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Lower Reinjury Rate With a Coach-Controlled Rehabilitation Program in Amateur Male Soccer

A Randomized Controlled Trial

From the Department of Health and Society, Linköping University, Linköping, Sweden

^* Address correspondence to Martin Hägglund, BSc, Department of Health and Society, Division of Social Medicine and Public Health Science, Linköping University, S-58183 Linköping, Sweden (e-mail: hagglund.martin{at}telia.com)

Background: Soccer injuries are common, and athletes returning to play after injury are especially at risk. Few studies have investigated how to prevent reinjury.

Hypothesis: The rate of reinjury is reduced using a coach-controlled rehabilitation program.

Study Design: Randomized controlled trial; Level of evidence, 1.

Methods: Twenty-four male amateur soccer teams were randomized into an intervention (n = 282) and control group (n = 300). The intervention was implemented by team coaches and consisted of information about risk factors for reinjury, rehabilitation principles, and a 10-step progressive rehabilitation program including return to play criteria. During the 2003 season, coaches reported individual exposure and all time loss injuries were evaluated by a doctor and a physiotherapist. Four teams (n = 100) withdrew from the study after randomization, leaving 10 teams with 241 players for analysis in both groups.

Results: There were 90 injured players (132 injuries) in the intervention group, and 10 of these (11%) suffered 14 reinjuries during the season. In the control group, 23 of 79 injured players (29%) had 40 recurrences (134 injuries). A Cox regression analysis showed a 66% reinjury risk reduction in the intervention group for all injury locations (hazard ratio [HR] 0.34, 95% confidence interval [CI] 0.16–0.72, P = .0047) and 75% for lower limb injuries (HR 0.25, 95% CI 0.11–0.57, P < .001). The preventive effect was greatest within the first week of return to play. Injured players in the intervention group complied with the intervention for 90 of 132 injuries (68%).

Conclusion: The reinjury rate in amateur male soccer players was reduced after a controlled rehabilitation program implemented by coaches.

Key Words: soccer • football • recurrent injury • prevention • rehabilitation

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