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Physical performance, injuries and osteoarthrosis in female soccer
Lunds universitet.ORCID iD: 0000-0001-5904-4428
2001 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall purpose was to investigate female soccer regarding injuries, risk factors, posttraumatic OA and non-traumatic OA. A prospective study of injuries in eight female soccer teams, from the six available levels, was performed during one season. The total injury rate was 14.3 and 3.7/1000 game and practice hours, respectively. The knee (26%) was the most common place for injury, followed by the foot (12%). An increased general joint laxity was found to be a significant risk factor for general injury and knee injury. In an attempt to find easy functional tests that do not require advanced equipment and that could be used instead of more advanced isokinetic tests, only low correlations between isokinetic strength measurements and functional tests, such as one-leg hop, triple jump, vertical jump, one-leg rising or square hop, were found. There were no differences in any of the tests found between players under /over the age of 20, except for knee flexor muscle strength, where a small but significant difference was seen. Female soccer players with ACL injury showed radiographic changes in the in 69%, and verified knee OA in 34% at the age of 31, 12 years after injury. A majority of the players suffered from symptoms affecting their sport and recreational activities and knee-related quality of life. However, the symptoms were not related to the presence of OA or having undergone surgery to the affected knee or not. Somewhat older female ex-soccer players (mean age 42 years) showed a prevalence of 3% and 17% of radiographic hip and knee OA, and had, with and without knee injuries, a 5-fold increased rate of knee osteoarthrosis compared to non-sporting females age 46, when age and BMI were adjusted for. No difference was seen between the female players and the non-sporting controls regarding hip OA. Increased general joint laxity was found to be a risk factor for injury. Female soccer players with an ACL injury had verified knee OA in 34% at the age of 31, 12 years after injury. Also, somewhat older female players after their career showed a high prevalence of radiographic knee OA and a 5-fold risk of developing knee OA compared to controls. Female soccer by itself and in combination with the high risk of knee injuries has an increased risk of OA. However, the positive effects of exercise, physical and mental, when playing soccer should not be ignored.

Abstract [sv]

Sedan 1970-talet har damfotboll i Sverige spelats med seriesystem på en nationell nivå. Damfotboll innebär troligtvis en ökad risk för knäledsförslitning, en risk som inte blir mindre med tanke på den höga förekomsten av allvarliga knäskador. Det går emellertid inte att bortse från de positiva effekterna, såväl fysiska som psykiska, som fotbollsspel också innebär. Damfotbollsspelare skadar sig i samma utsträckning som herrfotbollsspelare, men knäskador är vanligare i damfotbollen. Anledningen till detta är inte helt klarlagd. En skada i knät innebär en stor risk för knäledsförslitning. Ungefär hälften av de som skadar korsband eller menisker i knät har tecken på förslitning i knäleden efter 10–15 år. Syfte Syftet var att undersöka damfotboll från olika infallsvinklar: skador, riskfaktorer, och förekomst av knä- och höftledsförslitning. Dessutom var syftet att jämföra åldersgrupper och sambandet mellan maskinell muskelstyrkemätning och funktionella tester. Metod & population Samtliga licensierade damfotbollsspelare som under ett bestämt år skadade sitt korsband i knät under fotbollsspel undersöktes vid 31 års ålder, 12 år efter sin skada. En annan grupp bestående av före detta aktiva fotbollsspelare som uppnått 42 års ålder undersöktes med höft-och knäledsröntgen och rörlighetstest. Den tredje gruppen bestod av samtliga spelare från åtta lag i olika divisioner. Den gruppen genomgick fysiska tester och följdes under en säsong för att undersöka riskfaktorer för skada och förekomst av skada. Dessutom jämfördes sambandet mellan maskinellt uppmätt muskelstyrka med funktionella tester som t. ex. längdhopp på ett ben. Resultaten jämfördes mellan de spelare som var över respektive under 20 år. Resultat Vid 31 års ålder, 12 år efter främre korsbandsskada i knät visade en undersökning med röntgen att 1/3 av den studerade gruppen hade förslitning i knäleden, medan 2/3 hade någon form av förändring i knäleden. När de korsbandsskadade kvinnliga fotbollspelarna jämfördes med en referensgrupp bestående av 20 åriga kvinnliga fotbollsspelare som ej skadat knät, visade det att de korsbandsskadade spelarna hade mer smärta och dessutom fler problem vid sport och fritidsaktiviteter. En jämförelse mellan de som genomgått en korsbandsoperation och de som skadats men inte opererats, samt mellan de med eller utan knäledsförslitning visade att det inte fanns någon skillnad vad gäller symptom, smärta eller besvär vid sport och fritidsaktiviteter. Åttio procent av de undersökta utövade någon form av motionsaktivitet. Det kan betyda att de anpassat sin aktivitet efter sina besvär i det skadade knät och på så sätt har de kunnat behålla eller öka sin muskelstyrka, något som skyddar mot knäsmärta. Efter avslutad karriär hade 17 % av de som var 42 år gamla knäledsförslitning jämfört med 6 % av en kontrollgrupp bestående av 46-åriga kvinnor utan idrottsbakgrund. De f.d. spelarna, vare sig de hade en knäskada eller inte, löpte en 5 gånger högre risk att utveckla knäledsförslitning jämfört med kontrollgruppen när korrektioner för ålder och BMI hade gjorts. Av de som under sin karriär inte skadat sitt knä hade 14 % knäledsförslitning. När det gäller höftledsförslitning fanns ingen skillnad mellan före detta damfotbollsspelare och de 46-åriga kvinnorna. Åtta damfotbollslag, från alla fem divisioner, testades och följdes under en säsong. Skadeincidensen, alltså antalet skador, var 14,3 per 1000 matchtimmar och 3,7 per 1000 träningstimmar. Knät var den mest skadade kroppsdelen (26 %), följt av foten (12 %). En ökad ledrörlighet befanns vara en riskfaktor för såväl skador i allmänhet som knäskador. Endast svaga samband erhölls mellan maskinella muskelstyrkemätningar och olika funktionella tester. När man jämförde de olika funktionella testerna kunde ett acceptabelt samband mellan längdhopp på ett ben och trestegshopp konstateras. När damfotbollsspelare över och under 20 år jämfördes fanns det inga skillnader beträffande muskelstyrka, funktionella tester eller kondition. Dock visade den äldre gruppen ett något högre styrkemått för knäledsböjarmusklerna. Hos damfotbollsspelare med korsbandsskada fanns knäledsförslitning i 1/3 av fallen vid 31 års ålder, tolv år efter skadan. Även äldre damfotbollsspelare, 42 år, visade efter avslutad karriär en hög procent knäledsförslitning och löpte en 5 gånger högre risk att utveckla knäledsförslitning i jämförelse med icke idrottsaktiva kvinnor.

Place, publisher, year, edition, pages
Lund: Lund University, Departments of Physical Therapy and Orthopedics , 2001. , 122 p.
Keyword [en]
Kinesitherapy, Physical medicine, Osteoarthrosis, Female soccer, Injuries, Physical performance, Revalidation, Rehabilitation
Keyword [sv]
Rehabilitering (medicinsk och social)
National Category
Sport and Fitness Sciences
Research subject
Sport Science
Identifiers
URN: urn:nbn:se:lnu:diva-36607Libris ID: 8364520ISBN: 91-628-4912-3 (print)OAI: oai:DiVA.org:lnu-36607DiVA: diva2:740594
Opponent
Available from: 2014-08-25 Created: 2014-08-25 Last updated: 2015-12-14Bibliographically approved
List of papers
1. Injury risk factors in female European football: a prospective study of 123 players during one season
Open this publication in new window or tab >>Injury risk factors in female European football: a prospective study of 123 players during one season
2000 (English)In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 10, no 5, 279-285 p.Article in journal (Refereed) Published
Abstract [en]

The purpose of this study was to register prospectively the injuries in female soccer and to study their correlation to potential risk factors. A total of 123 senior players from eight teams of different levels were followed during one season. Isokinetic knee muscle strength at 60 and 180 degrees/s, one-leg-hop, vertical jump, square-hop, and continuous multistage fitness test (MFT) were tested at the end of the pre-season. In addition, Body Mass Index (BMI) and general joint laxity were measured. During the season, April-October, all injuries resulting in absence from one practice/game or more were registered. Forty-seven of the 123 players sustained altogether 65 injuries. The total injury rate was 14.3 per 1000 game hours and 3.7 per 1000 practice hours. The knee (26%) was the most commonly injured region followed by the foot (12%), ankle (11%), thigh (11%) and back (11%). The risk of sustaining moderate and major injuries increased in the later part of the game or practice. Significant risk factors for injuries were an increased general joint laxity (odds ratio (OR)=5.3, P<0.001), a high performance in the functional test square-hop (OR=4.3, P=0.002), and an age over 25 years (OR=3.7, P=0.01). The injury rate was not different compared to male soccer, but knee injuries were more common, which is in accordance with previous studies. None of the risk factors identified in this study is easily applicable for future intervention studies in the attempts to reduce the injury rate in female soccer.

Place, publisher, year, edition, pages
Munksgaard Forlag, 2000
Keyword
Female, Soccer, Injury, Risk factors
National Category
Sport and Fitness Sciences
Research subject
Sport Science; Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-36604 (URN)10.1034/j.1600-0838.2000.010005279.x (DOI)11001395 (PubMedID)
Available from: 2014-08-25 Created: 2014-08-25 Last updated: 2015-12-14Bibliographically approved
2. Isokinetic knee extensor strength and functional performance in healthy female soccer players
Open this publication in new window or tab >>Isokinetic knee extensor strength and functional performance in healthy female soccer players
1998 (English)In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 8, no 5, 257-264 p.Article in journal (Refereed) Published
Abstract [en]

The aims of this study were to determine the relationship between isokinetic knee extensor muscle strength at 60 degrees/s and 180 degrees/s and five functional performance tests (one-leg-hop, triple-jump, vertical-jump, one-leg-rising and square-hop), to determine the relationship between the five different functional performance tests and to present normative data and limb symmetry index concerning healthy female soccer players. In total 101 female soccer players (X = 20.3 years) were tested. A limb symmetry index, using weak/strong leg, varied from 83.9 to 96.3 in the tests. Between the functional performance tests there were in general correlations of r = 0.4-0.8 (P < 0.001). A correlation of r = 0.77 (P < 0.001) was obtained between one-leg-hop and triple-jump. No differences were found between the right and the left leg or the dominant and the non-dominant leg. Using linear regression models corrected for body weight, height and age, there were low correlations between the isokinetic strength measurements and the functional tests. It is not recommended using functional performance testing and isokinetic testing interchangeably.

Place, publisher, year, edition, pages
John Wiley & Sons, 1998
Keyword
Isokinetic strength, Functional performance tests, Normative data, Female soccer
National Category
Sport and Fitness Sciences
Research subject
Sport Science; Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-36603 (URN)10.1111/j.1600-0838.1998.tb00480.x (DOI)9809383 (PubMedID)
Available from: 2014-08-25 Created: 2014-08-25 Last updated: 2015-12-14Bibliographically approved
3. Physical capacity in female soccer players: does age make a difference?
Open this publication in new window or tab >>Physical capacity in female soccer players: does age make a difference?
2000 (English)In: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 2, no 1, 39-48 p.Article in journal (Refereed) Published
Abstract [en]

There is an increased risk of injuries, especially knee injuries, in young female soccer players. If age-related differences in physical capacity could be identified, the possibilities for injury prevention may increase. The objective was to study possible age-related differences in isokinetic muscle strength, aerobic capacity, functional performance, and general joint laxity in female soccer players. Body mass index (BMI) (kg × m-2) was also measured. In total 108 players, recruited from seven soccer teams, were tested. The mean age was 20.2 years (SD=4.1, range=14-30). Players aged ≦20 years and>20 years were compared. The following tests were employed: isokinetic knee extensor and flexor strength at velocities of 60 °/s and 180°/s, one-leg hop, triple jump, vertical jump, square-hop, and aerobic capacity. The older group had greater isokinetic strength for the flexor muscles at a peak torque of 60°/s (p=0.04), and total work at 60°/s and 180°/s (p=0.04 and 0.03). The older group had a higher BMI and more years of soccer playing (p≪0.001). The results revealed no significant differences between the age groups regarding, functional performance, aerobic capacity, or general joint laxity. Further studies are needed on intrinsic risk factors to identify variables explaining the difference in injury rate between younger and older players. 

Place, publisher, year, edition, pages
Taylor & Francis, 2000
Keyword
Women athletes, Soccer, Physical fitness testing
National Category
Sport and Fitness Sciences
Research subject
Sport Science; Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-36605 (URN)10.1080/140381900443427 (DOI)
Available from: 2014-08-25 Created: 2014-08-25 Last updated: 2015-12-14Bibliographically approved
4. High prevalence of knee osteoarthritis, pain, and functional limitations in female soccer players twelve years after anterior cruciate ligament injury
Open this publication in new window or tab >>High prevalence of knee osteoarthritis, pain, and functional limitations in female soccer players twelve years after anterior cruciate ligament injury
2004 (English)In: Arthritis and Rheumatism, ISSN 0004-3591, E-ISSN 1529-0131, Vol. 50, no 10, 3145-3152 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To determine the prevalence of radiographic knee osteoarthritis (OA) as well as knee-related symptoms and functional limitations in female soccer players 12 years after an anterior cruciate ligament (ACL) injury.

METHODS: Female soccer players who sustained an ACL injury 12 years earlier were examined with standardized weight-bearing knee radiography and 2 self-administered patient questionnaires, the Knee Injury and Osteoarthritis Outcome Score questionnaire and the Short Form 36-item health survey. Joint space narrowing and osteophytes were graded according to the radiographic atlas of the Osteoarthritis Research Society International. The cutoff value to define radiographic knee OA approximated a Kellgren/Lawrence grade of 2.

RESULTS: Of the available cohort of 103 female soccer players, 84 (82%) answered the questionnaires and 67 (65%) consented to undergo knee radiography. The mean age at assessment was 31 years (range 26-40 years) and mean body mass index was 23 kg/m2 (range 18-40 kg/m2). Fifty-five women (82%) had radiographic changes in their index knee, and 34 (51%) fulfilled the criterion for radiographic knee OA. Of the subjects answering the questionnaires, 63 (75%) reported having symptoms affecting their knee-related quality of life, and 28 (42%) were considered to have symptomatic radiographic knee OA. Slightly more than 60% of the players had undergone reconstructive surgery of the ACL. Using multivariate analyses, surgical reconstruction was found to have no significant influence on knee symptoms.

CONCLUSION: A very high prevalence of radiographic knee OA, pain, and functional limitations was observed in young women who sustained an ACL tear during soccer play 12 years earlier. These findings constitute a strong rationale to direct increased efforts toward prevention and better treatment of knee injury.

Place, publisher, year, edition, pages
John Wiley & Sons, 2004
National Category
Sport and Fitness Sciences
Research subject
Sport Science
Identifiers
urn:nbn:se:lnu:diva-36611 (URN)10.1002/art.20589 (DOI)
Available from: 2014-08-25 Created: 2014-08-25 Last updated: 2015-12-14Bibliographically approved
5. The prevalence of hip and knee osteoarthritis in female former soccer players
Open this publication in new window or tab >>The prevalence of hip and knee osteoarthritis in female former soccer players
Show others...
(English)Manuscript (preprint) (Other academic)
National Category
Sport and Fitness Sciences
Research subject
Sport Science
Identifiers
urn:nbn:se:lnu:diva-36612 (URN)
Available from: 2014-08-25 Created: 2014-08-25 Last updated: 2015-12-14Bibliographically approved

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