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Scand J Med Sci Sports 2009: 19: 243–251 Printed in Singapore . All rights reserved DOI: 10.1111/j.1600-0838.2008.00780.x

& 2009 John Wiley & Sons A/S

& 2009 John Wiley & Sons A/S Muscular strength, functional performances and injury risk

Muscular strength, functional performances and injury risk in professional and junior elite soccer players

C. Lehance 1 , J. Binet 2 , T. Bury 1 , J. L. Croisier 2

1 Department of Sports Physiology, University of Liege, Liege, Belgium, 2 Department of Physical Medicine and Rehabilitation, University Hospital Centre, Liege, Belgium

Corresponding author: Ce´dric Lehance, Department of Sports Physiology, Faculty of Medicine, ISEPK, B21, Alle´e des Sports 4, B-4000, University of Liege , Liege, Belgium. Tel: 0032-(0)43663886, Fax: 0032-(0)43662901, E-mail: clehance@ ulg.ac.be

Accepted for publication 10 January 2008

Muscle strength and anaerobic power of the lower extre- mities are neuromuscular variables that influence perfor- mance in many sports activities, including soccer. Despite frequent contradictions in the literature, it may be assumed that muscle strength and balance play a key role in targeted acute muscle injuries. The purpose of the present study was to provide and compare pre-season muscular strength and power profiles in professional and junior elite soccer players throughout the developmental years of 15–21. One original aspect of our study was that isokinetic data were considered alongside the past history of injury in these players. Fifty- seven elite and junior elite male soccer players were assigned to three groups: PRO, n 5 19; U-21, n 5 20 and U-17, n 5 18. Players benefited from knee flexor and extensor isokinetic testing consisting of concentric and eccentric exercises. A context of lingering muscle disorder was defined using statistically selected cut-offs. Functional performance

was evaluated throughout a squat jump and 10 m sprint. The PRO group ran faster and jumped higher than the U-17 group (Po0.05). No significant difference in isokinetic muscle strength performance was observed between the three groups when considering normalized body mass parameters. Individual isokinetic profiles enabled the identification of 32/ 57 (56%) subjects presenting lower limb muscular imbalance. Thirty-six out of 57 players were identified as having sustained a previous major lower limb injury. Of these 36 players, 23 still showed significant muscular imbalance (64%). New trends in rational training could focus more on the risk of imbalance and implement antagonist strengthening aimed at injury prevention. Such an intervention would benefit not only athletes recovering from injury, but also uninjured players. An interdisciplinary approach involving trainers, a physical coach, and medical staff would be of interest to consider in implementing a prevention programme.

Soccer performance depends on a myriad of factors such as technical, tactical, mental and physiological factors (Stolen et al., 2005). Muscle strength and anaerobic power of the lower extremities are neuro- muscular variables that influence performance in many sports activities, including soccer (Pa¨a¨suke et al., 2001). Although aerobic metabolism dominates the energy delivery during a soccer game, the most decisive actions are made by means of anaerobic metabolism. To perform short sprints, jumps, tackles and duel play, anaerobic energy release is determi- nant with regard to who is sprinting fastest or jumping highest. This is often crucial for the match outcome (Stolen et al., 2005). Anaerobic power is the product of strength and speed and refers to the ability of the neuromuscular system to produce the greatest possible impulse in a given time period (Wisloff et al., 2004). The idea of this maximal strength/power performance relationship is sup- ported by jump test results as well as in 30 m sprint results (Schmidtbleicher, 1992; Wisloff et al., 2004).

By increasing the available force of muscular con- traction in appropriate muscles or muscle groups, acceleration and speed may improve in skills critical to soccer such as turning, sprinting and changing pace (Bangsbo et al., 1991). Therefore, the accelera- tion phase and predominantly the initial acceleration phase (0–10 m) are of major importance to athletes (Cometti et al., 2001). The contribution of strength qualities to sprinting performance is not clear. Sev- eral studies have reported correlations between strength measurement and anaerobic power perfor- mance (Mero et al., 1981; Mero, 1985; Young et al., 1995), while others have reported low and non- significant relationships (Farrar & Thorland, 1987; Cometti et al., 2001). Such a discrepancy may result from variations in the sample studies with respect to age, gender and performance level. In addition, the specificity of strength measurements to sprinting may have influenced the results. Muscular strength evaluation of the lower extre- mities in athletes has been frequently performed

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using free weights (Wisloff et al., 1998), or isoinertial (Murphy & Wilson, 1996) or isokinetic dynamome-

¨

try (O berg et al., 1986; Bosco et al., 1995; Zakas et al., 1995; Murphy & Wilson, 1996; Dowson et al., 1998; Cometti et al., 2001; Croisier et al., 2002, 2003; Askling et al., 2003). Although widely used in strength assessment, some authors believe that iso-

kinetic dynamometry does not reflect the functional aspects of limb movements involved in soccer prac- tice. Consequently, they recommend the preferential use of functional tests through performance assess- ment (Cometti et al., 2001; Wisloff et al., 2004). While debate exists on the efficiency of isokinetic vs

functional testing in relation to performance assess-

¨

ment (O stenberg et al., 1998; Cometti et al., 2001), the usefulness of isokinetic dynamometry in assessing deficits and imbalances in muscle strength are not disputed (Croisier, 2004a, b) Despite frequent contra- diction in the literature, it may be assumed that muscle strength and balance play a key role in targeted acute muscle injuries (Croisier et al., 2005). Some prospective studies have also highlighted that a pre-season assessment of isokinetic muscle function is able to identify strength variables as predictors of hamstring muscle strain, especially in sports where there is a high risk of muscle injury (Croisier et al., 2005). The purpose of the present study was to provide and compare pre-season muscular strength and power profiles in professional and junior elite soccer players throughout the developmental years of 15–21. One original aspect of our study was that isokinetic data were considered alongside the past history of injury in these players. Through concentric and eccentric isokinetic assessment of knee flexor and extensor muscles, a vertical jump and 10-meter (10 m) sprint performance, we also analyzed possible relationships between variables.

Methods

Subjects

Fifty-seven elite and junior elite male soccer players from a Belgian First Division team took part in the study, and performed all the tests described below. The subjects were assigned to three groups: professional group (PRO, n 5 19, age: 26.1 3.5 years, weight: 77.9 6.2 kg, height: 178.4 6.1 cm), under-21 years group (U-21, n 5 20, age: 19.5 1.6 years, weight: 73.2 6.7 kg, height: 179.2 5.4 cm) and under- 17 years group (U-17, n 5 18, age: 15.7 0.8 years, weight:

65.6 5.5 kg, height: 176.2 7.8 cm). An injury report form was used to determine each players past history of major injury to the knee joint structures (bone, ligament, muscle, tendon). According to the team’s medical staff, all the players included in this investigation were injury free at the time of testing. The subject’s dominant leg was determined based on kicking preference. Informed consent was provided by all athletes before testing and experiments were carried out under the approval of the local Ethical Committee according to the code of Ethics of the World Medical Association (Declaration of Helsinki, 1975).

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Testing

All measurements were performed during the pre-season (6 weeks), 1 month before the beginning of the championship. All tests were completed over two different sessions, 3 days apart in the following order: (1) muscle strength evaluation; (2) anaerobic power tests. Bilateral isokinetic testing assessed maximal hamstring and quadriceps muscle performance using an isokinetic dynamometer (Cybex Norm). All measurements were pre- ceded by a standardized warm-up on an ergometric bicycle (75–100 W) and dynamic stretching exercises of subsequently involved muscles. The subject was seated on the dynamometer (105 1 of coxo-femoral flexion) with the body stabilized by several straps around the thigh, waist and chest in order to avoid compensations. The range of knee motion was fixed at 100 1 of flexion from the active maximum extension. The gravitational factor of the dynamometer’s lever arm and lower segment ensemble was calculated by the dynamometer and was automatically compensated during measurements. The subject did not receive visual feedback during the test; however, verbal encouragement was given. An adequate familiarization with the dynamometer was provided in the form of further warm-up isokinetic repetitions at various angular speeds. Before assessment, preliminary repetitions routinely preceded each test speed. The protocol included concentric exertions (angular speeds of 60 and 240 1/s) of both flexor and extensor muscles. Afterwards, flexor muscles were subjected to eccentric angular speeds of 30 and 1201 /s. The results analysis included the absolute peak torques (PT) in Newton-meters, and the bilateral comparison enabled the determination of asymmetries expressed in percentage terms. A conventional flexor/quadriceps PT (FL/Q) ratio was established for the same mode and speed of concentric contraction. An original mixed ratio associated the eccentric performance of the flexor muscles (at 30 1/s) with the con- centric action of the quadriceps muscles (at 240 1/s) (Croisier, 2004b). The nature of the deficiency was determined using statistically selected cut-offs: bilateral differences of 15% or more, a concentric ratio of o 0.47 and a mixed ratio of o0.80 (Croisier et al., 2002). During the second testing session, the players undertook vertical jump and 10 m sprint tests after a thorough 30-min warm-up. These tests were performed indoors and the players wore adapted shoes. The jumping ability of the subjects was evaluated with the Optojump system (Microgate, Bolzano, Italy), which measures the time of contact on the floor and the time flight using photoelectric cells. Flight time was used to calculate height of the rise using the body’s center of gravity. Each subject performed three squat jumps (SJ) inter- spersed with a 1-min rest between each jump. SJ were started from a static semi-squatting position with a flexed knee angle of 90 1, followed by a subsequent action, during which the leg and hip extensor muscles contracted concentrically. Subjects performed several trials for familiarization before the testing session. In order to standardize the test modalities, horizontal and lateral displacements were minimized, and the hands were kept on the hips. No countermovement of the trunk or knee was allowed before the SJ. Only the best jump for each player was used in the data analysis. The subjects also repeated three 10 m sprints, separated by a 5-min recovery period. Times were recorded by photocells (Microgate, SRL, Italy): at knee height (60 cm) for the departure and at the shoulder height (150 cm) for the arrival. In order to eliminate reaction time, the subjects started without any starting signal from a static position with parallel feet behind the start line. Only the best time taken to cover the 10 m distance was used in the data analysis.

Statistical analysis

Means and standard deviations were used to describe all the variables. In order to allow the comparison of unrelated observations, the Kruskal–Wallis test was used, which includes appropriate procedures for multiple comparisons between groups. Pearson’s w 2 test enabled us to compare the prevalence of muscular imbalance between the various groups. Pearson’s product–moment correlation was also calculated to determine the relationship between selected variables. A level of P o0.05 was selected to indicate statistical significance.

Results

Isokinetic results related to absolute and body mass normalized absolute PT for the PRO, U-21 and U-17 players are presented in Tables 1 and 2. The PRO and the U-21 groups showed higher flexor and extensor absolute PT than the U-17 group

Muscular strength in soccer players

for all modes of contraction and angular velocities. However, there were only significant differences (P o 0.05) in the quadriceps concentric absolute PT at 60 and 240 1/s between the PRO and U-17 groups and between the U-21 and U-17 groups in the concentric mode at 60 1/s. No significant differences in muscle strength performance were observed be- tween the three groups when considering the body mass normalized parameters. Muscle strength bal- ance between agonist/antagonist muscle groups and between dominant (D) and non-dominant (ND) legs in concentric and eccentric modes is presented in Tables 2 and 3. No significant differences concerning FL/Q imbal- ances or bilateral asymmetries were observed for all modes of contraction and angular velocities for the PRO, U-21 and U-17 groups. The individual isoki-

Table 1. Quadriceps and hamstring peak torques (means SD, in N m) for all modes of contraction and angular velocities in professional (PRO, n 5 19), U-21 (n 5 20) and U-17 ( n 5 18) soccer players

 

Quadriceps

Hamstring

C 60 1/s (N m)

C 2401 /s (N m)

C 601 /s (N m)

C 240 1/s (N m)

E 301 /s (N m)

E 120 1/s (N m)

PRO

224.2 (38.8) * 231.7 (30.4) w 194.7 (23.6)

136.9 (18.7) * 133.3 (17.6) 120.3 (15.8)

136.8 (34.1)

100.8 (12.3)

200.1 (52.4)

197.6 (44.2)

U-21

147.1 (23.4)

102.2 (10.8)

194.2 (44.5)

196.8 (39.8)

U-17

128.1 (18.8)

92.4 (15.3)

174.6 (36.7)

171.2 (41.6)

* Values represent significant differences ( Po0.05) between isokinetic performances for PRO and U-17 groups. w Values represent significant differences ( Po0.05) between isokinetic performances for U-21 and U-17 groups. Q, quadriceps; Fl, hamstring; C, concentric; E, eccentric.

Table 2. Quadriceps and hamstring body mass normalized peak torques (means SD, in N m/kg) for all modes of contraction and angular velocities for dominant (D) and non-dominant (ND) leg in professional (PRO, n 5 19), U-21 (n 5 20) and U-17 ( n 5 18) soccer players

 

PRO

U-21

U-17

D

ND

D

ND

D

ND

Q

C 60 1/s

2.98 (0.35)

2.94 (0.44)

3.06 (0.44)

3.22 (0.49)

2.97 (0.24)

3.09 (0.22)

Q

C 2401 /s

1.76 (0.19)

1.80 (0.23)

1.87 (0.19)

1.85 (0.26)

1.83 (0.17)

1.88 (0.19)

H

C 60 1/s

1.89 (0.30)

1.76 (0.26)

1.86 (0.39)

1.91 (0.35)

1.95 (0.23)

1.92 (0.26)

H

C 2401 /s

1.28 (0.17)

1.31 (0.15)

1.35 (0.22)

1.39 (0.25)

1.37 (0.21)

1.34 (0.19)

H

E 301 /s

2.50 (0.52)

2.51 (0.50)

2.72 (0.59)

2.77 (0.63)

2.66 (0.53)

2.90 (0.65)

H

E 1201/s

2.42 (0.49)

2.47 (0.51)

2.65 (0.47)

2.68 (0.36)

2.71 (0.57)

2.82 (0.62)

Values are means ( SD) Q, quadriceps; Fl, hamstring; C, concentric; E, eccentric.

Table 3. Conventional (C601/C601 and C2401/C2401) and mixed (E301/C2401) Fl/Q ratios for dominant (D) and non-dominant (ND) leg in professional (PRO, n 5 19), U-21 (n 5 20) and U-17 ( n 5 18) soccer players

 

PRO

U-21

U-17

D

ND

D

ND

D

ND

Ratio C60/C60

0.62 (0.07)

0.59 (0.07)

0.60 (0.07)

0.61 (0.08)

0.63 (0.07)

0.61 (0.08)

Ratio C240/C240

0.71 (0.16)

0.70 (0.15)

0.73 (0.12)

0.75 (0.17)

0.74 (0.15)

0.73 (0.13)

Ratio E30/C240

1.43 (0.26)

1.41 (0.23)

1.50 (0.29)

1.48 (0.26)

1.45 (0.26)

1.49 (0.31)

Lehance et al.

70 * * 60 50 40 30 20 10 0 % of players
70
*
*
60
50
40
30
20
10
0
% of players

PRO (n=20)

U-21 (n=19)

U-17 (n=18)

All players (n=57)

Fig. 1. Muscular imbalance observed among professional (PRO, n 5 19), under 21 (U-21, n 5 20) and under 17 (U-17, n 5 18) soccer players and percentage of players combined muscular imbalance and previous severe injury (PSI). *po 0.05.

57 players
57 players

Fig. 2. Muscular strength disorders among un-injuried and previously injured players.

netic profile analysis (taking into consideration PT bilateral differences and flexors/quadriceps ratios) enabled the identification of 32 subjects (56%; see Fig. 1), who had significant strength disorders in at least one of the following parameters: concentric bilateral asymmetries (22 out of 32 players); eccen- tric bilateral asymmetries (23 out of 32 players); concentric flexor/quadriceps ratio (eight out of 32 players); and mixed eccentric flexor/concentric quadriceps ratio (two out of 32 players). Statistical analysis (Pearson’s w 2 -test) allowed us to observe significantly (P o 0.05) more players presenting lower limb muscular imbalance within the U-21 (58%) and U-17 (61%) groups in comparison with the PRO group (50%). Among all the players with muscular imbalance, 23 out of 32 (72%) reported a past history of lower limb injury (PRO: nine out of 10; U-21:

seven out of 11; U-17: seven out of 11). Also, 63% (36/57) of the players were identified as having sustained a previous major lower limb injury. Of these 36 players, 23 subjects (64%) still showed significant Fl/Q imbalances and/or bilateral asym- metries through the isokinetic assessment (Fig. 2). The PRO players ran faster over 10 m than the U-17 players (Po0.05), but no significant differences were found between the PRO and U-21 groups or between the U-21 and U-17 groups (Fig. 3). Concerning vertical jump performance, the PRO subjects jumped higher than the U-17 players (Po0.05) (Fig. 3).

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higher than the U-17 players ( P o 0.05) (Fig. 3). 246 Fig. 3 . Mean

Fig. 3. Mean ( SD) squat jump (SJ) and 10 meters sprint time (10m) performances in professional (PRO, n 5 19), under 21 (U-21, n 5 20) and under 17 (U-17, n 5 18) soccer players.

*po0.05.

Table 4. Correlative coefficients between the characteristics of isokinetic knee flexors and extensors muscular strength, vertical jumping and sprint performances in soccer players ( n 5 57)

Parameters

SJ

10 m

Q

C

601 /s

0.45***

0.51***

Q

C

2401 /s

0.23

0.28*

Fl

C

601 /s

0.48***

0.48***

Fl

C

2401/s

0.42**

0.46***

Fl

E

301 /s

0.14

0.14

Fl

E

1201 /s

0.22

0.25

Ratio

C

60/C 60

0.21

0.18

Ratio

C

240/C 240

0.27

0.11

Ratio E 30/C 240

0.17

0.19

SJ

x

0.72***

10 m

 

x

* Po 0.05. ** Po0.01. *** Po0.001. Q, quadriceps; Fl, hamstring; C, concentric; E, eccentric; SJ, squat jump; 10 m 5 10 meters sprint.

Correlation coefficients between functional perfor- mance and isokinetic data are displayed in Table 4. The PT of knee flexor and extensor muscles, evalu- ated at slow speed and in concentric mode, showed correlations with SJ (respectively r 5 0.48; P o 0.001 and r 5 0.45; P o0.01) and 10 m sprint time (respec- tively r 5 0.48; P o0.001 and r 5 0.51; P o 0.001). At 240 1/s, isokinetic parameters presented significant relationships with SJ (r 5 0.42; P o 0.001) and 10 m (r 5 0.46; P o0.001). We also observed a strong relationship between vertical jump and sprint perfor- mance (r 5 0.72; P o0.001).

Discussion

Muscular strength is one of the most important components of physical performance in sport, in terms of both high-level performance and injury occurrence. As a factor contributing to success in soccer, the quadriceps muscle plays a role in sprint-

ing, jumping and ball-kicking; and hamstring contributes to the knee flexion, which is a major factor in stride power. In addition to their direct contribution to athletic performance, the hamstring muscles control the running activities and stabilize the knee turns (Zakas et al., 1995). Quadriceps and hamstring and the balance between their respective strength performances may influence sport-injury occurrence (Croisier et al., 2005). Three elements appear particularly interesting in the follow-up of muscular force: to make sure of the absence of asymmetry between the dominant and non-dominant leg (or for asymmetric sport, to make sure that certain limits not to be reached or over-passed to that asymmetry), to make sure of a good balance between flexor and extensor knee muscles and finally to check that the soccer player is located well within the standards of his age category and within his level of practice. In the present study, the absolute PT values in extensor muscles tested in concentric mode at 60 and 2401/s were significantly different between the PRO and U-17 groups. Also, the U-21 group presented higher concentric isokinetic values than the U-17 group at 601/s (Po0.05). However, for body mass normalized parameters, no significant differences were noted between our three groups. These results show the importance of the morphological aspect in high-level sport. When force is expressed according to body mass (mb), we observe that at around 17 years of age, junior elite soccer players are already close to their maximum level of isokinetic force performance for both flexor and extensor knee muscles. When considering compar- isons between the different groups of players, some authors advise to consider comparisons according to allometric scaling (Wisloff et al., 1998; Chamari et al., 2005). Strength and power variables expressed in mb 0.67 might provide results completely different than classically expressed as to mb. We have applied such procedure during our data analysis, yet it does not influence the results, in particular regarding statistical significance. Consequently, we have presented the results expressed to mb, which allows us to make comparisons with similar studies in the literature. In a transverse study, Le Gall et al. (1999) reported that relative PT values in flexor and extensor muscles increase, respectively, until between the ages of 16 and 21 before stabilization (Le Gall et al., 2002). Concerning the PRO group, the isokinetic perfor- mance of flexor and extensor knee muscles, evaluated in concentric and eccentric modes, was shown to be similar to that of French, Brazilian and Belgian first division soccer players but lower than that of the French national team’s soccer players (Le Gall et al., 1999; Croisier et al., 2005). In comparison with results presented by Le Gall et al. (1999), the isokinetic performances of our U-21

Muscular strength in soccer players

and U-17 groups were inferior to that of French junior elite soccer players. These results highlight the lack or the unsuitability of strength and power training session in the U-21 and U-17 Belgian groups. Despite frequent contradictions in the literature (Orchard et al., 1997; Bennell et al., 1998; Parkkari et al., 2001), it may be assumed that muscle strength and balance play a key role in targeted acute muscles injuries (Croisier, 2004b). Some authors have shown that persistent muscle performance abnormalities may cause recurrent injuries and lingering discomfort when the players resume sporting activities (Orchard, 2001; Croisier, 2004b) The pre-season isokinetic evaluation showed that 56% of the players evaluated in our study presented knee muscular strength im- balances. This result might appear high, taking into account the reduced size of our sample, but our results are in line with those presented by Croisier et al. (2006). Our results also showed that, in 32 imbalanced players, 70% presented flexor eccentric bilateral asymmetries. The possession of strong ham- strings, particularly in eccentric mode, is an impor- tant requirement for playing soccer (Reilly & Doran, 2003). The knee flexor muscles play an important part during ball-striking in slowing down the exten- sion of the leg on the thigh but also during dynamic phases without the ball such as rapid accelerations, decelerations, cutting and side-stepping manoeuvres. According to Jo¨nhagen et al. (1994), Croisier and Crielaard (2000) confirmed the discriminating char- acter of the eccentric assessment. The establishment of a mixed Fl ecc /Q conc ratio, nearer to the biomecha- nical conditions involved in running, was initially suggested by Dvir et al. (1989). The constructed ratio proposed by Croisier and Crielaard (2000) combines two extremely different velocities. Hamstring strains usually occur during joint movement at high velo- cities. Thus, it is preferable to select the same high isokinetic angular velocities for both muscle groups to be tested (Croisier & Crielaard, 2000). Croisier and Crielaard (2000) demonstrated no problems in validity or accuracy of concentric measurements at 2401 /s. However, the same authors described the reduced validity of high eccentric velocities. There- fore, a low eccentric velocity (30 1/s) was selected by Croisier and Crielaard (2000) to construct the mixed Fl ecc /Q conc ratio. This choice also results from two considerations: low speed is frequently recommended to optimize familiarization conditions and the iso- kinetic eccentric torque–velocity curve in human appears to remain essentially constant (Croisier & Crielaard, 2000). In a recent study, Croisier et al. (2005) verified whether pre-season isokinetic muscle testing could identify soccer players at risk of subsequent ham- string muscle strain (Croisier et al., 2005). As part of the study, 617 soccer players from professional teams

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Lehance et al.

in France, Belgium and Brazil benefited from pre- season isokinetic testing. Thereafter, players were followed for 9 months throughout the subsequent competitive season and hamstring muscle injuries were recorded. Of the 435 players who benefited from a complete follow-up, 37 sustained a hamstring injury causing them to miss more than 4 weeks of playing time. The risk factor of hamstring injury for one season significantly differed according to the pre- season isokinetic profile and the presence or absence of strength disorder management. This index was set at 4.1% in the context of a normal isokinetic profile, 16.5% in the presence of strength imbalance without any compensative treatment and 6.3% in the pre- sence of strength imbalance that had been success- fully treated (Croisier et al., 2005). Isokinetic intervention, as a pre-season screening tool in pro- fessional soccer players, contributes to a preventive strategy for the hamstring muscle group and the correction of pre-season muscle imbalance allows for a significant reduction in the risk of subsequent muscle strain (Croisier et al., 2005, 2006). The injury risk in professional soccer is high and regularly entails absence from competitive participation by the injured player. The decision as to when a player is considered fully rehabilitated after injury remains classically subjective, especially after muscular strain injury (Croisier et al., 2005, 2006). In our study, 36/57 (63%) players were identified as having sus- tained a previous major lower limb injury. Of these 36 players, 23 subjects (64%) still showed significant Fl/Q imbalances and/or bilateral asymmetries through the isokinetic assessment. Our results are similar to those presented in a recent work by Croisier et al. (2006). These authors revealed, in a study screening 617 professional soccer players, that after an injury, 65% of players returned to play despite serious muscle strength disorder. There is something lacking in standard return to play criteria as well as questionable options in professional soccer player treatment and rehabilitation injury (Croisier et al., 2006). As with other authors (Croisier et al., 2002), we emphasize the role of an isokinetic inter- vention for muscle performance assessment before return to play after a major lower limb injury. More worryingly, we counted significantly more players with muscular asymmetries within the U-21 and U-17 groups in comparison with the PRO group. This is unacceptable and we might ask the follow- ing questions: Does not the specific practice of increas- ingly early soccer involvement put youth and junior elite players at risk of strength disorders? Is the follow-up of the junior elite soccer players adequate in terms of physical training and injury prevention? What are the criteria for resumption of play after an injury? Specific training of the hamstring muscle group is not usually undertaken by professional soccer

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players (Croisier, 2004b), although it is likely that players would benefit from power-training sessions (notably dedicated to the knee extensors). It is well known that the maximal strength of the mobilizing muscle groups influences sports performance and the optimization of sports-related dynamic movement may require an increase in strength for specific synergistic muscle groups (Croisier, 2004b). Induced training modifications regularly disrupt the normal balance between agonists and antagonists. Finally, the issue of strength and balance should concern the physical coach as well as the medical staff. New trends in rational training could focus more on the risk of imbalance and could implement antagonist strengthening aimed at injury prevention (Croisier, 2004b). Such an intervention would benefit not only athletes recovering from injury but also uninjured players. The PRO players ran faster over 10 m than the U-17 players (P o 0.05). Cometti et al. (2001) showed that French soccer players from D1 and D2 ran faster than amateur players, confirming the findings of Bangsbo et al. (1991). Le Gall et al. (1999) reported that speed increases in relation to age and becomes maximal at the age of 20. Most commonly, the sprint starting position corresponds to split standing start (e.g., lead left foot on start line, right leg back). The background of soccer activity decided us to amend the classical procedure and, in this work, we selected an unusual position: both feet parallel to the start line. The starting position parallel feet often meets in specific gesture during soccer activity. We are aware that this choice deprives us from compar- ing with other studies. Nevertheless, we highlighted correlations between sprinting performances and other variables, especially vertical jump (P o 0.001). The most common measurement of vertical jumping performance is jumping height (Pa¨a¨suke et al., 2001). This variable depends on the physiological processes that take place in the muscular and nervous systems, as well as biomechanical factors (Bosco et al., 1982). The present study indicated that PRO players jumped significantly higher in SJ compared with U-17 players. For the PRO group, our SJ values were consistent with those found in other studies (Cometti et al., 2001; Dauty et al., 2002). Comparatively with French soccer players of the same age and practice level, the examples of performance shown by our U-21 and U-17 with the SJ were lower by 10% (Le Gall et al., 2002). The differences in performance observed between the PRO and U-17 groups can be explained by the fact that PRO performances are similar to those of elite soccer players from other countries while our U-17 group shows to be under the level of their age counterparts in other countries. Also, the specificity of certain training sessions can explain the difference of vertical jump performances

between PRO and U-17 groups. For Cometti et al. (2001), soccer practice may represent an inadequate training stimulus for developing jumping ability, and systematic plyometric programmes should therefore be implemented. The ability of the leg extensor muscles to develop force rapidly has a marked influ- ence on vertical jump performance. Vertical jumping is a multi-joint movement and requires intra- and inter-muscular coordination, which describes the abil- ity of the muscle engaged in the movement. It has been shown that explosive strength training is oriented toward optimizing intra- and inter-muscular coordi- nation (Bosco et al., 1982). The present study indicated that, in the U-21 and U-17 groups, players had a lower level of maximal knee extension strength in comparison with elite players, also associated with a lower ability to rapidly develop force. We highlighted correlations between isokinetic flexor and extensor muscle strength and anaerobic power performance. Sprint running is a fundamental activity for many sports and can be viewed as consisting of a number of components such as the start, acceleration and maximum speed phase (Young et al., 1995). A recent study reported that 96% of sprint bouts during a soccer game are shorter than 30 m, with 49% being o10 m (Wisloff et al., 2004). These results were confirmed in a recent work by Mohr et al. (2003), thus underlining the importance of the start and the acceleration phase. In the present study, significant relationships were found between isokinetic concentric knee flexor and extensor muscles strength and 10 m sprint time performance. The im- portance of muscular strength qualities for sprinting is not clear. Several studies have reported significant correlations between strength measures and speed (Mero et al., 1981; Mero, 1985; Young et al., 1995), while others have reported low and non-significant relationships (Farrar & Thorland, 1987; Cometti et al., 2001). It is possible that such a discrepancy results from variations in the samples studied with respect to age, gender and performance level (Young et al., 1995). Several authors have demonstrated relation- ships between isokinetic muscular strength and vertical jumping performance (Bosco et al., 1983; Wiklander & Lysholm, 1987; Wilson & Murphy, 1995; Jameson et al., 1997; Petschnig et al., 1998; Pa¨a¨suke et al., 2001). In contrast with the findings of Cometti et al. (2001), our investigations showed that, in soccer players, vertical jumping height in SJ was correlated with isokinetic knee extension and flexion PT at angular velocities of 601/s. However, the PRO group presented moderate correlations between max- imal strength and anaerobic power performance. Moreover, no relationship was observed in the U-17 and U-21 groups between isokinetic strength and vertical jumping height.

Muscular strength in soccer players

Strong correlations were shown to exist between sprinting and jumping performance (P o 0.001). Previous studies have also shown significant correla- tions between speed and various measurements of vertical jumping (Baker & Bell, 1994; Wisloff et al., 2004). The results of this study confirm that correla- tions exist between maximal strength, jumping and sprinting performance in elite soccer players. We observed that the professional soccer players differed from the U-17 players in terms of knee extensor muscle strength, vertical jumping and sprinting per- formance. This could be interpreted as a result of the adaptation to specific long-term explosive type of strength training. Also, this investigation did not reveal significant differences between PRO and U-21 player performance, and relationships were found between muscular isokinetic strength, vertical jumping and 10 m sprint performance. In conclusion, elite soccer is a complicated sport placing great demands on the players. However, the present study suggests that muscular strength and anaerobic power may be as important for perfor- mance as for injury prevention. The role of sports science in helping to identify soccer talent needs to be considered. The identification of players with good anaerobic power potential helps to ensure that these young players receive specialized coaching and training to accelerate the process of talent development. Furthermore, new trends in rational training could focus more on the risk entailed in muscle strength imbalance and could implement antagonist strengthening aimed at injury prevention. Such an intervention would be of benefit not only to athletes recovering from injury but also to uninjured players. An interdisciplinary approach involving trainers, a physical coach, and medical staff would be of interest to consider in implementing a preven- tive programme.

Perspectives

In this study, we highlighted a high rate of players as having sustained a previous major lower limb injury, especially among junior elite soccer players. Further- more, 64% of the previously injured players still showed muscular imbalance representing a risk fac- tor to undergo another injury. The next step is to investigate through a prospective epidemiological study over one or two competitive seasons the rate of muscular strains, especially among the players from U-17 and U-21 groups who presented knee muscular strength imbalance.

Key words: muscular strength, vertical jump, sprint, muscular imbalance, injury prevention.

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Lehance et al.

References

Askling C, Karlsson J, Thorstensson A. Hamstring injury occurence in elite soccer players after preseason strength training with eccentric overload. Scand J Med Sci Sports 2003: 13: 244–250. Baker JS, Bell W. Anaerobic performance and sprinting ability in elite male and female sprinters. J Hum Mov Stud 1994: 27: 235–242. Bangsbo J, Nooregard L, Thorsoe F. Activity profile of competition soccer. Can J Sport Sci 1991: 16:

110–116.

Bennell K, Wajswelner H, Lew P, Schall- Riaucour A, Leslie S, Plant D, Cirone J. Isokinetic strength testing does not predict hamstring muscle injury in Australian Rules footballers. Br J Sports Med 1998: 32: 309–314. Bosco C, Belli A, Astrua M, Tihanyi J, Pozzo R, Kellis S, Tsarpela O, Foti C, Manno R, Tranquilli C. A dynamometer for evaluation of dynamic muscle work. Eur J Appl Physiol 1995: 70: 379–386. Bosco C, Ito A, Komi PV, Luthanen P, Rahkila P, Rusko H, Viitasalo JT. Neuromuscular function and mechanical efficiency of human leg extensor muscles during jumping exercises. Acta Physiol Scand 1982:

114: 543–550. Bosco C, Mognoni P, Luthanen P. Relationship between isokinetic performance and ballistic movement. Eur J Appl Physiol Occup Physiol 1983: 51(3): 357–364. Chamari K, Moussa-Chamari I, Boussaı¨di L, Hachana Y, Kaouech F, Wisloff U. Appropriate interpretation of aerobic capacity: allometric scaling in adult and young soccer players. Br J Sports Med 2005: 39(2): 97–101. Cometti G, Maffiuletti NA, Pousson M, Chatard JC, Maffiuli N. Isokinetic strength and anaerobic power of elite, subelite and amateur French soccer players. Int J Sports Med 2001: 22:

45–51.

Croisier JL. Muscular imbalance and acute lower extremity muscle injuries in sport. Int Sport Med J 2004a: 5(3):

169–176.

Croisier J-L. Factors associated with recurrent hamstring injuries. Sports Med 2004b: 34(10): 681–695. Croisier JL, Crielaard JM. Hamstring muscle tear with recurrent complaints:

an isokinetic profile. Isokinetics Exerc Sci 2000: 8: 175–180. Croisier J-L, Forthomme B, Namurois MH, Vanderthommen M, Crielaard JM. Hamstring muscle strain recurrence and strength performance disorders. Am J Sports Med 2002:

30(2): 199–203.

250

Croisier JL, Ganteaume S, Ferret JM. Pre-season isokinetic intervention as a preventive strategy for hamstring injury in professional soccer players [abstract]. Br J Sports Med 2005:

39(6): 379. Croisier J-L, Ganteaume S, Genty M, et al. Incomplete muscle strength recovery in injured professional football players. Abstract book of the 11 th annual Congress of the European College of Sports Science. 2006:

p. 361. Croisier JL, Reveillon V, Ferret JM. Isokinetic assessment of knee flexors and extensors in professional soccer players. Isokinetics Exerc Sci 2003: 11:

61–62.

Dauty M, Bryand F, Potiron-Josse M. Relation between isokinetic torque, jump and sprint in high-level soccer player. Sci Sports 2002: 17: 122–127. Dowson MN, Nevill ME, Lakomy HKA, et al. Modelling the relationship between isokinetic muscle strength and sprint running performance. J Sports Sci 1998: 16: 257–265. Dvir Z, Eger G, Halperin N, Shklar A. Thigh muscles activity and ACL insufficiency. Clin Biomech 1989:

87–91.

Farrar M, Thorland W. Relationship between isokinetic strength and sprint times in college-age men. J Sports Med 1987: 27: 368–372. Jameson TD, Knight KL, Ingesoll CD, Edwards JE. Correlation of isokinetic isometric, isokinetic strength measurements with a one-leg vertical jump. Isokinetics Exerc Sci 1997: 6:

203–208.

Jo¨nhagen S, Nemeth G, Eriksson E. Hamstring injuries in sprinters: the role of concentric and eccentric hamstring muscle strength and flexibility. Am J Sports Med 1994: 22: 262–266. Le Gall F, Beillot J, Rochcongar P. The improvement in maximal anaerobic power from soccer players during growth. Sci Sports 2002: 17(4):

177–188.

Le Gall F, Laurent T, Rochcongar P. Improvement in hamstring and quadriceps strength in high level soccer players. Sci Sports 1999: 14:

167–172.

Mero A. Relationships between the muscle fibre characteristics, sprinting and jumping of sprinters. Biol Sport 1985: 2(3): 155–161. Mero A, Luhtanen P, Viitasalo JP, Komi PV. Relationships between the maximal running velocity, muscle fibre characteristics, force production and force relaxation of sprinters. Scand J Sports Sci 1981: 3(1): 16–22.

Mohr M, Krustrup P, Bangsbo J. Match performance of high-standard soccer players with special reference to development of fatigue. J Sports Sci 2003: 21: 519–528. Murphy AJ, Wilson GJ. The assessment of human dynamic muscular function:

a comparison of isoinertial and isokinetic tests. J. Sports Med Phys

Fitness 1996: 36: 169–177.

¨

O berg B, Mo¨ller M, Gillquist J, Ekstrand J. Isokinetic torque levels for knee extensors and knee flexors in soccer players. Int J Sports Med 1986:

17: 50–53. Orchard J, Marsden J, Lord S, Garlick D. Preseason hamstring muscle weakness associated with hamstring muscle injury in Australian footballers. Am J Sports Med 1997: 25: 81–85. Orchard JW. Intrinsic and extrinsic risk factors for muscle strains in Australian football. Am J Sports Med 2001: 29:

300–303.

¨

O stenberg A, Roos E, Ekdahl C, Roos H. Isokinetic extensor strength and functional performance in healthy female soccer players. Scand Med Sci Sports 1998: 8: 257–264. Pa¨a¨suke M, Ereline J, Gapayeva H. Knee extension strength and vertical jumping performance in nordic combined athletes. J. Sports Med Phys Fitness 2001: 41: 354–361. Parkkari J, Kujala UM, Kannus P. Is it possible to prevent sports injuries? Review of controlled clinical trials and recommendations for future work. Sports Med 2001: 31: 985–995. Petschnig R, Baron R, Albrecht M. The relationship between isolinetic quadriceps strength test and hop tests for distance and one-legged vertical jump test following anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther 1998: 28(1):

23–31.

Reilly T, Doran D. Fitness assessment. In: Reilly T, Williams M, eds. Science and soccer. London: Routledge, 2003:

21–46.

Schmidtbleicher D. Training for power event. In: Komi PV, ed. Strength and power in sport. London: Black- well Scientific Publications, 1992:

381–395.

Stolen T, Chamari K, Castagna C, Wisloff U. Physiology of soccer. An update. Sports Med 2005: 35(6):

501–506.

Wiklander J, Lysholm J. Simple test for surveying muscle strength and muscle stiffness in sportsmen. Int J Sports Med 1987: 8: 50–54. Wilson G, Murphy A. The efficacy of isometric and vertical jump tests in

exercise science. Aust J Sci Med Sport 1995: 27: 20–24. Wisloff U, Castagna C, Helgerud J, Jones R, Hoff J. Strong correlation of maximal squat strength with sprint performance and vertical jump height in elite soccer players. Br J Sports Med 2004: 38: 285–288.

Wisloff U, Helgerud J, Hoff J. Strength and endurance of elite soccer players. Med Sci Sports Exerc 1998: 30(3):

462–467.

Young W, Mc Lean B, Ardagna J. Relationship between strength qualities and sprinting performance. J Sports Med Phys Fitness 1995: 3: 13–19.

Muscular strength in soccer players

Zakas A, Mandroukas K, Vamvakoudis E, Christoulas K, Aggelopoulou N. Peak torque of quadriceps and hamstring muscles in basketball and soccer players of different divisions. J Sports Med Phys Fitness 1995: 35:

199–205.

251