Lower reinjury rate with a coach-controlled rehabilitation program in amateur male soccer: a randomized controlled trial.
BACKGROUND
Soccer injuries are common, and athletes returning to play after injury are especially at risk. Few studies have investigated how to prevent reinjury.


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


METHODS
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%).


CONCLUSIONS
The reinjury rate in amateur male soccer players was reduced after a controlled rehabilitation program implemented by coaches.
Hägglund
Martin
M
Department of Health and Society, Linköping University, Linköping, Sweden. hagglund.martin@telia.com
Waldén
Markus
M
Ekstrand
Jan
J
D001265:Athletic Injuries / Q000517:prevention & control / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D010349:Patient Compliance; D010806:Physical Education and Training / Q000379:methods; D016016:Proportional Hazards Models; D012046:Rehabilitation / Q000379:methods*; D012306:Risk; D055502:Secondary Prevention; D012916:Soccer / Q000293:injuries*; D016896:Treatment Outcome