Premier League Football Returns

Premier League Football is due back on our screens tonight. In this blog, Specialist Physiotherapist James Lee, explores the potential for injury during the last games of the season and what we can learn from the German Bundesliga.

Sport came to a standstill towards the end of March when COVID-19 was the opposition no-one wanted to face. The closure of gyms and cancellation of team sports and large sporting events has meant that most of you reading this won’t have played team sport or trained at normal intensity for over 2 months.

A return to sport may look daunting. If you have been watching elite sport then you will have seen the precautions taken to get back to performing; progressing from individual training sessions with social distancing measures, to full team training, ensuring minimal contact and constant testing. You may have also read about the injuries sustained on return to training and match-level intensity and are wondering what will happen to the Premiership players in these final matches of the season.

German Elite Football Returns #

The German Bundesliga was the first elite football league to re-start the beginning of the end of the season on May 16th 2020 behind closed doors. The players had taken part in virtual training during the 2 weeks of lockdown and returned to 1 – 1, and then small group training, from the 6th of April. They commenced full team training just 10 days before the re-start of the season on the 16th May. During this period, there were 13 injuries reported in the league, 10 of those were muscular injuries. Six players were deemed not fit enough to feature at all before the first round of matches for reasons which included recovering from a previous injury, surgery or a genuine lack of match fitness. 

It is important to bear in mind that a normal pre-season following a similar period of rest does not look like this. It is very difficult to mimic the demands of a sport by training on your own or with your pet dog! Though players would have had virtual input from their Strength and Conditioning and Physiotherapy teams during lock down, and these clinicians would have been using every novel idea they could think of to optimise player’s fitness; the competitive nature of sport is very different to training at home. A normal pre-season involves a graded increase in both training intensity, game situations and friendlies against teams of different levels (with unlimited substitutes) over a 4 – 6‑week period. To go from team training to competitive elite level football in 10 days is tough. 

The first round of matches saw 8 injuries, mostly muscular and all occurring after 45 minutes of play. One player was injured in the warm up and replaced by a player who was then injured in the 79th minute. This is suggestive of two things; a lack of match readiness and fatigue due to a lack of conditioning, both risk factors for injury. 

The Bundesliga had introduced new rules to help reduce the risk of fatigue and injury by allowing 5 substitutes in the game instead of 3. However, 8 of the 18 teams in the league did not utilise this number of substitutions in the first round of games. 2 out of the 8 teams had 2 injuries each which forced substitutes to be made, however the remaining 6 reported no injuries and therefore a lack of substitutes used did not significantly correlate to injuries reported.

Injury in sport is often luck of the draw. Awkward landings and mis-timed challenges for example are things that we can’t control. Player strength, conditioning and match readiness, however, is something that is well within the control of a medical team; though time, money and pressure often have their say. All of these will be difficult to control in a season trying to squeeze the remaining games into a short time period (some playing 3 games in 10 days) so that teams have a rest period and a full pre-season. It will be interesting to see how this pans out over the rest of the season when we can look back and review the whole thing.