‘Football Medicine’ has become a popular and well-recognised branch of Sports Medicine. Topics in football medicine often make headline news in sports medicine publications, and can be hotly debated. We are, therefore, very honoured to be able to present to you this selection of exciting and newsworthy articles, written by experts in their field, who dare to tackle some of these contentious issues with sensitivity and honesty.
It all starts with the player, and nobody knows this better than Dr Andrew Massey who has been there for so many years. He sets the scene by discussing the Elite Footballers Medical Conundrum and how this challenges our interpretation of the Hippocratic Oath, our traditional model of shared decision-making and our own moral compass.
Our Current Affairs section kicks off with an article about the pandemic that brought the world to a standstill – COVID-19. Olaf Schumacher highlights important lessons learnt about preventative measures when we attempted to return to football during this time. He specifically talks about what works and what doesn’t, and the results may be surprising. This is particularly important for us here in Qatar, as we prepare for the FIFA World CupTM which is now barely a year away.
The collapse of Christian Erikson with a cardiac arrest on the pitch in the Euros Championships in June 2021 made mainstream news headlines across the World. Mats Borjesson tackles the important and difficult question about whether such a situation is preventable.
Concussion in football has been a very hot topic for the last decade, and continues to generate lawsuits and debates across the globe. Football has come a long way, with the introduction of several new initiatives to help physicians (and ultimately players) to manage concussion and minimise its complications. However, we have not resolved this issue yet, and Louis Holtzhausen discusses some of the reasons for this, as well as the paradigm shift that will be required for us to be truly successful.
A discussion on mental health in football is long overdue. In this thought-provoking article, Vincent Gouttebarge, Gino Kerkhoffs and Margo Mountjoy provide some interesting insights into mental health in football and make very useful recommendations for clinicians involved in the management of football players.
Then there are the perennial favourites: groin, hamstring and ankle injuries, as well as imaging in football.
The fact is that almost every football player you work with will develop some degree of groin pain at some stage of their career. Andreas Serner, Willem Heijboer, Zarko Vuckovic and Adam Weir elaborate on the good news - and the bad news - when it comes to preventing and treating these injuries – and also provide some helpful advice on when it is safe to return to sport, and when surgery will be needed.
In their clinician’s guide to hamstring injury, Anthony Schache and Rod Whiteley explain why the aggregated research on hamstring injuries is barely more useful to us than knowing that on average, humans have slightly less than two legs. They also explain the difference between evidence-based and evidence-informed and add their extensive clinical experience to give us a useful tailored approach to the footballer with this injury.
Dr Pieter D’Hooghe gives us an excellent overview of one of the most difficult injuries to treat in athletes: insertional Achilles tendinopathy. He discusses minimally invasive treatment approaches, which could potentially allow athletes to return to sport much faster, compared to traditional surgical methods.
This section concludes with a whirlwind tour by Marcelo Bordalo, Eduardo Yamashira, Maryam Alnaimi and Javier Arnaiz through the arsenal of imaging options in football medicine. They discuss how to achieve fast and accurate diagnosis in athletes, as well as how to use image-guided interventions as non-surgical treatments.
Our final section is dedicated to New Concepts and Food for Thought: football boots and footballer welfare.
It is surprising that in 2021 there is still very little research about how the player, shoe and surface interact during football movements. Even more surprisingly (apart from one new start-up company and one Australian rules football boot), is the fact that women footballers still do not have any women-specific boots – even though there are clear differences in anthropometrics, movements patterns, and muscle activation patterns between men and women. Athol Thompson discuss these and other issues in his article on football boots and give useful tips on boot selection.
The final topic in our review touches on a subject which has existed like a pink elephant in the room for decades - but which has recently been pushed into the limelight: diversity, inclusiveness and player safety in football. More than half the planet’s population claim to be football fans. Kirsty Burrows eloquently argues the case that, as such, football is a reflection of society and if we, as a society, care to ensure equality and diversity in football (thereby committing to a wider social agenda), then a holistic, rights-based approach to player welfare must be taken – irrespective of gender, sex, race or any other characteristic.
We are grateful to the contributing authors and to the Aspetar Sports Medicine Journal for the vision and support in providing this excellent issue on Hot Topics in Sports Medicine in Football.
Celeste Geertsema MD
Consultant Sports and Exercise Medicine Physician
Pieter D’Hooghe MD, PhD
Consultant Orthopaedic Surgeon
Chief Medical Officer
Aspetar Orthopedic and Sports Medicine Hospital
Andrew Massey MD
Consultant Sports and exercise Medicine Physician