditioning Research. In press, doi: 10.1519/ JSC.0000000000003613. 9. Oliva-Lozano JM et al. (2021). Effect of training day, match, and length of the microcycle on the worst-case scenarios in professional soccer players. Research in Sports Medicine, 4, 1-14

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“Any practitioner wanting to enter the volatile, uncertain, complex and ambiguous world of professional football at any level; senior ladies, men’s or Academy would greatly benefit from undertaking this course. I would suggest any Head of Performance in bigger organisations may “enrol” new practitioners on this course and ask for their written learning outcomes… A start of formal reflective practice, CPD & an annual review.” Grant Downie OBE, Consultant in Medicine & Performance Solutions This unique course is designed for new graduates and those entering into a professional sports arena for the first time. The course is designed to prepare prospective employees in those areas that are specific to a Club environment.

“The MPA diploma is an excellent resource and qualification to help newly graduated practitioners with the transition into professional sport. Bridging the gap between formal education and the practicalities of the industry.” Russ Wrigley, Head of Academy Sports Science & Medicine, Blackburn Rovers FC

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MPA DIPLOMA PREPARATION FOR WORK IN PROFESSIONAL FOOTBALL Completing the Medicine and Performance Association (MPA) Diploma demonstrates a real commitment to engage with and fully understand the role of practitioners working in the unique environment of an MDT within professional football. Contact us at: admin@sportsmpa.co.uk 0333 4567897

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RELATIONAL PERFORMANCE: A MODEL & TOOL FOR THE TEAM BEHIND THE TEAM FEATURE / DAVID CLANCY BSC, MSC

Director and Co-Founder The Nxt Level Group

“Don’t listen to the person who has the answers; listen to the person who has the questions” Albert Einstein, Physicist and founder of the theory of relativity Introduction – the landscape How we interact with each other matters. How well we get along matters. Small talk matters. Getting people to work better together is at the heart of high performing football teams, inside and outside the dressing room. The question is, can we transform high potential individuals (staff and players) into accomplished individuals, using their talents and strengths to the utmost? That’s a challenge we must welcome with open arms. This article will unpack the scientifically informed and case-evidenced model of relational performance, which targets the environment and culture. Then, we will pivot to look more at the individual - where we will look at interdisciplinarity as a principle to adopt and understand why the soft skills are difference makers. This will be theoretical and strategic, but also, practical, and tactical. Investing in your people When it comes to football medicine and performance, rather than just looking at strength and speed benchmarking as an example, performance in football teams is a complex amalgam of physiotherapy, psychology, strength and conditioning, nutrition, sports science, wellbeing, sports medicine, physiology and so much more. To get the most from our footballers, considering their wellbeing, we must look at the sum of the department being greater than its parts (which is often not the case). This is not a linear process; often, this is an elegant dance of disparate elements that, when aligned properly, will unlock the full potential of the talent of the backroom team. The challenges and demand of the dynamic, modern football game are colossal, for players, but also for the team behind the team. This is why relational performance is needed as a lever mover. The ability to build meaningful connections,

collaborate, feel included, challenge one another, and learn is key. Professor and author Brené Brown once proclaimed – “I define connection as the energy that exists between people when they feel seen, heard and valued; when they can give and receive without judgement; and when they derive sustenance and strength from the relationship” (“Power of Connectedness - The Kim Foundation”). Connection. Relationships. Heard and valued. These words need re-emphasising. These are arteries that lead to sustained high performance. There is widespread awareness in the modern sports workplace of the importance of nurturing and enhancing wellbeing, career direction and fulfillment. A plethora of data point to the link between staff wellbeing with a team and a host of positive outcomes, at both the individual and organisational level: lower attrition, increased retention, enhanced productivity, more innovation, boosted creativity, and greater satisfaction, among others. Prestigious publications like Harvard Business Review and McKinsey & Company are spreading the message everywhere that investing in people more is not only worthwhile, but essential for success at a football club. Furthermore, investing in the people that are trying to get the best out of the footballers is a difference maker. The environment – why social wellbeing for a football team? Social capital is the glue that holds football teams and enduring cultures together. It is the presence of networks, healthy relationships, shared values, matching behaviours and a sense of belonging, a word popularised by culture architect and author Owen Eastwood, who has worked with the FA. Strong ties can improve retention and reduce burnout, heighten motivation amongst staff, and ignite engagement cross-departmentally, which is vital for player care. The current landscape

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in performance departments across professional sports, football included, is rife with examples of overwhelm and competitive pressure, chronic levels of stress and anxiety, a lack of cohesion and healthy team dynamics, low trust, misaligned communication channels, a lack of empathy and insufficient psychological safety. “All of our success is tied together. None of us are at this alone. We are allowed to make mistakes and be uplifted by others. We have a responsibility to support and uplift others. It’s more so about connecting with people at the right time, having the right information first, serving their needs, and then nudging towards whatever the process needs to look like’’, said John Wagle, Director-Performance Science and Player Development of the Kansas City Royals, now University of Notre Dame Fighting Irish (Portch, J., 2022). There is uncertainty around cohesion, collaboration, and trust. Another factor is the social element that builds connections, and is an antecedent to improved relationships across departments, where player availability is gold. This brings up questions like, how do we rely on a colleague if I feel their ego constantly gets in the way? How can we keep our top physiotherapist talent by knowing them better? Does this organisational design lend itself to clear, streamlined decision making processes? Do we have sufficient delineated support structures for our coaches, and are they involved in performance department appraisals and change? How do we build our performance department for sustained success, and which is highly functional? Sustained is a key hinge here. Defining Relational Performance Wellbeing and performance are inextricably linked, and creating a higher performing football team must involve relational performance (RP), defined as “thriving and achieving through teamwork”. Elements of RP are key contributors to high performance (Burns et al., 2019),

football medicine & performance and help protect organisational culture, transformational leadership, and access to social support (Hill et al., 2021). RP could induce positive physiological changes in response to stress (Coan et al., 2006), and improve the effectiveness of multidisciplinary player and organisational support teams (Sporer et al., 2018). Furthermore, there are various aspects of RP that filter into the meta trigger for group flow, or peak performance experiences, an area studied and taught by peak performance thought leaders like Steven Kotler, Rian Doris, Jamie Wheal and Dr Michael Gervais. Shared goals, improved openness to challenge, shared vulnerability, constant communication, clarity on direction, close listening, and balance, are major characteristics of group flow dynamics (Pels et al., 2018). An increased feeling of trust, heightened team symphony, coordination dynamics and interactional synchrony, the propensity for overall improved stability, a sense of increased safety and an atmosphere of benevolence have all been reported with teams we have worked with who focus on relationships (Clancy, 2023). The operating system of RP Relational performance (see Figure 1) works at three distinct levels, namely individual, team, and organisational (sport, or business), and forms four complementary, and equally important domains: boldness, cohesion, communication, and psychological safety (see Table 1 for definitions).

Concept

Figure 1: Relational performance wheel©

Domain Boldness “Thinking and acting beyond existing organisational limits”

Relational Performance “Thriving and achieving through teamwork”

Cohesion “Working with unity and commitment towards a common goal”

Communication “Exchanging information and ideas efficiently and effectively”

Psychological Safety “Sharing ideas, questions, or concerns without interpersonal fear”

Component

Definition

Adaptability

Adjusting to different conditions or circumstances

Ambition

Strongly desiring a goal or objective

Innovation

Generating new ideas, concepts, things, etc

Resilience

Overcoming unexpected change or adversity

Stability

Working with the same people for a sustained time frame

Collaboration

Working well with others to achieve a shared outcome

Shared Purpose

Embracing and pursuing a common objective

Teaming

Collaborating and coordinating to get important things done

Pathways

Having multiple means to exchange information

CQ/EQ

Possessing high cultural and emotional capabilities

Learnability

Becoming familiar with new content with ease and speed

Openness

Being receptive to new ideas, opinions, or arguments

Belonging

Feeling accepted and valued

Inclusion

Respecting everyone’s needs, perspectives and potential

Trust

Being accountable to and supportive of each other

Vulnerability

Willingness to express genuine thoughts and feelings

Table 1: Relational performance definitions

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feature The RP domains can be assessed, developed, and monitored using the bespoke Relational Performance Questionnaire (RPQ), thereby allowing any organisation to augment relational performance and, subsequently, individual, team, and organisational performance (for more information on RP or to administer the RPQ with your team, please contact the author directly – IP of Hauora Ltd., 2023). The individual - in and out of your lane As naturalist Charles Darwin wrote in his book The Descent of Man (1871), “Ignorance more often begets confidence than knowledge”. We must bear in mind that our circle of competence only extends so far, and thus we must accept the fact we do not always have all the answers. In each situation, it is critical to be aware of other people’s circles in your department and who have invested time, energy, and resources into their circle. The extraction of that information when used correctly could make the difference for a player to return to the pitch quicker than expected from a hamstring injury for example. Knowing how to navigate your circle (‘stay in your lane’), and others is a difference maker; also, when to move ‘outside your lane’ if you can be effective and it is called for. Understanding clearly what is in your lane and outside your lane is an elementary self-awareness building block to

succeed in a high performing football team. We can all think of scenarios where someone we worked with let ego come to the table too much; it was not about competence, but this can still lead to blind spots and dysfunction in the team behind the football team. We need to know what we lack knowledge and skill wise, show vulnerabilities and a willingness to learn and improve. This will help drive better decision-making processes, enhance outcomes and communication channels for our players. An important aside – building the role toolkit Each team member must be given tools to excel in their specific roles, be it the physiotherapist devising more innovative and effective recovery protocols, the sports scientist evaluating their data using latest systems, or the performance nutritionist discerning and iterating a dietary plan based on Ramadan. When each cog in the machine is performing at its best, the entire machine runs more smoothly, creating a potential path for fewer games lost to injury, and a greater likelihood for more wins on the pitch. Teamwork across disciplines The terms multidisciplinary, interdisciplinary, and transdisciplinary are increasingly used in the scientific literature, but are ambiguously

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defined and used interchangeably, which is confusing. Multidisciplinarity takes knowledge from varying disciplines - but stays within certain, determined boundaries. Interdisciplinarity harmoniously links different disciplines into a coordinated and coherent whole. Transdisciplinarity integrates the natural, social and health sciences in a humanities context, transcending traditional boundaries (Choi and Pak, 2006, and “Transdisciplinarity - an overview | ScienceDirect Topics - PubMed”). Multiple disciplinary teamwork has both benefits and drawbacks and is worth considering in a football performance department. In this article we will look a little deeper at interdisciplinarity. Learning soft skills from being more interdisciplinary minded The art. The science. We are not taught this in university and third level institutions, nor in clinical placements or postgraduate courses, but this really matters. The soft skills are typically only learned experientially or by mentorship - and that is why The Learning Physiotherapist was created as a soft skills catalyst. “Science is much more than a body of knowledge. It is a way of thinking”, astronomer and astrophysicist Carl Sagan said. Interdisciplinary practice involves

football medicine & performance applying knowledge, systems, and processes from different disciplines to help rectify complex problems, such as looking after a footballer during a rehabilitation pathway. Soft skills, or real skills as marketing expert and author Seth Godin calls them, refer to personal attributes and social capabilities that enable individuals to interact effectively with others, leading to a greater propensity towards improved performance in a team-based setting. Interdisciplinary practice requires individuals to have robust, well versed soft skills. Elevated levels of competence in communication, collaboration, empathy, adaptability, and critical thinking are prerequisites to thrive in this working environment. When working in interdisciplinary teams and smaller units, individuals need to be able to have open and constructive dialogue with team members from divergent backgrounds, understand and appreciate cognitively diverse perspectives, and be willing to adapt their approach to accommodate different thinking approaches. Interdisciplinary practice often involves working in complex, ever evolving and dynamic environments, where problem-solving requires the ability to think analytically, creatively, and independently. Soft skills such as emotional intelligence, adaptability, and antifragility, are essential for individuals to flourish in such environments. Interdisciplinary practice and soft skills are like siblings; individuals who have exemplary soft skills are better equipped to work cohesively in interdisciplinary teams, embrace different perspectives and contribute to solving complex rooted problems. Change agency The transtheoretical model of behaviour change (see Figure 2) assesses an individual’s readiness to act on a new healthier behaviour, habit, and supplies strategies, or processes of change to illuminate a path for an individual (Hashemzadeh et al., 2019). The model is composed of elements considering self-efficacy, stages of change, change processes, levels of change, and decisional balance. Conclusion – using relational performance Change is inevitable in the highly competitive and complex football arena. Managers are moving around at an alarming rate. Performance and medical departments are restructured

Precontemplation

Maintenance

Contemplation

Action

Preparation

Figure 2: Transtheoretical model of behaviour change • Precontemplation: No recognition of interest or need for change • Contemplation: Thinking about changing • Preparation: Getting ready to change • Action: Taking a step forward • Maintenance: Ongoing practice of new habits and behaviours Answer the three questions below to function as a catalyst for change: 1. How does reviewing this model inform any of your prior professional efforts to change? Use a specific and tangible example. 2. What stage are you at now for a current project? 3. What immediate actions could you take to progress the stage of that project? Use this model to reflect on where you are in terms of your current level in football medicine and/or performance, to embrace positive change.

nearly every off-season, and players are constantly moving clubs. The ability to navigate this change, welcome and leverage it, and in-turn, remodel is what separates the best from the rest. Relational performance is a model but also a practical tool to expose the strengths and gaps in a football medical and performance ecosystem, leading to an ability to adapt, pivot and grow. By recognising the domains of boldness, psychological safety, cohesion, and communication a football team can thrive and achieve through mutual respect, teamwork, interconnectedness and ultimately, high performance.

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Interdisciplinary thinking encourages the blending of different disciplines in a department, putting high value on compassion, emotional intelligence, and openness, as examples. This can lead to more innovative solutions and schemas when facing complex problems. Highly proficient soft skills are at the heart of this approach, driving clearer communication, sharpened decision-making progressions and a better ability to adapt…key ingredients for success. These will be compounded when discussions around circles of competence and role toolkits are commonplace. An awareness and understanding of the

feature transtheoretical model of behavioural change will help one assess readiness to implement change, and the necessary steps needed to make that change, an area often poorly judged and mismanaged in football. To take your team to the next level, one must look at team relationships, connections, and performance, not only an individual’s performance (this relates to off the pitch context). Investing more in the people who look after the player will help create an environment where everyone can thrive which will ultimately lead to fewer injuries, possibly more wins on the pitch and a culture that embodies an ethos of teamwork. A culture where everyone belongs, feels seen, valued, and heard can be a powerful cocktail, to unlock the full potential of the team behind the team. The challenge is significant but with a clear focus on relational performance, the rewards can be transformative. The journey towards high performance must start with building meaningful connections and those connections start with us. They start with you. As John Donne said, “No man is an island, entire of itself; every man is a piece of the continent, a part of the main” (“No Man Is an Island: Meaning & Context”).

football medicine & performance Key takeaways 1. Relational performance can be potent: fostering an environment in the team behind the team, where individuals feel included, and part of the journey is crucial. Emphasizing boldness, cohesion, psychological safety and communication, and the underlying components can help a more supportive atmosphere to drive better team performance, on and off the pitch. 2. Interdisciplinarity and soft skills: the value and practice of interdisciplinary thinking, along with the sharpening up of the soft skills skillset is essential in the multifaceted, highly demanding world of football, where success is driven by a plethora of factors. 3. Accept and understand change with a positive mindset. Reflecting on and navigating the distinct stages of change will help with the adoption of healthier behaviours and habits to move in the right direction. Change, when embraced and understood strategically and tactically can ignite continuous learning and talent development. Reflective practice 1. Name one thing you have learned from this article. 2. Name one thing you will start now based on this article. 3. Name one area you will dig deeper on based on this article.

John Donne

Acknowledgements I would like to thank several people who have influenced this article (in no order) - Mike Davison, Carl Gombrich, Ciaran Dunne, Rachel Sheehan, Jamie Wheal and Steven Kotler. References Burns, L., Weissensteiner, J. R., and Cohen, M. (2019). Supportive interpersonal relationships: a key component to high-performance sport. British Journal of Sports Medicine. 53: 1386–1389. Choi, B., and Pak, A. (2006). Multidisciplinarity, interdisciplinarity and transdisciplinarity in health research, services, education, and policy: 1. Definitions, objectives, and evidence of effectiveness. (“Multidisciplinarity, interdisciplinarity and transdisciplinarity in health research, services, education and policy: 1. Definitions, objectives, and evidence of effectiveness”) Clin Invest Med. 29(6): 351-64. Clancy, D. (2023). Relational Performance (RP): A Cultural and Strategic Competitive Advantage – white paper for Magnum Opus, High Flow Coaching, Flow Research Collective. Coan, J.A., Schaefer, H.S. and Davidson, R.J. (2006). “Lending a hand: Social regulation of the neural response to threat.” (“Lending a hand: social regulation of the neural response to threat”) Psychological science, 17(12), pp.1032-1039. Hashemzadeh, M., Rahimi, A., Farashbandi, F., Naeini, A., and Daei, A. (2019). Transtheoretical Model of Health Behavioral Change: A Systematic Review. Iran J Nurs Midwifery Res. 24(2): 83-90. Hill, D. M., Brown, G., Lambert, T.-L., Mackintosh, K., Knight, C., and Gorczynski, P. (2021). Factors perceived to affect the wellbeing and mental health of coaches and practitioners working within elite sport. Sport Exerc. Perform. Psychol. 10: 504–518. Pels, F., Kleinert, J., and Mennigen, F. (2018). Group flow: a scoping review of definitions, theoretical approaches, measures, and findings. (“Group flow: A scoping review of definitions, theoretical approaches ...”) PLOS one. 13(12) Portch, J. (2022) Leaders Performance Podcast - Ultimately leadership is about influence - it’s not about who takes the most action’ [Podcast]. 17 July 2022. Available at https://leadersinsport.com/performance-institute/articles/leaders-performance-podcastultimately-leadership-is-about-influence-its-not-about-who-takes-the-most-action/ Sporer, B.C. and Windt, J. (2018). Integrated performance support: facilitating effective and collaborative performance teams. British Journal of Sports Medicine, 52(16), pp.1014-1015.

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football medicine & performance

FROM SCOTTY DOGS TO BIRD DOGS & MORE: REHABBING PARS INJURIES BACK TO THE PITCH FEATURE / ED CLARKE Introduction If you work with adolescents, particularly athletic youngsters, you should be aware of pars interarticularis injuries. The pars interarticularis is the segment of bone bounded by the lamina, pedicle, inferior articular process, and superior articular process of each vertebra1. Research over the last 35 years has shown that adolescents involved in activities that involve repetitive extension and combined extension and rotation2,3 are at higher risk of experiencing this injury. Therefore, it is no surprise that athletes are at a higher risk than the general population1,4. It is thought that the repetitive movements mentioned above cause stress reactions in the pars interarticularis portion of the vertebrae which without appropriate activity modification can lead to acute fractures (spondylolysis) and eventually chronic

Lead U21 Physiotherapist, Chelsea FC

fractures5. Once it has reached the fracture stage of the continuum, this gives rise to the “scotty dog sign” on a lateral view x-ray (Figure 1). The majority of spondylolysis occurs in L5, followed by L4, then combined L4-L5 involvement1. Given the above, a pars injury should be high up on the list of possible diagnoses whenever you see an active teenager with low back pain. If their symptoms persist despite offload or recurrently flare when returning to activity, specialist opinion should be sought. They can organize the appropriate imaging to confirm the severity of the injury and determine the necessary offload from sport and physical activity.

Figure 1: X-ray of the lumbar spine (lateral view) showing a spondylolytic defect. Tawfik et al.

This piece will focus on the rehabilitation of these injuries within an Academy football environment following an agreed period of rest from sporting activities.

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Control Challenge control in a variety of positions

Endurance Increase duration of holds and/or number of reps

Strength Progressive overload

RFD Train along the force / velocity curve

Figure 2: An illustration of the progression of gym based rehabilitation.

Assessment Whilst imaging will confirm the diagnosis, it is still important to establish the factors that might have contributed to the injury. Establishing what the main aggravating or provocative movements have been will give you a good start. From there, your physical assessment will help identify any restriction in range of movement in the lumbar spine and surrounding joints with hips and thoracic spine being key areas in the author’s experience. Observing and/ or videoing the athlete perform a range of movement patterns can highlight what aspects need particular work to improve. Gym based rehab With the gym-based component of rehabilitation of this injury, I like to think of it as layering components of muscular function on top of one another (figure 2). Each component, once developed, works in synchrony with the others. Particular exercises will be able to be used to work on more than element whilst certain aspects may require very specific exercises or movements. Although these exercises will be performed in the gym, it’s important to keep the end of goal of what sports and activities the athlete will be returning to in mind. It’s also important to identify the key movement patterns that need re-training. A diverse programme is likely to cover most bases, but it is important to be specific to the player’s needs. For example, most players with this issue will benefit from controlling movement in all planes. But there is likely to be one or more directions that needs particular focus (e.g., anti-extension) and you should bias

your exercise selection and programming accordingly. The foundation for a successful rehabilitation is built in developing the athlete’s lumbopelvic control. Depending on the outcome of your assessment, it is likely to involve working on spinal dissociation and the ability to resist extension, rotation, and/or side flexion. Initially this might be focused on static positions, but it is useful to assess this capability in dynamic positions early on. Whilst Pilates based exercises and other mat based variations can be useful, I like to include standing work from day one. This might be in the form of supported leaning tower drills, pallof press variations, or standing rows (figure 3).

It is often not necessary to change exercises to develop strength and endurance. I tend to focus on endurance earlier in the rehab process as I want the players I am working with to be able to maintain control during sporting activities that may last close to two hours. Because of this, fatigue resistance is an important quality to develop. Strength is important to develop to ensure that the high forces involved in sporting activity can be resisted. By progressively overloading specific movement patterns you will help the athlete to cope with the demands of their sports. Ensure that the different positions that the athlete will find themselves in their sport are being addressed. Multi-directional lunge variations, step ups, and deadlifts are just a few to consider but don’t forget running specific postures. An often neglected, but extremely important, component of gym-based rehabilitation is to program exercises that develop power. A high rate of force development (RFD) is important in athletic tasks and the patient needs to be exposed to this in a progressive manner during their rehab to ensure that their body is used to working at high velocities. Examples include slams, throws, and catches in different positions when appropriate.

Figure 3: An example of a standing stability exercise

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Running & Football based Rehab Reduced weight bearing running and sport/functional drills play a key part in getting the player comfortable and confident with sport specific movements.

football medicine & performance Figure 4: Example of a hydrotherapy exercise

If you are lucky enough to have access to a hydrotherapy pool, Alter G treadmill or similar then you can start running with a significant percentage of bodyweight offloaded. A walk / run programme can commence with the run component initially being relatively slow and the overall volume of the session low. Over time you can manipulate the key variables – weight bearing, speed, and volume. I consider it almost like an equalizer where you may have to reduce one or two variables when progressing another and looking to avoid progressing them all in one go.

their spines – seem to prefer the multidirectional nature of pitch-based sessions to the extension biased treadmill running.

modified training. Matt Taberner’s work does a great job at outlining a framework for this7.

In my experience, an average time frame of 6 weeks is usually advised to progress through reduced weight bearing modalities, onto the grass and then into modified training. This can be quicker if the injury has been a stress response rather than fracture, or longer if there are any potential complicating factors.

The modifications used are often a combination of additional recovery day(s) across the week, sometimes transitioning as far back as to a one day on/one day off schedule, and modified participation in particular drills that the team have identified as being more challenging for the injured player (e.g. intense 1v1s).

To successfully return the player to training, you must have objective targets that are related to what they will be returning to. It will be no surprise that a player returning to U21 training will need to be able to cope with much higher physical demands than that of an U16 and the rehab will need to reflect that. The first goal is to gradually build volume, and this usually starts with one day on grass followed by an indoor recovery day. Once the player can tolerate a sufficient amount of volume – active duration and GPS markers such as total distance and distance per minute can be useful to guide this – then we progress to add blocks of higher intensity work. Here the player gets exposure to higher numbers of good quality accelerations and decelerations, as well as a progressive reintroduction to high-speed work. This is initially in the form of more controlled work before progressing to more reactive work and position specific drills towards the end stage of outdoor rehabilitation in preparation for returning the player into

If you have access to a pool with a varied or adjustable depth, multi-directional work can take place to help the player’s body start to adapt to the specific demands these movements place in a reduced weight bearing environment. This can involve reactive work in the latter stages as well as throwing and catching a ball even if they usually use their feet!

Conclusion - Have a high index of suspicion for Pars articularis injuries in the adolescent athlete complaining of extension related low back pain. - Have a low threshold for imaging and specialist input as necessary if this persists despite offload or flare ups quickly and/or repeatedly. - Work on establishing movement competency and capacity in the gym whilst gradually building running and football-based loading after an appropriate period of offload. - Modify the players training schedule on RTT in the short term to allow them to return to football without a spike in load. References 1. Tawfik, Samuel, et al. “The incidence of pars interarticularis defects in athletes.” Global Spine Journal 10.1 (2020): 89-101. 2. Letts, Merv, et al. “Fracture of the pars interarticularis in adolescent athletes: a clinical-biomechanical analysis.” Journal of pediatric orthopedics 6.1 (1986): 40-46. 3. Jackson, Douglas W., et al. “Stress reactions involving the pars interarticularis in young athletes.” The American journal of sports medicine 9.5 (1981): 304-312. 4. Sundell, C-G., et al. “Clinical examination, spondylolysis and adolescent athletes.” International journal of sports medicine (2012): 263-267.

The weight bearing percentage on the Alter G can be easily progressed over a timescale that fits with the player’s rehab plan. It is worth noting that there is research (albeit in the lower limbs) to suggest that increasing the running speed has a bigger impact on joint loading than increasing weight bearing6. This takes us back to my earlier point about being mindful not to increase weight bearing, speed, and volume all at the same time.

5. Hollenberg, Gary M., et al. “Stress reactions of the lumbar pars interarticularis: the development of a new MRI classification system.” Spine 27.2 (2002): 181-186. 6. Thomson, A., et al. “Running speed increases plantar load more than percent bodyweight on AlterG treadmill.” Journal of Science and Medicine in Sport 19 (2015): e57-e58. 7. Taberner, Matt, Tom Allen, and Daniel Dylan Cohen. “Progressing rehabilitation after injury: consider the ‘control-chaos continuum’.” British Journal of Sports Medicine 53.18 (2019): 1132-1136.

Once the player has progressed to 90-95% weight bearing then they can transition to pitch based work. Players – and

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THE INFLUENCE OF PHYSICAL PERFORMANCE ON TECHNICAL AND TACTICAL OUTCOMES IN THE UEFA CHAMPIONS LEAGUE FEATURE / DR JAMES J. MALONE Introduction Football is a multifactorial, complex sport that requires high levels of technical, tactical, physical and psycho-social qualities1. Successful match performance is highly dependent on the interaction between these factors2. Interestingly, although technical-tactical performance (TP) are considered decisive for success in football, physical performance (quantified by running performance (RP) such as total distances covered in various speed zones) are more commonly investigated3,4. The interest in RP has led to practitioners emphasizing the importance of highintensity running when designing training programmes in order to enhance overall performance. However, the current research remains equivocal regarding

Senior Lecturer in Coaching Science Liverpool Hope University

the high-intensity distance covered and success in football. For example, some research has demonstrated that football players perform significantly lower amounts of high-intensity running when winning than when compared to losing situations5–8. Conversely, other studies report no differences in highintensity running regardless of the match outcome9–11.

in professional football12,13. Previous research has suggested that top-ranked teams have greater amounts of ball possession in the opponent’s half, number of passes in the final third of the field and overall time in possession14,15. Furthermore, significant differences in total shots, shots on target and crosses were evidenced between successful and unsuccessful teams16.

The inconsistencies in these findings suggests that utilizing success indicators, such as match outcome and position within the league table, may not be suitable to determine how RP influences success in football. The use of TP variables, such as passes and shots, are considered essential for match success

Therefore, the purpose of the present study was to identify differences in TP between teams covering high and low RP during the UEFA Champions League (UCL) matches. Initially, we hypothesized that teams covering high RP at highintensity will be more successful (i.e., will achieve greater TP).

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football medicine & performance Methods The sample comprised 547 individual match observations of 378 outfield players (excluding goalkeepers) which were members of 24 teams that competed in the group stage of the UEFA Champions League (UCL) in the 2020/21 season. To identify association between teams’ RP and TP, individual players’ performances were jointly evaluated into the teams’ performances, and used as cases in this study. All data were recorded using a multicamera, semi-automatic optical tracking system (InStat Fitness, Instat Limited, Limerick, Republic of Ireland). This system includes 3 static cameras installed on the roof of the soccer stadium. The system has a sampling frequency of 25 Hz and has previously received ‘FIFA Quality’ status as part of the test protocol for Electronic and Performance Tracking Systems (EPTS) validation (authorization number: 1007382), demonstrating high levels of absolute and relative reliability. We observed the overall RP and RP when the team was in ball possession. The

variables included total distance (TD), high-intensity running (> 19.8 km/h) (HIR), total distance when in ball possession (TDB), and highintensity running when in ball possession (> 19.8 km/h) (HIRB). The TP variables and associated definitions are presented in Table 1. The Kolmogorov–Smirnov test revealed that all data were normally distributed (all K-S p > 0.05). Homogeneity was confirmed using Levene’s test. The statistical analyses were performed throughout several phases. As a preliminary analysis, we correlated TP and total group points at the end of the group stage to evaluate the validity of TP variables as benchmark of success in the UCL. For this purpose, we performed multiple regression analysis with TP as a predictor and total group points at the end of the UCL group stage as the criterion. We computed and reported multiple correlations (multiple R) and coefficients of determination (R2). Next, we classified teams into the two groups (low performance/high performance) according to their RP using the k-means cluster analysis method. Two clusters for each RP variable identified teams covering

(i) low and high TD, (ii) low and high HIR, (iii) low and high TDB, (iv) low and high and HIRB. Afterwards, a series of linear mixed models were developed to identify differences in team TP according to their RP, considering the team identity to account for repeated measures (i.e., random effect). The 95% confidence intervals were computed to assess the precision of the estimates. The t-statistics from the mixed models were converted into Cohen’s d effect sizes and interpreted as < 0.2, trivial; 0.2–0.6, small; 0.6–1.2, moderate; 1.2–2.0, large; > 2.0, very large17. Finally, Pearson’s correlation coefficients were computed to establish direct association between team TP and RP, With the r coefficient classification as previously suggested: r < 0.35 indicates a low or weak correlation, r = 0.35 to 0.67 denotes a modest or moderate correlation, r = 0.68 to 0.9 implies a strong or high correlation, and r > 0.90 refers to a very high correlation18. All analyses were performed using SPSS software (IBM, SPSS, Version 25.0), and the significance level was set to p < 0.05.

Table 1: Technical-tactical performance variables and their definitions. Goal chances

Number of created goal chances, finished with a shot or without a shot.

Shots

Total number of shots to score.

Shots on target

Number of shots within a goal.

Passes

Total number of passes.

Accurate passes

Total number of accurate passes.

Key passes

Passes to a partner who is in a goal scoring position (i.e., one-on-one situation, empty net, etc.) And passes to a partner that “cuts off” the whole defensive line of the opponent’s team (3 or more players) in the attacking phase.

Key passes accurate

Total number of accurate key passes.

Crosses

Number of long passes performed by a player from an offensive zone (last 40 m of pitch between the short side of the penalty area and the lateral side of the field) and directly to the penalty area.

Crosses accurate

Total number of accurate crosses.

Counter attacks

Open play attack after the opponent team loses the ball (a counterattack lasts no longer than 20 sec, and the speed of moving to the target in a counterattack is not less than 3 m/s).

Counter attacks with a shot

Counterattacks that include shots toward the goal.

High pressing

Total number of collective attempts to force the opponents to lose the ball or to stop the development of an attack on the opponent’s half of the pitch.

High pressing success

Number of successfully performed high pressings.

Low pressing

Total number of collective attempts to force the opponents to lose the ball or to stop the development of an attack one one’s own half of the pitch.

Low pressing success

Number of successfully performed low pressings.

Tackles

Active action of a player who tries to tackle the ball from the player possessing it.

Tackles successful

Total number of successful tackles.

Entrances to the opponent’s box

Number of entries into the opponent’s penalty area.

Total actions

Total number of all types of actions (including passes, crosses, set pieces passes, tackles, challenges, shots, etc.).

Successful actions

Total number of successful actions.

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feature Table 2: Multiple regression calculation for total points earned at the end of the group stage of UCL. β

Std.Err. β

Intercept

Std.Err. B

10.85

8.19

1.33

0.20

Goal chances

-0.72

0.48

-1.06

0.70

-1.51

0.15

Shots

0.41

0.38

0.42

0.39

1.08

0.29

Shots on target

0.08

0.28

0.16

0.59

0.28

0.78

Passes

-0.31

4.93

-0.01

0.17

-0.06

0.95

Accurate passes

2.30

5.44

0.08

0.20

0.42

0.68

Key passes

0.79

0.39

0.93

0.46

2.02

0.06

Key passes accurate

-0.16

0.50

-0.33

1.00

-0.33

0.74

Crosses

-0.17

0.36

-0.11

0.22

-0.47

0.64

Crosses accurate

-0.33

0.30

-0.56

0.51

-1.10

0.29

Counterattacks

0.12

0.23

0.14

0.26

0.52

0.61

Counter attacks with a shot

0.20

0.19

0.09

0.08

1.07

0.30

High pressing

-0.34

0.36

-0.39

0.41

-0.95

0.35

High pressing successful

0.43

0.40

0.71

0.64

1.10

0.29

Low pressing

-0.38

0.25

-0.43

0.28

-1.55

0.14

Low pressing successful

-0.14

0.26

-0.30

0.56

-0.53

0.60

Tackles

-0.33

0.19

-0.23

0.13

-1.70

0.11

Tackles successful

0.59

0.24

0.76

0.31

2.49

0.02

Entrances to the opponent’s box

0.27

0.40

0.19

0.28

0.69

0.50

Total actions

-0.26

2.60

-0.01

0.09

-0.10

0.92

Successful actions

-1.54

3.54

-0.05

0.12

-0.44

0.67

0.84

0.71

0.03

Intercept – interception coefficient, β – standardized regression coefficient, B – non-standardized regression coefficient, R – coefficient of the multiple correlation, R2 – coefficient of determination

Results The TP variables as predictors were significantly correlated with total points earned at the end of the group stage as criteria, demonstrating the appropriate validity of herein studied TP as a benchmark of success in the group stage of the UCL. In brief, the predictors explained 71% of the criterion’s variance (Table 2). Average values of teams covering low (L-TD) and high (H-TD) TD were 113,105 ± 2797 m (range 105,653– 116,482 m, n = 22) and 120,141 ± 2332 m (range 116,991–125,258 m, n = 18), respectively. Average values of teams covering low (L-HIR) and high (H-HIR) HIR were 8565 ± 631 m (range 6995–9327 m, n = 17) and 10,321 ± 761 m (range 9541–12,200 m, n = 23), respectively. Average values of teams covering low (L-TD) and high (H-TD) TDB were 30,613 ± 4613 m (range 23,281–37,593 m, n = 19) and 46,359 ± 5806 m (range 39,132–63,098, n = 21), respectively. Average values of teams covering low (L-HIR) and high (H-HIR) HIRB were 3034 ± 335 m (range 2203–3650 m, n =

23) and 4388 ± 675 m (range 3739–5736 m, n = 17), respectively. There were no significant differences in any TP variable between the H-TD and L-TD teams. Additionally, there were no significant differences in TP between the H-HIR and L-HIR teams (Table 3). We noted significant differences in TP variables between the H-TDB and L-TDB teams, and between the H-HIRB and L-HIRB teams. The H-TDB and H-HIRB teams had greater number of goal chances (4.2 and 4.34, respectively), shots (6.93 and 5.03, respectively), shots on target (2.49 and 2.72, respectively), passes (160 and 127, respectively), accurate passes (142 and 114, respectively), key passes (4.03 and 3.92, respectively), accurate key passes (1.89 and 2.65, respectively), crosses (7.76 and 4.99, respectively), successful high pressings (2.96 and 2.56, respectively), entrances to the opponent’s box (8.95 and 9.34, respectively), total actions (168 and 158, respectively), and successful actions (150 and 140, respectively) (all moderate to very large effect sizes) (Table 4).

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football medicine & performance Table 3: Differences in technical performance according to the running performance. Total distance

High intensity running

B (SE)

Lower CI – Upper CI

Effect size

B (SE)

Lower CI – Upper CI

Effect size

Goal chances

0.31 (1.08)

-1.87–2.5

0.10

0.97 (1.04)

-1.15–3.08

0.33

Shots

0.75 (1.52)

-2.34–3.83

0.17

2.09 (1.47)

-0.89–5.06

0.48

Shots on target

-0.27 (0.72)

-1.72–1.19

-0.13

1.16 (0.68)

-0.22–2.54

0.61

Passes

-2.16 (33.55)

-71.09–66.77

-0.02

1.62 (31.64)

-63.65–66.9

0.02

Accurate passes

3.7 (31.17)

-60.53–67.93

0.05

5.9 (29.35)

-54.82–66.63

0.08

Key passes

0.00 (1.44)

-2.92–2.91

0.00

0.76 (1.4)

-2.09–3.6

0.18

Key passes accurate

-0.2 (0.86)

-1.94–1.54

-0.08

0.70 (0.84)

-0.99–2.4

0.28

Crosses

-0.67 (2.15)

-5.08–3.74

-0.12

3.73 (1.97)

-0.32–7.78

0.76

Crosses accurate

-0.07 (0.68)

-1.47–1.33

-0.05

0.4 (0.64)

-0.94–1.75

0.28

Counter attacks

-0.28 (1.49)

-3.29–2.73

-0.06

1.91 (1.43)

-0.99–4.81

0.44

Counter attacks with a shot

2.74 (3.89)

-5.21–10.68

0.26

-3.21 (3.61)

-10.66–4.23

-0.36

High pressing

-0.4 (1.47)

-3.37–2.58

-0.09

1.47 (1.41)

-1.39–4.33

0.36

High pressing successful

-0.81 (1.04)

-2.91–1.3

-0.25

0.57 (1.02)

-1.49–2.64

0.19

Low pressing

2.24 (1.45)

-0.72–5.21

0.59

1.04 (1.49)

-1.99–4.07

0.23

Low pressing successful

-0.17 (0.80)

-1.80–1.45

-0.07

-0.14 (0.79)

-1.75–1.47

-0.06

Tackles

0.16 (2.45)

-4.8–5.12

0.02

-3.16 (2.41)

-8.04–1.72

-0.43

Tackles successful

0.77 (1.3)

-1.89–3.43

0.22

0.43 (1.3)

-2.21–3.07

0.11

Entrances to the opponent’s box

0.92 (1.95)

-3.07–4.92

0.18

1.78 (1.89)

-2.09–5.65

0.35

Total actions

22.44 (37.68)

-54.76–99.64

0.23

-3.89 (36.02)

-77.95–70.18

-0.04

Successful actions

22.98 (34.06)

-47.16–93.12

0.27

-2.01 (32.52)

-69.22–65.2

-0.03

Table 4: Differences in technical performance according to the running performance with ball in possession. Total distance with ball in possession

High intensity running with ball in possession

B (SE)

Lower CI – Upper CI

Effect size

B (SE)

Lower CI – Upper CI

Effect size

Goal chances

4.2 (0.92)

2.26–6.14

2.18

4.34 (1.00)

2.31–6.36

1.41

Shots

6.93 (1.2)

4.49–9.36

1.91

5.03 (1.47)

2.04–8.02

1.16

Shots on target

2.49 (0.7)

1.08–3.91

1.21

2.73 (0.69)

1.33–4.12

1.29

Passes

160.09 (29.86)

99.09–221.1

1.97

126.87 (37.11)

51.73–202.01

1.11

Accurate passes

142.39 (29.66)

81.64–203.14

1.81

113.68 (35.71)

41.29–186.06

1.05

Key passes

4.03 (1.25)

1.5–6.57

1.04

3.92 (1.38)

1.07–6.77

1.17

Key passes accurate

1.89 (0.77)

0.34–3.44

0.80

2.65 (0.81)

0.95–4.34

1.53

Crosses

7.76 (2.06)

3.56–11.97

1.39

4.99 (2.47)

0.02–10

0.66

Crosses accurate

1.09 (0.78)

-0.51–2.7

0.58

2.00 (0.8)

0.36–3.64

0.87

Counter attacks

0.13 (1.53)

-3–3.26

0.03

2.46 (1.52)

-0.64–5.55

0.59

Counter attacks with a shot

0.85 (4.25)

-7.79–9.5

0.07

2.34 (4.44)

-6.65–11.34

0.17

High pressing

2.28 (1.53)

-0.81–5.38

0.50

2.02 (1.57)

-1.17–5.2

0.44

High pressing successful

2.96 (0.93)

0.98–4.93

1.60

2.56 (0.97)

0.5–4.62

1.30

Low pressing

2.34 (1.46)

-0.68–5.38

0.69

-1.97 (1.56)

-5.16–1.23

-0.48

Low pressing successful

1.84 (0.71)

0.39–3.30

0.83

-0.52 (0.82)

-1.74–1.63

-0.02

Tackles

-1.43 (2.43)

-6.35–3.48

-0.19

-3.49 (2.4)

-8.34–1.37

-0.47

Tackles successful

1.91 (1.26)

-0.63–4.45

0.49

-0.03 (1.31)

-2.75–2.7

-0.01

Entrances to the opponent’s box

8.95 (1.82)

5.27–12.63

1.62

9.34 (1.73)

5.83–12.85

1.80

Total actions

168.18 (35.09)

96.86–239.5

1.65

158.28 (39.34)

78.62–237.93

1.31

Successful actions

150.12 (33.45)

81.78–218.47

1.65

140 (37.86)

63.33–216.67

1.31

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feature

football medicine & performance

Table 5 presents direct associations between the teams’ RP and TP. We did not observe any correlations between TD and TP (all p > 0.05). HIR in general was not strongly related to the TP. More precisely, of 21 correlations, only two reached statistical significance, with shots and accurate crosses being positively correlated with HIR (both approximately 15% of common variance). On the other hand, TDB and HIRB were positively correlated with goal chances (both moderate correlations), shots (strong and moderate correlations, respectively), shots on target (both moderate correlations), passes (very strong and moderate correlations, respectively), accurate passes (very strong and moderate correlations, respectively), key passes (moderate and small correlations, respectively), accurate key passes (moderate and small correlations, respectively), entrances to the opponent’s box (strong and moderate correlations, respectively), total actions (very strong and moderate correlations, respectively), and successful actions (strong and moderate correlations, respectively). In addition, high pressings, successful high pressings, and low pressings were correlated with TDB (small to moderate correlations).

Table 5: Associations between technical performance and running performance (data are given as r (p)) Running performance

Running performance with ball in possession

HIR

TDB

HIRB

Goal chances

0.06 (0.694)

0.27 (0.086)

0.59 (0.001)

0.51 (0.001)

Shots

0.23 (0.162)

0.39 (0.012)

0.68 (0.001)

0.50 (0.001)

Shots on target

0.04 (0.822)

0.23 (0.161)

0.63 (0.001)

0.46 (0.003)

Passes

-0.01 (0.97)

0.12 (0.466)

0.96 (0.001)

0.49 (0.001)

Accurate passes

0.02 (0.888)

0.11 (0.483)

0.96 (0.001)

0.48 (0.002)

Key passes

-0.01 (0.954)

0.19 (0.253)

0.49 (0.001)

0.35 (0.033)

Key passes accurate

0.04 (0.809)

0.20 (0.228)

0.42 (0.007)

0.35 (0.036)

Crosses

-0.06 (0.718)

0.20 (0.206)

0.64 (0.001)

0.27 (0.094)

Crosses accurate

0.07 (0.65)

0.38 (0.015)

0.58 (0.001)

0.42 (0.007)

Counter attacks

0.10 (0.534)

0.22 (0.169)

-0.04 (0.83)

0.29 (0.065)

Counter attacks with a shot

-0.03 (0.837)

-0.10 (0.531)

0.10 (0.556)

-0.02 (0.886)

High pressing

-0.01 (0.939)

0.28 (0.078)

0.35 (0.028)

0.11 (0.486)

High pressing successful

-0.10 (0.539)

0.26 (0.103)

0.42 (0.006)

0.20 (0.225)

Low pressing

0.02 (0.88)

0.17 (0.27)

0.09 (0.56)

-0.06 (0.69)

Low pressing successful

-0.26 (0.10)

0.10 (0.52)

0.35 (0.02)

0.05 (0.73)

Tackles

-0.01 (0.952)

-0.31 (0.05)

-0.15 (0.371)

-0.18 (0.256)

Tackles successful

0.01 (0.934)

0.07 (0.652)

0.14 (0.405)

0.07 (0.65)

Entrances to the opponent’s box

0.03 (0.863)

0.29 (0.071)

0.80 (0.001)

0.54 (0.001)

Total actions

0.07 (0.67)

0.10 (0.53)

0.93 (0.001)

0.50 (0.001)

Successful actions

0.09 (0.60)

0.10 (0.54)

0.94 (0.001)

0.50 (0.001)

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feature Conclusion This study aimed to identify differences in TP between teams covering high and low RP during the UCL matches. Results indicated that the teams’ TP was not affected by their overall RP (i.e., TD and HIR). On the other hand, we demonstrated significant influence of TDB and HIRB on specific TP, highlighting the importance of the physical performance of the entire team when have ball in possession. This most specifically means that, irrespective of the TD covered and the HIR of the teams, soccer teams that competed in the UCL had similar numbers of goal chances, shots, passes, key passes, crosses, counterattacks, pressings, tackles, and entrances to the opponent’s box. Moreover, no differences in these successfully performed TPs were found regardless to the teams’ accumulated TD and HIR. Finally, UCL teams achieved a similar number of

football medicine & performance total actions and total successful actions, irrespective of the TD coverage and HIR of their teams. Such findings clearly indicate that overall RP does not affect TP at the highest level of soccer competition. More importantly, it seems that such team behaviour may even have a critical influence, not only on more frequent execution of fundamental soccer skills, but on successfully performed key skills that influence match outcome. Namely, we evidenced that H-TDB and H-HIRB achieved a greater number of shots or targets, successful passes, accurate key passes and successful high pressings than the L-TDB and L-HIRB teams (all moderate to large effect sizes). Such results clearly show that, when in ball possession, team RP have important influence on successful execution of specific TP, which are in general considered as crucial for achieving

success in matches. In view of this, TDB and HIRB could be important determinants of success in highest- level soccer. In summary of our findings: • Technical-tactical performance of players within the UEFA Champions League were not associated with overall total distance or high intensity running distance covered. • However, both total distance and high intensity running distance covered when in ball possession was associated with increased more frequent execution of fundamental technical-tactical performance actions, such as shots on target, accurate passes and goal chances. • Therefore, physical conditioning exercises with the ball should be emphasized over traditional physical drills without the ball. • Such drills should be carried out in spaces that allows players to achieve high intensity of running with the ball.

Acknowledgements The author would like to thank Toni Modric, Sime Versic, Marcin Andrzejewski, Paweł Chmura, Marek Konefał, Patrik Drid and Damir Sekulic who were part of the authorship team for the original published version of the study. The full article can be accessed here: https://bmcsportsscimedrehabil.biomedcentral.com/articles/10.1186/s13102-022-00573-4 References 1. Barnes C, Archer D, Hogg B, Bush M, Bradley P. The Evolution of Physical and Technical Performance Parameters in the English Premier League. Int J Sports Med. 2014 Jul 10;35(13):1095–100. 2. Sarmento H, Marcelino R, Anguera MT, CampaniÇo J, Nuno Matos, LeitÃo JC. Match analysis in football: a systematic review. J Sports Sci. 2014;32:1831–43. 3. Rampinini E, Coutts AJ, Castagna C, Sassi R, Impellizzeri FM. Variation in top level soccer match performance. Int J Sports Med. 2007;28(12):1018–24. 4. Buchheit M, Mendez-Villanueva A. Effects of age, maturity and body dimensions on match running performance in highly trained under-15 soccer players. J Sports Sci. 2014;32(13):1271–8. 5. Castellano J, Blanco-Villaseñor A, Álvarez D. Contextual variables and time-motion analysis in soccer. Int J Sports Med. 2011;32(6):415–21. 6. Moalla W, Fessi M, Makni E, Dellal A, Filetti C, Di Salvo V, et al. Association of physical and technical activities with partial match status in a soccer professional team. J Strength Cond Res. 2018;32:1708–14. 7. Bloomfield J, Polman R, Donoghue P. Effects of score-line on intensity of play in midfield and forward players in FA Premier League. J Sports Sci. 2005;23:191–2. 8. Lago-Peñas C. The role of situational variables in analysing physical performance in soccer. J Hum Kinet [Internet]. 2012 [cited 2023 Feb 21];35:89. Available from: https://sciendo.com/downloadpdf/journals/hukin/35/1/article-p89.pdf 9. Barrera J, Sarmento H, Clemente FM, Field A, Figueiredo AJ, Slivka R. The effect of contextual variables on match performance across different playing positions in professional portuguese soccer players. Int J Environ Res Public Health. 2021;18:5175. 10. Aquino R, Carling C, Orcid ; Vieira L, Martins G, Jabor G, Machado J, et al. Influence of situational variables, team formation, and playing position on match running performance and social network analysis in Brazilian professional soccer. J Strength Cond Res. 2020;34(3):808–17. 11. García-Unanue J, Pérez-Gómez J, Giménez JV, Felipe JL, Gómez-Pomares S, Gallardo L, et al. Influence of contextual variables and the pressure to keep category on physical match performance in soccer players. PLoS One. 2018 Sep 1;13(9). 12. Antonio J, Clemente A, Requena B, Jukic I, Nayler J, Santalla Hernández A, et al. Is physical performance a differentiating element between more or less successful football teams? Sports. 2019;7(10):216. 13. Castellano J, Casamichana D, Lago C. The use of match statistics that discriminate between successful and unsuccessful soccer teams. J Hum Kinet. 2012 Mar 1;31(1):139–47. 14. Yang G, Leicht AS, Lago C, Gómez MÁ. Key team physical and technical performance indicators indicative of team quality in the soccer Chinese super league. Res Sport Med. 2018;26(2):158–67. 15. Collet C. The possession game? A comparative analysis of ball retention and team success in European and international football, 2007-2010. J Sports Sci. 2013 Jan 16;31(2):123–36. 16. Lago-Peñas C, Lago-Ballesteros J, Dellal A, Gomez M. Game-related statistics that discriminated winning, drawing and losing teams from the Spanish soccer league. J Sports Sci Med. 2010;9(2):288. 17. Batterham AM, Hopkins WG. Making meaningful inferences about magnitudes. Int J Sports Physiol Perform. 2006;1(1):50–7. 18. Taylor R. Interpretation of the Correlation Coefficient: A Basic Review. J Diagnostic Med Sonogr. 1990;6(1):35–9.

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