Can prognostic factors for indirect muscle injuries in elite football (soccer) players be identified using data from preseason screening? An exploratory analysis using routinely-collected periodic health examination records

Abstract

ABSTRACTThis study used periodic health examination (PHE) data from 134 outfield elite male football players, over 5 seasons (1st July 2013 to 19th May 2018). Univariable and multivariable logistic regression models were used to determine prognostic associations between 36 variables and time-loss, lower extremity index indirect muscle injuries (I-IMIs). Non-linear associations were explored using fractional polynomials. During 317 participant-seasons, 138 I-IMIs were recorded. Univariable associations were determined for previous calf indirect muscle injury (IMI) frequency (OR=1.80, 95% confidence interval (CI) = 1.09 to 2.97), hamstring IMI frequency (OR=1.56, 95% CI=1.17 to 2.09), if the most recent hamstring IMI occurred > 12 months but < 3 years prior to PHE (OR= 2.95, 95% CI = 1.51 to 5.73) and age (OR =1.12 per 1-year increase, 95% CI = 1.06 to 1.18). Multivariable analyses demonstrated that if a player’s most recent previous hamstring IMI was >12 months but <3 years prior to PHE (OR= 2.24, 95% CI = 1.11 to 4.53), then this was the only variable with added prognostic value over and above age (OR=1.12 per 1-year increase, 95%CI = 1.05 to 1.18). Allowing non-linear associations conferred no advantage over linear ones. Therefore, PHE has limited use for injury risk prediction.