Welcome back to Mick's 2 cents blog!
If you missed my first one, you can read it here. In a nutshell, every 2 weeks I'm going to chime in and give my hot takes on what was discussed recently on my good mate Randall Cooper's Journal Club Podcast, and how physios & exercise professionals can easily apply the research discussed in their everyday practice.
In the latest Podcast, Randall sat down and talked with Dr Matt Whalan, an Australian Sports Physiotherapist and Exercise Physiologist who has recently completed his PhD and authored and co-authored a growing body of research in Footballers/Soccer players.
The paper that was discussed between Randall and Matt was one of Matt’s recent publications titled “Do niggles matter? Increased injury risk following physical complaints in Football (Soccer).
For those unfamiliar with the term “niggle”, it is a colloquial/slang word often used here in Australian sporting circles to describe a minor musculoskeletal complaint from an athlete that isn’t bad enough to call an “injury”, nor stop the athlete from fully participating in training or sport. Common mild complaints that are often referred to as a “niggle” would be a “tight” hamstring or “tight” calf.
There was plenty presented and discussed by Matt, but I want to focus this blog on a couple of key findings.
Firstly, amateur soccer players who reported a “mild niggle” within the 2 days after a game and the first training session of the next week had a 3x greater risk of sustaining an actual time loss injury (one that prevented the player from training and/or playing a game all together) in the next 7 days. Furthermore, players that reported a “moderate niggle” were nearly 7x more likely to sustain a time loss injury in the next 7 days.
Now it is these figures that I think are really important thing to address.
On paper, these figures are quite dramatic.
“3x-7x greater chance of becoming injured in the next 7 days after reporting either a mild or moderate “niggle”.
However, it needs to be acknowledged that players that did not report a “niggle” in the 2 days after a game and leading into the first training session of the week, all had a 10% chance of getting injured in the next 7 days.
So with this in mind, those athletes who are reporting a “mild niggle”; yes there’s a 30% chance that these athletes may go on to sustain a time-loss injury in the next 7 days, but there is also a 70% chance that they will be able to train and play fully for the remainder of the week and WON’T sustain a time loss injury in the next 7 days.
So a big take home here is that the context of the injury incidence and risk of injury needs to be taken into account here; and rather than saying to a coach “this player cant train today or he’ll need to miss this weekends game because he’s got a tight hamstring and has a 30% chance of getting injured” really needs to be tempered down with a more open conversation that takes into the account the athlete in front of you, their injury history and the stage of the season (just to name a few variables).
For example, think about a 30 year old athlete who has had a long history of recurrent hamstring strains throughout the last 3 years that usually keeps the player out of games for 4-6 weeks is complaining of tightness 2 weeks into a long 26 round competitive season. The risk vs reward conversation you have with the player, coach and support staff may land on a decision that sees this athlete modify his training and playing availability for the next 2-3 weeks. Conversely the risk vs reward conversation you have regarding an 18 year old athlete who has no hamstring injury history, has played every game this season and is complaining of hamstring tightness a week out from playing in the grand final may land on a decision that he continues training and playing as normal this week leading into the grand final.