football medicine & performance by Football Medicine & Performance Association

medicine & performance Issue 27 Winter 2018/19

The official magazine of the Football Medicine & Performance Association

Feature

Testing & Training

output across an 8-week training cycle amongst elite level soccer players

In this issue The Effect of Sleep Nutritionists in Academy Football Life After Football Gilmoreâ&#x20AC;&#x2122;s Groin

Legal Education Recruitment Wellbeing

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CEO MESSAGE Already this season we have seen colleagues who have been in the game for many years suddenly lose their jobs for no apparent reason, other than perhaps on the whim of a manager or a hierarchy that wants a change of personnel. I am reminded what Alex Ferguson once said, reflecting on the release of back room staff with the arrival of a new manager: “There is no point suddenly changing routines that players are comfortable with. It is counterproductive, saps morale and immediately provokes players to question the new man’s motives. A leader who arrives in a new setting, or inherits a big role, needs to curb the impulse to display his manhood.” Valuable and insightful opinion indeed but, in spite of this advice, we know there will still be an exodus of staff as the New Year begins. The football industry remains a most precarious working environment and a sense of stability at a club is a rare commodity. While players and managers will inevitably move (market forces), should not the medical and performance sector be ring-fenced to provide a bedrock of familiarity at a club? Should they not have a separate line manager so that they, as a working department, cannot easily be disassembled by a new coach or manager? Should not the years of endeavour and established network of practitioners and systems they put in place be protected? In an ideal world, and for the benefit of the game, the answer is probably ‘yes.’ The reality, however, is that this is never likely to happen with current thinking. Do clubs really have any awareness of what constitutes a good practitioner? Is it the case, as far as they are concerned that a Physio is a Physio and a Scientist is a Scientist. If appointments comply with the rules, the boxes are ticked and, ideally it’s a case of the cheaper the better. With this in mind, you can see why some of the more experienced personnel referred to above are therefore vulnerable. Such cost saving exercises will invariably leave clubs with inexperienced personnel, often new graduates, who are unable to deliver the complex needs of the modern footballer. Playing careers will be jeopardised, mistakes will be made and some of these will be costly. Ultimately, clubs don’t want to ring fence and protect their medicine and performance departments, rather they need the flexibility to dispense with staff whenever they want, to save money or to act on the whim of a new manager. Meanwhile the cost to our members of this destructive practice is huge, both on a personal and professional level. And while the FMPA is there to support members through these devastating times, we need to campaign for common sense to prevail and for Clubs to recognise the true value of stability, and familiarity!

Chief Executive Officer Football Medicine & Performance Association

CONTENTS WELCOME

Updates

FEATURES

Research & Development

FMPA Conference and Awards

The effect of sleep on high speed running during a weekly micro-cycle in elite female soccer players Wiseman, A Stebbings, G.K

Gilmore’s Groin Revisited Simon Marsh Rachel Rolph

Neurogenic hamstring and calf pain in football When is a tear not a tear? Dr Simon Petrides

The association between physical testing and training output across an 8-week training cycle amongst elite level soccer players Adam L. Owen Leo Djaoui Bruno Mendes Shane Malone Osman Ates

FMPA Register

The temporal pattern of recovery in eccentric hamstring strength postsoccer specific fatigue David Rhodes Lars McNaughton Matt Greig

Life After Football – Simon Maltby

ABOUT

The Officiating Team Modern care of football referees Carlo Castagna Mario Rizzini

Nutritionists in Academy football: A recipe for success? Mark Russell

Football Medicine & Performance Association 6A Cromwell Terrace, Gisburn Road, Barrowford, Lancashire, BB9 8PT T: 0333 456 7897 E: info@fmpa.co.uk W: www.fmpa.co.uk Chief Executive Officer Eamonn Salmon eamonn.salmon@fmpa.co.uk

Design Oporto Sports www.oportosports.com

Executive Administrator Lindsay Butler admin@fmpa.co.uk

Photography PA Images, FMPA, Dan Gold, Nathan Rogers, RawPixel

Administration Assistant Amie Hodgson amie.hodgson@fmpa.co.uk

Contributors Wiseman.A, Stebbings.G.K, Mark Russell, Simon Marsh, Rachel Rolph, Dr Simon Petrides, Adam L. Owen, Leo Djaoui, Bruno Mendes, Shane Malone, Osman Ates, Carlo Castagna, Mario Rizzini, David Rhodes, Lars McNaughton, Matt Greig

Project Manager Angela Walton angela.walton@fmpa.co.uk Marketing/Advertising Charles Whitney - 0845 004 1040

Print Media Village www.media-village.co.uk

COVER IMAGE Leicester City’s Harry Maguire receives treatment for an injury. Nigel French/EMPICS Sport/ PA Images Football Medicine & Performance Association. All rights reserved. The views and opinions of contributors expressed in Football Medicine & Performance are their own and not necessarily of the FMPA Members, FMPA employees or of the association. No part of this publication may be reproduced or transmitted in any form or by any means, or stored in a retrieval system without prior permission except as permitted under the Copyright Designs Patents Act 1988. Application for permission for use of copyright material shall be made to FMPA. For permissions contact admin@fmpa.co.uk

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football medicine & performance

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21ST CENTURY PLAYER PREPARATIONS... HOW FAR HAVE WE COME 17/18 MAY: RADISSON BLU EAST MIDLANDS HOTEL

The 2019 Conference will take a critical look at Medicine and Performance across the professional men’s and women’s game.

In 30 years the number of days lost to injuries has not improved. What has changed in the game and are we really capable of influencing these figures? Do we prepare players using optimal methodology to avoid injury? Do we encourage a holistic player approach with an MDT emphasis, or is it a case of individual disciplines working in specialised silos? How do we accommodate coaching goals into creating an integrated health and performance plan?

Speakers will explore the nuances of player preparation as we discuss areas of ‘best practice’ and take ideas and actions from the FMPA Conference that will help steer our working practices and positively affect our risk reduction strategies. Innovative, controversial but most of all informative. You can’t afford to miss it!

21ST CENTURY PLAYER PREPARATIONS... HOW FAR HAVE WE COME 17/18 MAY: RADISSON BLU EAST MIDLANDS HOTEL

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football medicine & performance DISCUSSION The aim of the current investigation was to analyse the relationship between physicaltest performances and physical-output during soccer training sessions amongst elite level soccer players. The main findings were that the majority of the sprint and jump tests performance were correlated to the number of accelerations, decelerations, sprints, HSR and HSR.min-1. Furthermore, that VO2max test performance was positively correlated to the number of sprints, accelerations, HSR, HSR.min-1, TDC.min-1 and explosive distance. The investigation did not find any levels of significance within the physical-test performance according to playing positions even though the physical activity during training sessions was positional dependant for most of the training outputs. Testing analysis Assessments of physical-tests were realised over Portuguese top-elite professional soccer players. They were tested on sprinting-speed, agility-speed, jumping and on a VO2max tests to measure their fitness at the beginning of the pre-season period. Our hypothesis was not confirmed as no differences were found between playing positions in all these physical-tests. A part of the present results were not in accordance with the literature on this topic. Indeed, over speed and jump tests, elite Belgium FW and FB were faster when compared across other positions, and FW and CB jumped higher than other positions when performing both SJ and CMJ (Boone et al., 2012). Elite Croatian FW were faster and performed better in the SJ when compared to other positions (Sporis et al., 2009), and elite Norwegian FW and defenders (no differentiations in the study) were faster, with midfielders presenting lower jumping profiles compared across other positions (Haugen et al., 2013). One of the explanation about differences between these studies and the present one could be the size of the sample: 289, 270 and 939 players in theirs, respectively, against 20 in the present study. However, results from another large investigation reported no differences between playing positions in different sprint-tests within 243 elite Turkish players (Taskin, 2008), and an investigation with a similar sample size, across 17 top-level Norwegian soccer teams also observed no differences among playing positions (Wisloff et al., 2004). Sporis et al., (2009) confirmed in accordance with findings in this study that no differences among the playing positions were found in CMJ tests across 270 elite Croatian players. Concerning the endurance capacities of various positions and more concisely VO2max, the current investigation observed how FBs revealed higher values when compared across other positions, although recent reports observed different outcomes with midfielders

having greater VO2max values vs. defenders and forward positions (Sporis et al., 2009; Tonnessen et al., 2013). As a result, the findings observed in this study was generally in line with recent the literature (Boone et al., 2012, Rebelo et al., 2013), however the main difference between all studies compared was the testing period, which may influence the outcome. The Belgian players were tested during pre-season (Boone et al., 2012), Croatian players at the end of pre-season (Sporis et al., 2009), Norwegian players at different moment during the season (Haugen et al., 2013), and Turkish players during the competitive period (Taskin, 2008). Therefore, the differences in the physical profiles to cross comparison with data obtained within the current literature may be difficult and taken with caution. As soccer is a high-intensity-intermittent sport, the ability to sustain high work rates during training sessions and match play is an essential component to achieve performance (Owen et al., 2015). As the ability to repeat high intensity actions is well related to performance (Rampinini et al., 2007) and recovery, the efficiency of the process depends on the power of the aerobic metabolism (Sahlin et al., 1979; Spencer et al., 2005). Elite-level soccer players have been reported to have attained VO2max measures up to the equivalent of 75ml.min-1.kg-1 (Stolen et al., 2005). In the present investigation, VO2max values (range 52.66 â&#x20AC;&#x201C; 59.92 ml.min-1.kg-1) were largely below this maximal observed maybe as a result of the timing of the season tested. Training analysis Within the current study, training output highlighted no differences among playing positions in terms of absolute TDC and relative TDC.min-1 as presented in Table 2. Although TDC is known to significantly differ during soccer matches according to playing positions (Dellal et al., 2011), it is well known that high-intensity actions are more important in the decisive moments of competitive matches (Mohr et al., 2003). In this context, levels of significance were detected among playing positions in high intensity and speed metrics. FB, WM and FW listed greater number of accelerations vs. CB, and more sprints, HSR distance and subsequent intensity drawn through HSR. min-1 distance when compared with CB and CM (p<0.005). Also WM and FB reported significantly greater levels of explosive distance vs. CB (p<0.005). These findings concur with previous literature concerning observations within Champions League-level matches that suggested positional output similarities with respect to number of total, explosive and leading sprints (Di Salvo et al., 2010) showing similarities with training and match activity.

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Link between training and testing In agreement with our hypothesis, significant correlations were found between Sp-20, SJ, CMJ and the GPS metrics related to speed and explosive power such as A, D, number of sprints, HSR and HSR.min-1. Therefore, taking the current study into context with elite UEFA Championsâ&#x20AC;&#x2122; League level soccer players, it can be suggested that the quicker and more explosive players assumed from the pre-season physical laboratory tests, the higher the values accumulated in the functionality of training, related to those physical qualities (Table 3). Nevertheless, the present investigation is unique in its concept to assess the relationship between physical performance testing, and its transferable capacity to physical activity generated across the training microcycle on the pitch in an elite soccer team. Additional results from the current investigation highlighted Sp-5 and its correlation with number of sprints and explosive distance capacity, which highlight the fact that the most explosive players in a testing scenario generally reproduce this physical quality within the training session. Repeatedly performing intense running actions have shown to impose high mechanical strain and induce possible risk of injury (Raastad et al., 2010), however the fact that increasing playerâ&#x20AC;&#x2122;s capacity to produce explosive, fast actions when tested will positively improve that performance aspect in the training session. Subsequently, the risk of injury vs. improvement in performance must be managed safely, but this study highlights the need to overload players for a developmental response. Furthermore, lab based tests SJ and CMJ revealed significant correlations with speedand power-related in-session training GPS metrics. From the findings, it is interesting to observe (Table 3) how CMJ was similarly correlated to the same training metric response as SJ performance. Even though SJ and CMJ performance are both relative markers of power, SJ has previously being related to maximal sprinting capability (Chelly et al., 2010) and CMJ with repeated sprint capacity (Baldi et al., 2016). However, in this particular context, CMJ has been shown as more relevant relating its performance to speed- and power-related training outputs. This is in-line with previous research suggesting that the most-explosive players in terms of jumping capacity generally posted the faster speed scores in a testing environment but again this is the first study to report the link between testing capacity and in-session training outputs of jump and sprint tests vs. GPS metrics. In partial agreement with our hypothesis, correlations were observed between VO2max and A, sprints, explosive distance, TDC.min-1,

FMPA MEMBERSHIP WHATS IN IT FOR YOU? Expert LEGAL representation in employment law, medicolegal and Regulatory law AND full contract appraisal Full support on any issue from the FMPA 7 days a week Confidential access to clinical experts to discuss issues within your discipline Annual FMPA Conference & Awards with Member discounts & priority Priority MEMBER ONLY access to job listings on FMPA website Regular e-news/updates Education/CPD via quarterly edition of ”football medicine & performance” magazine delivered to your door plus on-line resources Member discounts on car leasing, insurance & more Savings on courses and events for FMPA Members Eligibility to join the FMPA Register for members moving into private practice or offering consultancy to professional football clubs Plus much more…….

”Thank you for helping me through my recent exit from my club. Martin Price’s advice was exceptional. In a situation where an 'ordinary' person was in conflict with a large organisation Martin's knowledge and execution was empowering. Being represented by someone who clearly knew more than the opponents was really supportive. I would definitely recommend the FMPA legal team for Members going forward” Fitness Coach, Premier League Club

THE NETWORK FOR MEDICINE & PERFORMANCE PRACTITIONERS IN THE PROFESSIONAL GAME

JOIN NOW www.fmpa.co.uk Tel: 0333 4567897

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REGISTER Following the launch of the FMPA Register, we have received incredible feedback and seen an increase in registrants who are keen to promote themselves within professional football, to the grassroots community and fans. Analytics have shown an increase in traffic to the FMPA site on the Register pages with a 43.8% increase, which proves that more people are accessing the Register, including grassroots and professional clubs. We have been extremely busy highlighting members to their chosen audience and on average a member has been put in front of approximately 45,000 potential clients! This is a fantastic figure and so soon after the launch! We have further initiatives in place to increase our reach even further. Watch this space!

Angela Walton Project Manager

FMPA REGISTER TO REACH 500,000 FAN BASE The FMPA Register has been in recent talks with various organisations to help create a greater awareness of the support our members offer to fans and grassroots players. One of those we have connected with is the Football Supporters’ Federation (FSF). The Football Supporters’ Federation is an organisation representing football fans in England and Wales. It campaigns across a range of issues and supports fan representation.

The Football Supporters’ Federation has a combined individual and affiliate/associate membership of just over

500,000 and we are delighted to be able to flag up the FMPA Register which we believe will be a valuable resource to all fans who are in need of professional advice from our Register members.

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football medicine & performance

Direct Messaging Contact anyone on the FMPA Register

Unlimited People Browsing View unlimited profiles from search results

Feature Coding Choose your own coding to stand out to your audience

Geographical Location Feature Enables you to be located by customers/ client

Filtered Search Option Allows detailed search by job title, location or practitioner name

PROFILE LISTING ONLY

This category provides members with the opportunity to showcase their skills, experience and expertise working in professional football.

PRIVATE PRACTICE CONSULTATIONS & APPOINTMENTS

This category offers a great opportunity for members already in private practice or those just starting out in business, to highlight their experience, services and professional profile to potential clients. There is a specific section on the listing to highlight your private practice, which pulls through a location map.

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PROFESSIONAL CONSULTANCY TO FOOTBALL CLUBS

Practitioners will be highlighted regularly to heads of department who may wish to seek employment cover, temporary staff or consultancy within a particular speciality. We also feature practitioners on the website and within our magazine and promote this category well into the semiprofessional football arena. Please see listed below a selection of practitioners available for professional consultancy:

INJURY UPDATE The FMPA Register brings together the public, who are looking for practitioners they can trust, with the experience and skills to treat a football injury and promote a rapid return to play. To support grassroots football and their lack of medical knowledge, the FMPA is supplying these clubs with an injury update. If any of our members would like to offer their support and contribute, please email register@fmpa.co.uk with the following information: Approx. 400 word article, together with images Nature of injury Signs and Symptoms Treatment Rehabilitation Prevention

Taking up private practice is the natural progression for most of us as we leave the game. We genuinely do want to give something back to football and working with the FMPA Register and at grassroots level gives us the perfect opportunity. Alan Smith Head Physiotherapist Aston Villa FC

Since being listed on the FMPA Register, Alan Smith has been promoted to

40,525 potential clients, grassroots players and football fans

Not only will this keep grassroots clubs up to date and familiar with advances in football injury and treatment regimes but it will also highlight you and your clinic.

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football medicine & performance

If you have not yet listed yourself on the FMPA Register, please take a look at the following benefits and join online at www.fmpa.co.uk/practitioners-join-fmpa-register WHAT THE FMPA REGISTER WILL DO FOR YOU… 9 The FMPA Register highlights YOU as a unique practitioner who has the skills, experience and expertise from working in professional football. 9 A listing on the Register sets YOU apart from your competitors 9 Ensures YOU are accessible and can be easily sourced by clubs, patients, grassroots players and football fans 9 The Register will engage you as part of the Register network, facilitating inter-disciplinary referrals from like minded colleagues 9 Allow YOU to display the FMPA Registration certificate in your practice and use our logo on your stationery, website and all marketing material FMPA REGISTER MARKETING WILL… 9 Grow YOUR reputation – amplified through our continual marketing of FMPA Register 9 Expand YOUR client base through a trusted medium which has a nationwide reach 9 Directly market YOU to clubs in your area giving you an immediate target audience of players, staff and the local football community 9 Highlight YOU as the go to practitioner in your area 9 Showcase YOUR profile and experience in football 9 Promote YOU to football fans who wish to seek the same professional care as their favourite players 9 Give you a platform to advertise your practice via publication of an article in ‘football medicine & performance’ magazine

Go online now to be promoted to your target audience! www.fmpa.co.uk

Any questions, please get in touch: email register@fmpa.co.uk or telephone 0333 456 7897

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21 CENTURY PLAYER PREPARATIONS... HOW FAR HAVE WE COME?

FRI 17TH / SAT 18TH MAY RADISSON BLU EAST MIDLANDS DE74 2TZ FOR MORE DETAILS

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