CC BY
0УДК 796.015.55 DOI: 10.36028/2308-8826-2024-12-3-45-52
METHOD FOR PREVENTION OF ANKLE AND KNEE INJURIES IN YOUNG FOOTBALL PLAYERS AT THE STAGE OF SPORTS SPECIALIZATION
A.S. Al-jaberi
Ural Federal University named after the First President of Russia B. N. Yeltsin, Yekaterinburg, Russia
Abstract
The purpose is to develop a methodology to improve motor and control skills in young football players in order to reduce risk factors associated with movement, to prevent injuries to the ankle and knee joints at the stage of sports specialization.
Materials and methods. This study was developed on the basis of the State Autonomous Institution of Additional Education - sports school "ACADEMY OF THE FOOTBALL CLUB «URAL»" of the Sverdlovsk region, Yekaterinburg. The first step was the commitment to develop a study in accordance with the Helsinki Declaration of the World Medical Association on Ethical Principles of Human Research. The participants of this study are 20 football players of the team born in 2008, that took first place in the "Volga Region-3" Youth Football League in 2023.
Results. The results of using field screening methods to identify high-risk groups for ankle sprain injuries and contact / non-contact knee injuries are an important step in preventing these injuries in players at the youth football academic level.
Conclusion. The proposed method of targeted impact measures has demonstrated statistical significance in the development of functional assessment abilities. This is evidenced by efficient movement and control to reduce the risk factors associated with the movement of young football players and designed to prevent ankle and knee injuries.
Keywords: prevention, movement, motor control, neuromuscular control, balance, injury prevention, knee joint, ankle joint, young football players.
МЕТОДИКА ПРОФИЛАКТИКИ ТРАВМ ГОЛЕНОСТОПНОГО СУСТАВА И КОЛЕНА У ЮНЫХ ФУТБОЛИСТОВ НА ЭТАПЕ СПОРТИВНОЙ СПЕЦИАЛИЗАЦИИ
А.С. Аль-Джабери
Уральский федеральный университет имени первого президента России Б. Н. Ельцина, Екатеринбург, Россия
Аннотация
Целью исследования является разработка методики для улучшения моторики и контроля у юных футболистов с целью снижения факторов риска, связанных с движением, для предотвращения травм связок голеностопа и коленных суставов на этапе спортивной специализации.
Методы и организация исследования. Данное исследование было разработано на базе ГАУ ДО СО СШ «АКАДЕМИЯ ФК «УРАЛ» Свердловской области, город Екатеринбург. Первым шагом стало обязательство разработать исследование в соответствии с правилами Хельсинкской декларации Всемирной медицинской ассоциации об этических принципах проведений исследований на человеке. Участниками данного исследования являются 20 футболистов, родившихся в 2008 году, команды, занявшей первое место в Юношеской футбольной лиге «Приволжье-3» в 2023 г.
Результаты исследования. Результаты применения методов полевого скрининга для выявления высокорисковых групп в отношении получения травм связок голеностопа и травм коленей при контактном и неконтактном воздействии являются важным этапом в предотвращении этих травм у игроков юношеского футбольного академического уровня.
Заключение. Предлагаемая методика целенаправленной меры воздействия продемонстрировала статистическую значимость в развитии функциональных способностей к оценке. Это подтверждается эффективным движением и контролем для снижения факторов риска, связанных с движением, и разработанным для предотвращения травм голеностопного и коленного суставов.
Ключевые слова: профилактика, движение, двигательный контроль, нервно-мышечный контроль, равновесие, профилактика травм, коленный сустав, голеностопный сустав, юные футболисты.
INTRODUCTION
Despite the positive contribution of football to the health of youth football players, injuries in this sport are a common and serious phenomenon [8]. Especially at the level of elite football academies [9]. Epidemiology shows that among youth male football players, for every 1,000 hours of training and competition, there are from 9.5 to 48.7 injuries [2]. The most serious injuries are injuries to the ankle [3] and knee [4], which can lead to long periods of absence of youth football players from training and competitions. This, in turn, can negatively affect the development of player skills and team performance. Studies show that knee injuries, being a common occurrence, cause greater economic damage, exceeding the average cost by 28-36%, compared with injuries to the ankle, hip and thigh [7]. Due to all the negative consequences of knee and ankle injuries, there is an urgent need to develop evidence-based preventive strategies. To do this, it is necessary to increase the level of competence in the field of football injury prevention and work on the widespread dissemination and implementation of scientific achievements in this field. The main goal of training youth football players should be not only to develop technical skills of the game, but also to improve motor and control in order to prevent injuries to the ankle and knee joints by reducing risk factors based on movement. Aim. formation of a methodology for improving the motor and control of youth footballers to reduce the risk factors associated with movement, to prevent injuries to the ankle sprains and knee joints at the stage of sports specialization.
METHODS AND ORGANIZATION
This study was developed on the basis of the GAU TO «ACADEMY of FC URAL» of the Sverdlovsk region, Yekaterinburg. This study was developed in accordance with the federal standards of sports training in the sport of football. Before starting to apply the study protocol, the ethical and theoretical foundations for conducting the study were laid. The first step was the commitment to develop a
study in accordance with the rules of the Helsinki Declaration of the World Medical Association on the Ethical Principles of Human Research. Then the protocol of the study was previously explained in detail to the football players participating in it, as well as to their parents, from whom written informed consent was then obtained to conduct the study. These measures were necessary due to the underage age of the players.
The study designs. Experimental design, one control group and one experimental group. The stage of sports training. The stage of sports specialization.
The participants of the study. The participants of this study are 32 football players of the team born in 2008, which took first place in the Volga-3 Youth Football League in 2023. Football players train on the basis of the federal state budgetary organization GAU TO «ACADEMY of FC URAL». We selected three criteria for the selection of participants: (1) football players who had no history of injuries or disorders of the musculoskeletal system in the last three months before the study, (2) football players with at least 4 years of football training experience, (3) football players who train at least 4-6 times per week.
Excluded: 2 goalkeepers were excluded, a player with an injury in the previous season that prevented him from training with the group, a player with a muscle injury (in the anterior thigh muscle) that was sustained during training in the last week from the transition phase before the start of the experiment, which prevented him from start and completing the experiment and conducting the tests. A sample of the study. A homogeneous sample of 28 football players was selected, 20 of which belonged to the sample under study. The sample under study was randomly selected based on the Steven K. Thompson formula with a confidence level (95%). Since the study sample represented (71.42%) of the entire study population, the study sample was divided into two groups, the experimental group (EG) consisted of 10 players. While the control group (CG) consisted of 10 football players too. Both groups
Table 1 - Anthropometric indicators of study groups
Таблица 1 - Антропометрические показатели исследуемых групп
Control season Intervention Season
Indicators CG EG CG EG
(n = 10) (n = 10) (n = 10) (n = 10)
Age (years) 14.66 ± 0.49 14.78 ± 0.82 15.24 ± 0.26 15.36 ± 0.37
Height (cm) 169.1 ± 5.9 170.66 ± 7.23 173.6 ± 7.5 175.54 ± 6.78
Body weight (kg) 58 ± 6.33 60.1 ± 8.92 64 ± 8.21 62.1 ± 10.70
Experience (years) 5.9 ± 2.14 6.43 ± 2.23 6.5 ± 1.95 7.2 ± 1.68
train five to six days a week in accordance with the regulations of the Russian Football Federation, as well as in accordance with the federal standards of sports training in the sport of football. Sprained ankle joint injuries and knee injuries of the groups under study during the preparatory period were recorded by analyzing the medical documentation of the Academy during the control season and the experiment season.
Two participants CG were withdrawn from the Posttests in intervention season due to knee injuries that prevented their inclusion in the control testing. Time frame of the study: the preparatory period of the annual cycle, from 9/01/2023 to 11/04/2023.
Control tests. The tasks of the tests included the assessment and identification of the following indicators:
• assessment of balance and stability (dynamic balance: Y-Balance test);
• assessment of a football player's ability to accelerate, change direction and accelerate again (speed
and agility: Illinois agility Test (IAT), and Quadrant Jump test (QJT), this is a non-running type agility test, measuring the ability to move around in a small space with maximum speed, while maintaining balance and neuromuscular-control (coordination). In the Quadrant Jump test, participants jump around);
• assessment of the biomechanics of landing from a jump (determining the risk of non-contact injuries: landing error scoring system (LESS) [11, 10]. The LESS is based on noticeable landing errors, with a high score indicating a low landing technique. Interventions
In this study, scientifically based preventive measures described in Etiology were used. They consist in influencing internal and external risk factors. The purpose of these measures is to reduce the risk of movement-related ankle sprain and knee injuries. The proposed technique is based on the formation of physical and motor qualities that will help youth football players prevent the occurrence of injuries in these two joints, which are considered
Coordination
Motor control
T
Balance
The content of the method of prevention of ankle sprain and knee injuries in youth football players at the stage of sports specialization
T
Landing technique ■ pr0pri0cepti0n I Functional stability
Figure 1 - A conceptual model of the components underlying the method of preventing Ankle sprains ankle and knee injuries in youth football players at the stage of sports specialization
Рисунок 1 - Концептуальная модель компонентов, положенных в основу метода профилактики растяжений связок голеностопного сустава, травм голеностопного сустава и колена у юных футболистов на этапе спортивной специализации
the most important in the football game. These qualities include motor control, coordination, balancing ability (dynamic and static balance), stability, proprioception, and landing technique. By applying isolated preventive training sessions were held twice a week with an interval of at least two days, before the basic football training. The sequence of epidemiological studies performed in accordance with established criteria is considered a decisive factor in determining the preventive framework. In order to achieve maximum effectiveness of preventive strategies and achieve the set goal, it is necessary to use an adapted implementation framework based on pedagogical supervision, along with theoretical competencies and practice. The level of effectiveness and achievement of the preventive goal is reflected in the pedagogical competence to implement strategies combined with the use of external pedagogical feedback. Pre-workout Warm-up protocol: (1) Physical warm-up for gym workouts: 8-12 minutes of dynamic stretching. (2) Warm-up for training on the football pitch: 10—15-minute warm-up with dy-
namic stretching, followed by dynamic neuromus-cular mixed warm-up with ballistic stretches. Methods of mathematical statistics. Statistical analysis of the data obtained was carried out using MS EXCEL, SPSS (version 18; SPSS, Inc., Chicago, Illinois, USA) (for Microsoft Windows), where the arithmetic mean, standard deviation, T-test were found, the reliability of the differences was considered reliable at 95% (p<0.05).
RESULTS AND DISCUSSION
The results of field screening tools to identify high-risk groups for ankle sprain injuries and contact / non-contact knee injuries are an important step in preventing these injuries in youth football players at the academy level. We examined the predictive ability of an adequate field assessment of the efficient of movement during the performance of tests that we identified in the current study as a reliable indicator for identifying high-risk groups for ankle joint sprains and knee injuries [12, 13]. Despite the limitations of our current study, which did not study the uniqueness of the study community, but
Table 2 - Part of the protocol of the exercise complex Таблица 2 - Часть протокола комплекса упражнений
Exercise Purpose of exercise Intensity % Sets Reps Rest Location Type of shoes
between sets between exercises
front Bounds fast kick by using Bosu balance Development of ankle joint control on one foot 90-95 2 20 second 30 second 30 second gym gym shoes
One leg anti-lateral flexion drill Development of static balance 85-90 2 30 second 30 second 30 second gym barefoot
Landing with a box crossing and catching a tennis ball with a perturbation (with partner) Developing control and landing technique 85-90 2 40 second 30 second 30 second gym gym shoes
Split stance offset drops with kettlebell perturbations Development of dynamic balance 85-90 2 30 second 30 second 30 second gym gym shoes
Eccentric lateral landing reactive (with partner) Developing control and landing lateral technique on one foot 80-85 2 30 second 30 second 30 second football pitch football boots
Plyogility (lateral) Lateral agility 85-90 2 4 1.30 minute 1.30 minute football pitch football boots
Table 3 - Injuries during the control season and the intervention season Таблица 3 - Травмы во время контрольного сезона и сезона вмешательства
Indicators Control season Intervention Season CG +/- EG +/-
CG (n = 10) EG (n = 10) CG (n = 10) EG (n = 10)
Ankle sprain 7 6 6 2 - 14.2 % - 66.6 %
Knee 4 5 3 1 - 15 % - 80 %
Table 4 - Post-tests results of EG and CG
Таблица 4 - Результаты итогового тестирования экспериментальной и контрольной групп
Indicators Units of measurement Mean difference Std deviation difference Т Р
Y-Balance Right leg Centimeters 3.42 0.62 2.09 0.05
Left leg 4.73 0.25 2.94 0.01
QJT Quantity 4.90 1.64 2.99 0.01
IAT Seconds 1.00 0.23 3.83 0.01
LESS Points Assessment 4.70 0.23 5.25 0.01
Table 5 - Test results (Pre-test - Post-tests) of CG
Таблица 5 - Результаты тестирования (Предварительное тестирование - Итоговое тестирование) контрольной группы
Indicators Units of measurement Pre-tests (n = 10) Post-tests (n = 8) Т Р
Y-Balance Right leg Centimeters 105 ± 4.32 105.77 ± 3.95 2.28 0.05
Left leg 99.6 ± 3.73 100.43 ± 3.90 5.33 0.01
QJT Quantity 26.1 ± 4.58 26.3 ± 2.75 0.20 0.85
IAT Seconds 15.99 ± 0.58 15.30 ± 0.69 3.18 0.01
LESS Points assessment 12.2 ± 2.62 11 ± 1.89 3.09 0.01
Table 6 - Test results (Pre-tests - Post-tests) of EG
Таблица 6 - Результаты тестирования (Предварительное тестирование - Итоговое тестирование) экспериментальной группы
Indicators Units of measurement Pre-tests (n = 10) Post-tests (n = 10) Т Р
Y-Balance Right leg Centimeters 106.75 ± 3.82 109.19 ± 3.33 7.71 0.01
Left leg 101 ± 3.47 105.16 ± 4.42 9.05 0.01
QJT Quantity 26.6 ± 5.87 31.2 ± 4.39 5.01 0.01
IAT Seconds 16.29 ± 0.46 15.84 ± 0.39 4.47 0.02
LESS Points Assessment 10.5 ± 2.11 6.3 ± 2.84 5.78 0.03
Figure 2 - The results of finding mean of the Post-tests of the EG and CG
Рисунок 2 - Результаты нахождения среднего значения итогового тестирования экспериментальной и контрольной групп
studied groups as a whole, depending on what previous studies have reported, individuals with high results in the tests specified in the current study can be described as individuals who are not at high risk for ankle sprains and knee injuries among youth football players. An increase in the moment of displacement of the internal (valgus) or external (varus) knee during landing is considered as a possible risk factor for knee injury. Lack of leg balance, the balance between the strength of the front thigh and hamstring muscle, and lack of posture control are a frequent cause of lateral ankle sprains in football. [6] Regarding our results, it has also been proven that these programs develop the quality of movement by working to reduce the scores for the LESS precisely with feedback below the cut-off point threshold in relation to susceptibility to the risk of injury. The changes in the biomechanics of landing revealed by the LESS correspond to our hypotheses in this research by showing that movement, as quality is one of the biomechanical risk factors that predict knee injury, with similar levels of results with previous studies, as it is very common that people with wrong movement patterns are prone to ankle and knee injuries associated with biomechanics, and this is what the LESS showed us.
Unfortunately, there is not much recent scientific research specifically looking at the IAT and its direct correlation with injuries. The IAT is more commonly used as a measurement tool to improve agility and speed, not necessarily to predict injuries. One of the important reasons why we used the IAT in our current study is the relationship of agility to the degree of hip control among youth football players at the stage of sports specialization, considering that high ability for agility and hip control is associated with knee injuries associated with movement-based risk factors. However, based on what we know, the validity of the IAT to predict injuries has not yet been proven, but studies have shown that the most skilled and movement-efficient players have lower rates of ankle and knee sprains associated with movement than their peers with lower skills, which is reflected in the ability to control posture and change direction. Moreover, there may be associations between the IAT with other factors, such as flexibility or reduced core strength, it can predict the risk of injury. Future studies can analyze specific movements specific to the mechanics of movement and their direct/indirect correlation with the risk of injury in the IAT and determine whether the wrong/lack technique during the test is
associated with a greater likelihood of ankle and knee sprain injuries among youth football players. However, there are no studies to date that directly correlate the predictive ability of the IAT with the prognosis of movement-related knee injuries, even if the IAT shows some association with injuries, it may be useful to use the results for targeted injury prevention programs. Nevertheless, based on the results of our study, the high hip control ability of youth football players can be inferred as an indirect method of preventing ankle and knee sprain injuries associated with biomechanics of movement.
For the Y-Balance test, it was found that the risk of injury in the future is associated with asymmetry of anterior access, asymmetry of the posterior and lateral posterior directions, as well as asymmetry of access in different directions [1]. In our methodology, Isotonic / Isometric balance and stability exercises were used, and the development of these qualities between the two groups was revealed in the Y-Balance test statistically (right leg: p> 0.05, left leg: p> 0.01). That the result of the Y-Balance test of the vehicle (right leg: 109.19 ± 3.33, left leg: 105.16 ± 4.42) may predict the injury of the lower limb by non-contact in youth football players. In our methodology, Isotonic / Isometric balance and stability exercises were used, and the development of these qualities between the two groups was revealed in the Y-Balance test statistically (right leg: p> 0.05, left leg: p> 0.01). That the result of the Y-Balance test (right leg: 109.19 ± 3.33, left leg: 105.16 ± 4.42) may predict the injury of the lower limb by non-contact in youth football players. Based on these results, the Y-Balance test, especially the direction of external lateral access and the asymmetry of frontal access, may be associated with non-contact/ direct knee injuries relative to the non-dominant leg and specifically not the dominant leg in youth football players with low Y-Balance test results, since there are few studies evaluating the risk of ankle and knee sprain injury in youth football players based on lower limb mobility and stability performance. Our study does not agree with the results of the González-Fernández study, although the participants in the González-Fernández study are not limited to youth football players, otherwise they also included amateur football players, as the study found that for the forward directions, amateurs and semi-professionals received the highest values for dominant and non-dominant legs [5]. Regarding the asymmetry of the parties in the González-Fernández study, no meaningful
differences were found between the players. Despite the discrepancies between the studies regarding the results of the Y-Balance test, we can draw a preliminary conclusion and based on previous studies, despite the difference in methodologies, the correlation of deficits in neuromuscular dynamic control as an indicator of the reach in the three directions measured by the Y-Balance test of the lower part indicates future consequences in the direction of increased risk of ankle sprain and knee injury in youth football players. However, the current study on the Y-Balance test has not conclusively proved that this test can be considered as a tool for identifying these deficits in youth football players at the academic level. For the Quadrant test, the main purpose of choosing the Quadrant test in the current study is to assess the motor control and posture of the ankles in youth football players. The Quadrant test has been proven to be a valid and reliable measure of agility and neuromuscular control in football players [14]. In the experimental group, significant differences were found in the Quadrant test (P <0.01). The proposed method statistically showed that the proposed measures have a positive effect on the indices of motor control between the experimental group (31.2 ± 4.39) and the control group (26.3 ± 2.75). The specified period for the duration of training is most likely aimed at developing / maintaining motor control of the ankles to promote biomechanical and neuromuscular changes among youth football players specifically for the Prevention of ankle joint sprain injuries. The method, which is based on reducing the risk factors associated with
ЛИТЕРАТУРА:
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movement, involves the mechanisms of the foot and the control of the position of the ankle and knee during football tasks/performances among youth football players. The improvement of these indicators, in turn, leads to the development of stability and the ability to control ankle movements, which was most pronounced at the Post-tests stage. The basis on which our method is built is the supporting motor interaction of the player during the performance between the ability to change the direction of functional balance through postural control in the hip and ankle and the landing technique, which represents the formation of the prevention capabilities of ankle and knee sprain injuries assumed by our study in youth football players at the stage of sports specialization at the level of academies. In addition, and in particular, attention is paid to coordination, body control in the lateral and frontal planes and the strength of one leg relying on the landing technique.
CONCLUSION
We conducted a study in real pedagogical conditions and according to a pedagogical scenario, in which the motor of youth football players associated with efficient movement was studied in order to reduce risk factors and prevent injuries to the ankle sprain and knee joints. The proposed method of targeted impact measures has demonstrated statistical significance in the development of functional assessment abilities. This is evidenced by efficient movement and control to reduce the risk factors associated with the movement of youth football players and designed to prevent injuries to the ankle and knee joints.
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СВЕДЕНИЯ ОБ АВТОРЕ:
Аль-Джабери Амиир Салах - аспирант института физической культуры, спорта и молодежной политики; Уральский федеральный университет имени первого президента России Б.Н. Ельцина; г. Екатеринбург, ул. Комсомольская, 70; e-mail: ameerhattab@mail.ru, ORCID: 0000-0001-9688-4928.
• Поступила в редакцию 21 апреля 2024 г.
• Принята к публикации 19 июля 2024 г.
ОБРАЗЕЦ ЦИТИРОВАНИЯ
Al-jaberi, A.S. Method for prevention of ankle and knee injuries in young football players at the stage of sports specialization / A.S. Al-jaberi // Наука и спорт: современные тенденции. - 2024. - Т. 12, №3. - С. 45-52. DOI: 10.36028/2308-8826-2024-12-3-45-52.
FOR CITATION
Al-jaberi A.S. Method for prevention of ankle and knee injuries in young football players at the stage of sports specialization. Science and sport: current trends, 2024, vol. 12, no. 3. - pp. 45-52. DOI: 10.36028/2308-88262024-12-3-45-52.
