Fluids and electrolytes in football
This process of losing body water is called dehydration, due to which acute or chronic dehydration, called hypohydration, occurs.
During the last two decades, the muscle injury ratio and the players’ attendance to the training sessions and competition matches have remained stable in male professional football.1,2 Prevention strategies that have tried to reduce injury risk, haven’t achieved a significant decline in injury rate.3
Doctors responsible for clubs that participated in the UEFA Elite Club Injury Study suggest that the most important risk facts that can cause an injury are as follows:
A recent research4 has just demonstrated the importance of internal communication within elite football teams and how it relates to injuries and the availability of players to train and compete. This study, published in the British Journal of Sports Medicine magazine in 2019, focused on the analysis of 36 elite teams from 17 different European countries during the years 2012 to 2016. A member of the medical staff of each club answered a questionnaire to describe his assessment in regard to the quality of the internal communication within his club. The quality of the communication was rated on a Likert scale of 5 points from “poor” (rating = 1) to “very, very good” (rating = 5). The quality of the communication evaluated the internal relationships between the medical staff (doctors and physical therapists), their relationship with the coach and the strength and conditioning coaches, and their communication with the sport’s director and the management board. The results are very interesting. In general, a good internal communication within clubs (rating = 5) was correlated to a smaller number of injuries (rs = 0.31, p = 0.007); a low incidence of serious injuries (rs = 0.32, p = 0.005), and a greater availability of players to exercise (rs=0.31, p=0.006) and play matches (rs=0.27 p=0.048). The best communication was produced within the medical staff (between doctors and physical therapists) rating 4.5 (range of 2 to 5). Communication between other members of the team varied between 3.4 and 3.9 (range of 1 to 5 for everybody).
Communication between the main coach and the medical staff was the one with the greatest influence in the injury and availability of footballers to exercise and compete-rate. Teams with a low-quality internal communication (rating 1-2), obtained a 5%-8% less of training attendance (76% vs 83%, p=0.001) and less availability of players to play matches (82% vs 88%, p=0.004) compared to teams with medium or high-quality internal communications (rating 3-5).
Other facts to consider. The total number of player days absence in teams with low, medium or high rating level for internal communication within the medical staff and S&C coaches was 184, 127 and 106, respectively. For the relationship between the medical staff and the management board, it was 148, 127 and 107, respectively. Lastly, for the relationship between the medical staff and the sports director, it was 147, 140 and 107, respectively.
Having in mind these results, it is necessary to pay a lot of attention to create a good team task force. It is also important to create a good working atmosphere respecting the opinions of others. Coaches should ask and show interest in the job done by other members of the technical staff. It is crucial for teams to work internal communication protocols (channels, meeting schedules, reports to present, etc.) in order to encourage positive interactions between all staff members.
Carlos Lago Peñas
1 Ekstrand J, Hägglund M, Kristenson K, et al. Fewer ligament injuries but no preventive effect on muscle injuries and severe injuries: an 11-year follow-up of the UEFA Champions League injury study. Br J Sports Med 2013; 47:732–7.
2 Ekstrand J, Waldén M, Hägglund M. Hamstring injuries have increased by 4% annually in men’s professional football since 2001: a 13-year longitudinal analysis of the UEFA Elite Club injury study. Br J Sports Med 2016; 50:731–7.
3 Ekstrand J. Preventing injuries in professional football: thinking bigger and working together. Br J Sports Med 2016; 50:709-10
4 Ekstrand J, Lundqvist D, Davison M, et al. Communication quality between the medical team and the head coach/manager is associated with injury burden and player availability in elite football clubs Br J Sports Med 2019; 53: 304-308.
An article published in The Orthopaedic Journal of Sports Medicine —in which members of the club’s medical services participated— now suggests to consider the detailed structure of the area affected, and treating the extracellular matrix as an essential player in the prognosis of the injury.