Injuries are a part of professional football, with most in-direct injuries occurring in the lower extremities. Thigh, knee and ankle injuries are amongst the most prevalent injured areas. The multifaceted nature of injuries infer that they cannot be prevented but an effort can be made to reduce the likelihood of one occurring.

Player profiling (PP) is a standard screening practice in professional football and is used as a strategy to reduce injury incidence.

Player unavailability (time loss) caused by injuries could negatively impact the medical and financial resources as well as negatively influence team performance but can be prevented through PP.

PP generally consists of medical, musculoskeletal (MSK) and performance tests that are conducted during pre-season as well as in-season. The information obtained provides a baseline measurement, as well as highlights, risk factors that are either modifiable (muscular strength, cardiovascular fitness and anthropometric measures) or non-modifiable (age and previous injuries).

PP also functions as a monitoring tool in-season, interpreting the objective and subjective data collected provides the medical team with insight in answering the question “Is the player coping with current load?”

No universal or gold standard screening/monitoring tool exists that suits all players (Targett, 2021). Financial resources, available equipment and expertise of staff all influence what is included in a screening protocol.

How does SFC profile their players?

 

Medical

The pre-competition or medical screening players undergo function to assess players for risk of sudden cardiac death, soft tissue injury as well as general illness. It also aims to identify medical conditions that could be aggravated by exercise and possibly lead to cardiac arrest. This is achieved by a focused investigation of the players medical history, family medical history, psychosocial wellbeing and a physical examination. All players are subject to a resting electrocardiogram (ECG) and basic lung capacity tests. Further investigation such as specific blood tests, stress ECG and/or specific orthopedic tests are warranted if abnormalities are identified.

Musculoskeletal

The rationale behind MSK screening is using a battery of objective tests to identify risk factors and monitor athletes. Test selection and frequency of data collection largely depends on the sport, test validity, convenience and equipment availability.

At Stellenbosch Football Club (SFC) we weekly monitor weight, groin strength, lower-back/hamstring and ankle mobility.

Weight

• Weight management for footballers are unique because of the high energy expenditure. Large fluctuations, in a short period of time, in body weight is considered a red flag.

Strength (Groin squeeze)

• Delahunt et al suggest that the groin squeeze test is a useful diagnostic tool for groin pain as well as an accurate and reliable measurement of groin muscle strength. When conducting the test, a substantial drop in groin strength or elicitation of pain is highlighted as a red flag.

Mobility and flexibility (Knee to wall, Sit & Reach)

• Good flexibility is associated with a reduced risk of injury. A decrease in a player’s mobility or flexibility scores are highlighted as a red flag.

The MSK scores, along with their wellness questionnaire scores are uploaded onto an online platform called “Kitman labs.” Large fluctuations in these scores are used to stimulate a conversation between the player and medical staff rather than being used as a predictive tool. The subjective information obtained aids in early intervention and management of light injuries (niggles).

Performance

SFC aims to assess a football player’s physical abilities through sport-specific performance testing. Due to the complexity of football, performance tests cannot fully replicate its demands. Mcall et al state that tests of muscular strength, balance/proprioception and physical fitness are the most important performance tests. Hence, highlighting the importance of gathering sufficient information to effectively profile a player.

Strength and power tests

• Three rep max (3RM) bench press and trap-bar deadlift tests are used to measure relative strength.
• The Nordic Hamstring strength test is used to record maximal eccentric and isometric hamstring strength as well as inter-limb imbalances. This is done by using the Vald Nordboard.
• Bike Peak Power test measures the players peak power and cadence. The test can be conducted on a Wattbike or bike erg, with only slight differences in protocol.

Balance and Jump tests

• Proprioception and explosive lower body power are independently measured using the Sparta Science force plate.
• The lateral hop test measures lower leg muscular strength, endurance and inter-limb differences.

Cardiovascular fitness

• The 30-15 is an intermittent running test that functions to measure several physical qualities (VO2max indirectly) which are challenged during intermittent sport.

 

In football each player has his own unique risk, the testing provides insights into the players’ physical strengths and weaknesses.  The results can therefore be used as a baseline measurement for future comparison also illustrating the effectiveness of a training modality (retest). Cone (2012) refers to this information as a key component in the pre-habilitative, rehabilitative and athlete development processes. Also serving as performance-based progression criteria for players returning from injury.

At SFC we profile each player by analysing the medical, MSK, performance and global positioning (GPS) data, rather than looking at each factor independently. Thus enabling us to provide an intervention or management plan that is specific to the needs of each player.

1. Cone, J., 2012. Soccer-Specific Performance Testing of Fitness and Athleticism. Strength & Conditioning Journal, 34(5), pp.11-19.
2. McCall, A., Davison, M., Andersen, T., Beasley, I., Bizzini, M., Dupont, G., Duffield, R., Carling, C. and Dvorak, J., 2015. Injury prevention strategies at the FIFA 2014 World Cup: perceptions and practices of the physicians from the 32 participating national teams. British Journal of Sports Medicine, 49(9), pp.603-608.
3. Targett, S. and Geertsema, C., 2021. SCREENING IN FOOTBALL PLAYERS. Aspetar Sports Medecine Journal, 10.