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The Young Player: Special Considerations

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Return to Play in Football

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Abstract

More than half of all registered football players in the world are under 18 years of age. Despite this, the scientific literature on injuries in youth football is scarce compared to senior football, especially in players younger than 12 years. The literature suggests that injuries to the upper extremities are relatively more frequent in players younger than 15 years, mainly attributed to fractures. Players younger than 15 years also suffer fewer sprains and strains than their senior counterparts, whereas older adolescent players have approximately the same injury characteristics as senior players.

Injuries of particular interest in the young player include concussion and anterior cruciate ligament (ACL) injury which both can serve as models for a safe return to play (RTP) in this setting. Youth players are believed to be more prone to suffer concussion than senior players. It is advisable that the stepwise rehabilitation programme is more cautious and the time to RTP is prolonged if needed, especially in children under 12 years. Moreover, although being rare in paediatric players, an ACL injury sidelines the player for a long time and can severely compromise further football playing. Currently there is little consensus regarding rehabilitation protocols, and there are few published RTP criteria. The optimal management of both these injuries in the young player clearly needs to include both time-based and criteria-based cut-offs in the rehabilitation phases in order to make the RTP as safe as possible.

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Top Five Evidence Based References

  • Caccese JB, Kaminski TW (2016) Minimizing head acceleration in soccer: a review of the literature. Sports Med 46:1591–1604

    Article  PubMed  Google Scholar 

  • Faude O, Rössler R, Junge A (2013) Football injuries in children and adolescent players: are there clues for prevention? Sports Med 43:819–837

    Article  PubMed  Google Scholar 

  • Froholdt A, Olsen OE, Bahr R (2009) Low risk of injuries among children playing organized soccer: a prospective cohort study. Am J Sports Med 37:1155–1160

    Article  PubMed  Google Scholar 

  • Rössler R, Junge A, Chomiak J, Dvorak J, Faude O (2015) Soccer injuries in players aged 7–12 years. Am J Sports Med 44:309–317

    Article  PubMed  Google Scholar 

  • Shea KG, Pfeiffer R, Wang JH, Curtin M, Apel PJ (2004) Anterior cruciate ligament injury in pediatric and adolescent soccer players: an analysis of insurance data. J Pediatr Orthop 24:623–628

    Article  PubMed  Google Scholar 

References

  1. FIFA Communications Division (2007) FIFA big count 2006: 270 million people active in football. FIFA, Zurich, Switzerland

    Google Scholar 

  2. Karapanou O, Papadimitriou A (2010) Determinants of menarche. Rep Biol Endocrinol 8:115

    Article  Google Scholar 

  3. Hawkins RD, Fuller CW (1999) A prospective epidemiological study of injuries in four English professional football clubs. Br J Sports Med 33:196–203

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Inklaar H, Bol E, Schmikli SL, Mosterd WL (1996) Injuries in male soccer players: team risk analysis. Int J Sports Med 17:229–234

    Article  CAS  PubMed  Google Scholar 

  5. Latella F, Serni G, Aglietti P, Zaccherotti G, De Biase P (1992) The epidemiology and mechanisms of soccer injuries. J Sports Traumatol 14:107–117

    Google Scholar 

  6. McNoe BM, Chalmers DJ (2010) Injury in community-level soccer: development of an injury surveillance system. Am J Sports Med 38:2542–2551

    Article  PubMed  Google Scholar 

  7. Nielsen AB, Yde J (1989) Epidemiology and traumatology of injuries in soccer. Am J Sports Med 17:803–807

    Article  CAS  PubMed  Google Scholar 

  8. Peterson L, Junge A, Chomiak J, Graf-Baumann T, Dvorak J (2000) Incidence of football injuries and complaints in different age groups and skill-level groups. Am J Sports Med 28:S51–S57

    Article  CAS  PubMed  Google Scholar 

  9. Froholdt A, Olsen OE, Bahr R (2009) Low risk of injuries among children playing organized soccer: a prospective cohort study. Am J Sports Med 37:1155–1160

    Article  PubMed  Google Scholar 

  10. Rössler R, Junge A, Chomiak J, Dvorak J, Faude O (2015) Soccer injuries in players aged 7–12 years. Am J Sports Med 44:309–317

    Article  PubMed  Google Scholar 

  11. Faude O, Rössler R, Junge A (2013) Football injuries in children and adolescent players: are there clues for prevention? Sports Med 43:819–837

    Article  PubMed  Google Scholar 

  12. Hägglund M, Waldén M, Ekstrand J (2009) UEFA injury study – an injury audit of European Championships 2006 to 2008. Br J Sports Med 43:483–489

    Article  PubMed  Google Scholar 

  13. Junge A, Dvorak J (2013) Injury surveillance in the World Football Tournaments 1998–2012. Br J Sports Med 47:782–788

    Article  PubMed  Google Scholar 

  14. Andersen TB, Bendiksen M, Pedersen JM, Ørntoft C, Brito J, Jackman SR, Williams CA, Krustrup P (2012) Kicking velocity and physical, technical, tactical match performance for U18 female football players - effect of a new ball. Hum Mov Sci 31:1624–1638

    Article  PubMed  Google Scholar 

  15. Zebis MK, Thorborg K, Andersen LL, Møller M, Christensen KB, Clausen MB, Hölmich P, Wedderkopp N, Andersen TB, Krustrup P (in press) Effects of a lighter, smaller football on acute match injuries in adolescent female football: a pilot cluster-randomised controlled trial. J Sports Med Phys Fitness

    Google Scholar 

  16. Kelly KD, Lissel HL, Rowe BH, Vincenten JA, Voaklander DC (2001) Sport and recreation-related head injuries treated in the emergency department. Clin J Sport Med 11:77–81

    Article  CAS  PubMed  Google Scholar 

  17. Yard EE, Comstock RD (2009) Compliance with return to play guidelines following concussion in US high school athletes, 2005–2008. Brain Inj 23:888–898

    Article  PubMed  Google Scholar 

  18. Bramley H, Patrick K, Lehman E, Silvis M (2012) High school soccer players with concussion education are more likely to notify their coach of a suspected concussion. Clin Pediatr (Phil) 51:332–336

    Article  Google Scholar 

  19. Caccese JB, Kaminski TW (2016) Minimizing head acceleration in soccer: a review of the literature. Sports Med 46:1591–1604

    Article  PubMed  Google Scholar 

  20. McCrory P, Meeuwisse WH, Dvořák J, Aubry M, Bailes J, Broglio S, Cantu RC, Cassidy D, Echemendia RJ, Castellani RJ, Davis GA, Ellenbogen RG, Emery C, Engebretsen L, Fedderman-Demont N, Giza CC, Guskiewicz K, Herring S, Iverson GL, Johnston KM, Kissick J, Kutcher J, Leddy JJ, Maddocks D, Makdissi M, Manley GT, McCrea M, Meehan WP, Nagahiro S, Patricios J, Putukian M, Schneider KJ, Sills A, Tator CH, Turner M, Vos PE (2017) Consensus statement on concussion in sport: the 5th International Conference on Concussion in Sport held in Berlin, October 2016. Br J Sports Med 51:838–847

    PubMed  Google Scholar 

  21. McClincy MP, Lovell MR, Pardini J, Collins MW, Spore MK (2006) Recovery from sports concussion in high school and collegiate athletes. Brain Inj 20:33–39

    Article  PubMed  Google Scholar 

  22. Reddy CC, Collins MW (2009) Sports concussion: management and predictors of outcome. Curr Sports Med Rep 8:10–15

    Article  PubMed  Google Scholar 

  23. Shea KG, Grimm NL, Ewin CK, Aoki SK (2011) Youth sports anterior cruciate ligament and knee injury epidemiology: who is getting injured? In what sports? When? Clin Sports Med 30:691–706

    Article  PubMed  Google Scholar 

  24. Beynnon BD, Vacek PM, Newell MK, Tourville TW, Smith HC, Shultz SJ, Slauterbeck JR, Johnson RJ (2014) The effects of level of competition, sport, and sex on the incidence of first-time noncontact anterior cruciate ligament injury. Am J Sports Med 42:1806–1812

    Article  PubMed  Google Scholar 

  25. Joseph AM, Collins CL, Henke NM, Yard EE, Fields SK, Comstock RD (2013) A multisport epidemiologic comparison of anterior cruciate ligament injuries in high school athletics. J Athl Train 48:810–817

    Article  PubMed  PubMed Central  Google Scholar 

  26. Roos H, Ornell M, Gärdsell P, Lohmander LS, Lindstrand A (1995) Soccer after anterior cruciate ligament injury – an incompatible combination? A national survey of incidence and risk factors and a 7-year follow-up of 310 players. Acta Orthop Scand 66:107–112

    Article  CAS  PubMed  Google Scholar 

  27. Swenson DM, Collins CL, Best TM, Flanigan DC, Fields SK, Comstock RD (2013) Epidemiology of knee injuries among US high school athletes, 2005/2006–2010/2011. Med Sci Sports Exerc 45:462–469

    Article  PubMed  PubMed Central  Google Scholar 

  28. Waldén M, Atroshi I, Magnusson H, Wagner P, Hägglund M (2012) Prevention of acute knee injuries in adolescent female football players: cluster randomised controlled trial. BMJ 344:e3042

    Article  PubMed  PubMed Central  Google Scholar 

  29. Shea KG, Pfeiffer R, Wang JH, Curtin M, Apel PJ (2004) Anterior cruciate ligament injury in pediatric and adolescent soccer players: an analysis of insurance data. J Pediatr Orthop 24:623–628

    Article  PubMed  Google Scholar 

  30. Moksnes H, Engebretsen L, Eitzen I, Risberg MA (2013) Functional outcomes following a non-operative treatment algorithm for anterior cruciate ligament injuries in skeletally immature children 12 years and younger. A prospective cohort with 2 years follow-up. Br J Sports Med 47:488–494

    Article  PubMed  Google Scholar 

  31. Frosch KH, Stengel D, Brodhun T (2010) Outcomes and risks of operative treatment of rupture of the anterior cruciate ligament in children and adolescents. Arthroscopy 26:1539–1550

    Article  PubMed  Google Scholar 

  32. Fabricant PD, Jones KJ, Delos D, Cordasco FA, Marx RG, Pearle AD, Warren RF, Green DW (2013) Reconstruction of the anterior cruciate ligament in the skelettaly immature athlete: a review of current concepts: AAOS exhibit selection. J Bone Joint Surg Am 95:e28

    Article  PubMed  Google Scholar 

  33. Kocher MS, Saxon JS, Hovis WD, Hawkins RJ (2002) Management and complications of anterior cruciate ligament injuries in skeletally immature patients: survey of the Herodicus Society and The ACL Study Group. J Pediatr Orthop 22:452–457

    PubMed  Google Scholar 

  34. Courvoisier A, Grimaldi M, Plaweski S (2011) Good surgical outcome of transphyseal ACL reconstruction in skeletally immature patients using four-strand hamstring graft. Knee Surg Sports Traumatol Arthrosc 19:588–591

    Article  PubMed  Google Scholar 

  35. Yellin JL, Fabricant PD, Gornitzky A, Greenberg EM, Conrad S, Dyke JA, Ganley TJ (2016) Rehabilitation following anterior cruciate ligament tears in children: a systematic review. JBJS Rev 4(1). pii: 01874474-201601000-00004

    Google Scholar 

  36. Fältström A, Hägglund M, Magnusson H, Forssblad M, Kvist J (2016) Predictors for additional anterior cruciate ligament reconstruction: data from the Swedish national ACL register. Knee Surg Sports Traumatol Arthrosc 24:885–894

    Article  PubMed  Google Scholar 

  37. Wiggins AJ, Grandhi RK, Schneider DK, Stanfield D, Webster KE, Myer GD (2016) Risk of secondary injury in younger athletes after anterior cruciate ligament reconstruction: a systematic review and meta-analysis. Am J Sports Med 44:1861–1876

    Article  PubMed  PubMed Central  Google Scholar 

  38. Grindem H, Snyder-Mackler L, Moksnes H, Engebretsen L, Risberg MA (2016) Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction; the Delaware-Oslo ACL cohort study. Br J Sports Med 50:804–808

    Article  PubMed  PubMed Central  Google Scholar 

  39. Yard EE, Schroeder MJ, Fields SK, Collins CL, Comstock RD (2008) The epidemiology of United States high school soccer injuries, 2005–2007. Am J Sports Med 36:1930–1937

    Article  PubMed  Google Scholar 

  40. Salter R, Harris WR (1963) Injuries involving the epiphyseal plate. J Bone Joint Surg Am 45:587–622

    Article  Google Scholar 

  41. Lindaman LM (2001) Bone healing in children. Clin Podiatr Med Surg 18:97–108

    CAS  PubMed  Google Scholar 

  42. DiFiori J, Caine D, Malina R (2006) Wrist pain, distal radial growth plate injury, and ulnar variance in the young gymnast. Am J Sports Med 34:840–849

    Article  PubMed  Google Scholar 

  43. Dwek JR, Cardoso F, Chung CR (2009) MR imaging of overuse injuries in the skeletally immature gymnast: spectrum of soft-tissue and osseous lesions in the hand and wrist. Pediatr Radiol 39:1310–1316

    Article  PubMed  PubMed Central  Google Scholar 

  44. Caine D, DiFiori J, Mafulli N (2006) Physeal injuries in children’s and youth sports: reasons for concern? Br J Sports Med 40:749–760

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Agricola R, Heijboer MP, Ginai AZ, Roels P, Zadpoor AA, Verhaar JA, Weinans H, Waarsing JH (2014) A cam deformity is gradually acquired during skeletal maturation in adolescent and young male soccer players: a prospective study with minimum 2-year follow-up. Am J Sports Med 42:798–806

    Article  PubMed  Google Scholar 

  46. Griffin DR, Dickenson EJ, O’Donnell J, Agricola R, Awan T, Beck M, Clohisy JC, Dijkstra HP, Falvey E, Gimpel M, Hinman RS, Hölmich P, Kassarjian A, Martin HD, Martin R, Mather RC, Philippon MJ, Reiman MP, Takla A, Thorborg K, Walker S, Weir A, Bennell KL (2016) The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement. Br J Sports Med 50:1169–1176

    Article  CAS  PubMed  Google Scholar 

  47. Hägglund M, Waldén M, Ekstrand J (2007) Lower reinjury rate with a coach-controlled rehabilitation program in amateur male soccer: a randomized controlled trial. Am J Sports Med 35(9):1433–1442

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Football Research Group, Department of Orthopaedics, Vrinnevisjukhuset, Norrköping, Sweden

    Jonas Werner

  2. Football Research Group, Division of Physiotherapy, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden

    Martin Hägglund

  3. Football Research Group, Linköping, Sweden

    Mariann Gajhede Knudsen

  4. Football Research Group, Division of Community Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden

    Jan Ekstrand & Markus Waldén

Authors
  1. Jonas Werner
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  2. Martin Hägglund
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  3. Mariann Gajhede Knudsen
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  4. Jan Ekstrand
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  5. Markus Waldén
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Corresponding author

Correspondence to Jonas Werner .

Editor information

Editors and Affiliations

  1. UPMC Rooney Sports Complex, University of Pittsburgh, Pittsburgh, Pennsylvania, USA

    Volker Musahl

  2. Department of Orthopaedics, University of Gothenburg, Gothenburg, Sweden

    Jón Karlsson

  3. Department of Trauma Surgery, University Medical Centre Regensburg, Regensburg, Germany

    Werner Krutsch

  4. Santa Monica, California, USA

    Bert R. Mandelbaum

  5. Clínica do Dragão, Espregueira-Mendes Sports Centre, Porto, Portugal

    João Espregueira-Mendes

  6. Orthopaedic Surgery, Aspetar Hospital, Doha, Qatar

    Pieter d'Hooghe

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Werner, J., Hägglund, M., Knudsen, M.G., Ekstrand, J., Waldén, M. (2018). The Young Player: Special Considerations. In: Musahl, V., Karlsson, J., Krutsch, W., Mandelbaum, B., Espregueira-Mendes, J., d'Hooghe, P. (eds) Return to Play in Football. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-55713-6_73

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  • DOI: https://doi.org/10.1007/978-3-662-55713-6_73

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