Philip J. Hennis

Due to the lack of large‐scale research investigating the epidemiology of injury in English men's professional football, the present study aimed to examine the incidence rate, severity, and burden of injury in English men's domestic football. Injury surveillance data was prospectively collected and retrospectively analyzed. Time‐loss injuries, and match and training exposure, were collected by club medical staff across 12 seasons (2013–2014 to 2024–2025) from English men's domestic clubs playing in the English Premier League and English Football League (EFL—Championship, League One, League Two) (416 team seasons). A bootstrapped negative binomial approach was adopted to calculate incidence rate and burden estimates, temporal analysis and incidence rate (IRR) and burden ratios (IBR), all with accompanying 95% CI. 15 986 time‐loss injuries were recorded, resulting in 498 108 days absent over 2 286 030 exposure hours. Injury incidence rate was substantially higher in matches than training (24.9 vs. 3.6 injuries/1000 h; IRR: 7.0 [6.6–7.4]), as was injury burden (835.5 vs. 104.1 days absent/1000 h; IBR: 8.0 [7.5–8.7]). Match injury incidence rate remained stable across the study period, training injury incidence rate decreased by 4% per season ( p < 0.001), but match injury burden increased by 5% ( p < 0.001). Muscle injury incidence rate increased by 3% per season in matches ( p = 0.004), but decreased by 3% in training ( p = 0.028). Muscle injury burden increased in both matches (10%, p < 0.001) and training (4%, p = 0.006). Ligament injury incidence rate decreased by 5% per season in training ( p < 0.001). Hamstring injuries were the most common diagnosis (1.33 injuries/1000 h) and contributed the greatest overall burden (40.37 days absent/1000 h). Over 12 seasons in English men's professional football, match‐play consistently accounts for a greater injury incidence rate and burden than training. While match injury incidence rate has remained stable, burden has increased, specifically for muscle‐related injuries.

The epidemiology of injuries in English women's professional football is yet to be investigated. Therefore, the aim was to examine the incidence, severity, and burden of injury in English women's domestic football. Time‐loss injuries, and match and training exposure, were collected by club medical staff across 5 seasons (2018–2023) from English Women's Super League and Championship teams (93 team seasons). The incidence, severity, burden, cause, onset and patterns of injury were examined. A bootstrapped negative binomial approach was employed to calculate incidence and burden estimates, time‐trend analysis and injury rate ratios (IRR), all with accompanying 95% CI. 2167 injuries were reported, resulting in 76 687 days absent. Of these, 981 match injuries (eliciting 37 269 days absent) and 1186 training injuries (eliciting 39 418 days absent) were reported. Injury incidence was greater in matches than training (20.5 [16.9–24.1] vs. 2.9 [2.0–4.0] injuries per 1000 h [95% CI]; IRR: 7.3, 95% CI: 5.1–10.1). Match injury burden (775.1 days absent/1000 h [95% CI; 630.0–934.9]) was greater than training (96.9 days absent/1000 h [95% CI: 66.1–138.5]) (IRR: 8.3, 95% CI: 5.4–12.0). Training injury incidence decreased by 28% across the study period (p = 0.041), with no significant seasonal changes for match injury incidence (p = 0.218) or injury burden (p > 0.05). The most common diagnosis was hamstring injury (match: 2.37; training: 0.38; injuries/1000 h), while ACL injuries were the most burdensome (match: 136.31; training: 10.86 days absent/1000 h), with no significant seasonal changes observed (p > 0.05). Overall, the present study showed that injury incidence and burden were greater in matches than training, with incidence decreasing by 28% across the study period in training in English women's domestic football. Hamstring injuries were the most common injury diagnosis, and ACL injuries were the most burdensome; illustrating the need to continue to develop prevention strategies for these injuries. The present study provides injury surveillance information in English women's domestic football and can be a benchmark for the success of future injury prevention strategies.

Walking Football is an adaptation of Association Football, played primarily by middle-aged and older adults, with rule changes to enhance accessibility. Sport participation poses injury risks, yet the risk of injury in Walking Football has not been established. This study quantifies injury incidence, estimates injury burden, and examines injury characteristics. The prospective observational study recorded injuries during The FA Walking Football Cup 2024, featuring 84 teams in three categories: Women's 40 years+, Mixed Gender 50 years+, and Mixed Gender 60 years+. Time-loss injuries (≥1 day estimated absence), and medical attention injuries (on-field attention only) were measured along with match exposure (total playing-hours). Injury incidence and estimated injury burden per 1000 player-hours, and injury characteristics, were analysed. Across all categories, 42 match injuries occurred over 850.6 h of exposure, with 8 time-loss (19%) and 34 medical attention injuries (81%). The overall injury incidence was 49.4 injuries per 1000 h, with time-loss injury incidence at 9.4 and medical attention injury incidence at 40.0 injuries per 1000 h. The total estimated injury burden was 156.4 days absent per 1000 h. Injuries were evenly distributed between non-contact (52%) and contact mechanisms (48%), with tackles representing 45% of cases and running, explicitly prohibited in Walking Football, accounting for 12%. Overall, Walking Football has a low injury risk, with most injuries classified as non-time-loss. However, the prevalence of contact-related injuries suggests stricter enforcement of minimal contact rules could further reduce injury incidence. Safety strategies should prioritise reducing tackle-related injuries and minimising running to ensure player welfare.

Walking Football is a growing adapted sport offering a viable alternative to traditional exercise for middle-aged and older adults. While rule modifications aim to reduce injury risk, this has yet to be established. This study conducted injury surveillance in community-based Walking Football to determine injury incidence and characteristics in training and matches. A four-month observational cohort study remotely tracked injuries and exposure time across seven Walking Football clubs in England using a sub-elite injury surveillance framework. Injuries were classified as medical attention (requiring on-field attention without subsequent absence) or time-loss (≥1 day of participation absence). Injury incidence was calculated per 1000 h of play. Across 6364.55 h of exposure, 45 injuries were reported: 30 (66.7%) medical attention and 15 (33.3%) time-loss injuries. Injury incidence was 5.3 [1.5–11.5] per 1000 h in training (medical attention: 3.3 [0.8–7.3]; time-loss: 2.0 [0.5–4.5]) and 37.6 [8.7–83.9] per 1000 h in matches (medical attention: 28.9 [5.8–66.6]; time-loss: 8.7 [0–23.2]). Match injury incidence was significantly higher than training (rate ratio: 7.1 [1.3–31.4]). Findings suggest that injury incidence in community-based Walking Football is low, supporting its safety and potential as a sustainable physical activity strategy for middle-aged and older adults.

Aim: Physical activity (PA) is widely acknowledged as a cost-effective strategy to support mental health in students. However, the COVID-19 pandemic’s disruptive influence raises questions about how the relationship between PA and student mental health may have evolved. Therefore, the present study explored this relationship before, during and after the pandemic. Methods: A repeated cross-sectional design was employed with survey data collected annually (2019–2022) in term one (October) at an English university. Mental well-being was evaluated using the Short Warwick-Edinburgh Mental Well-being Scale and weekly moderate to vigorous physical activity (MVPA) measured in 6,250 students. Pearson’s Product Moment Correlation tests were used to assess the correlation between mental well-being and MVPA for each year. Results: There was a weak (r = 0.14–0.19, p < 0.001) positive correlation between mental well-being and MVPA for each year. This relationship was stronger for males compared to females in 2020 (Z = 1.02, p < 0.01) and 2022 (Z = 3.56, p < 0.001). Conclusion: The consistent correlation between mental well-being and MVPA suggests that the pandemic did not alter the discernible link between the two variables, emphasising the importance of PA for student mental health even during unprecedented circumstances.

Background: Individuals with glycogen storage disease IIIa (GSD IIIa) (OMIM #232400) experience muscle weakness and exercise limitation that worsen through adulthood. However, normative data for markers of physical capacity, such as strength and cardiovascular fitness, are limited. Furthermore, the impact of the disease on muscle size and quality is unstudied in weight bearing skeletal muscle, a key predictor of physical function. We aim to produce normative reference values of aerobic capacity and strength in individuals with GSD IIIa, and to investigate the role of muscle size and quality on exercise impairment. Results: Peak oxygen uptake (V̇O₂peak) was lower in the individuals with GSD IIIa than predicted based on demographic data (17.0 (9.0) ml/kg/min, 53 (24)% of predicted, p = 0.001). Knee extension maximum voluntary contraction (MVC) was also substantially lower than age matched predicted values (MVC: 146 (116) Nm, 57% predicted, p = 0.045), though no difference was found in MVC relative to body mass (1.88 (2.74) Nm/kg, 61% of predicted, p = 0.263). There was a strong association between aerobic capacity and maximal leg strength (r = 0.920; p = 0.003). Substantial inter-individual variation was present, with a high physical capacity group that had normal leg strength (MVC), and relatively high V̇O₂peak, and a low physical capacity that display impaired strength and substantially lower V̇O₂peak. The higher physical capacity sub-group were younger, had larger Vastus Lateralis (VL) muscles, greater muscle quality, undertook more physical activity (PA), and reported higher health-related quality of life. Conclusions: V̇O₂peak and knee extension strength are lower in individuals with GSD IIIa than predicted based on their demographic data. Patients with higher physical capacity have superior muscle size and structure characteristics and higher health-related quality of life, than those with lower physical capacity. This study provides normative values of these important markers of physical capacity.

Initial studies indicated that student mental health was impaired during the early stages of the pandemic and that maintaining/improving physical activity gave some protection from mental illness. However, as the pandemic persists, these data may not reflect current circumstances and may have been confounded by exam stress. Methods: This study used an online survey to assess the changes in, and associations between, mental health and movement behaviours in 255 UK university students from before the COVID-19 pandemic (October 2019) to 9 months following the UK’s first confirmed case (October 2020). Changes in and associations between mental wellbeing, perceived stress, physical activity, and sedentary behaviour were assessed using a mixed model ANOVA; a multiple linear regression model determined the predictive value of variables associated with Δ mental wellbeing. Results: Mental wellbeing and physical activity decreased (45.2 to 42.3 (p < 0.001); 223 to 173 min/week (p < 0.001)), whereas perceived stress and time spent sedentary increased (19.8 to 22.8 (p < 0.001); 66.0 to 71.2 h/week (p = 0.036)). Δ perceived stress, Δ sedentary behaviour and university year accounted for 64.7%, 12.9%, and 10.1% of the variance in Δ mental wellbeing (p < 0.001; p = 0.006; p = 0.035). Conclusion: The COVID-19 pandemic is having a sustained negative impact on student mental health and movement behaviour.

Low bone mineral density (BMD) is established as a primary predictor of osteoporotic risk and can also have substantial implications for athlete health and injury risk in the elite sporting environment. BMD is a highly multi-factorial phenotype influenced by diet, hormonal characteristics and physical activity. The interrelationships between such factors, and a strong genetic component, suggested to be around 50–85% at various anatomical sites, determine skeletal health throughout life. Genome-wide association studies and case–control designs have revealed many loci associated with variation in BMD. However, a number of the candidate genes identified at these loci have no known associated biological function or have yet to be replicated in subsequent investigations. Furthermore, few investigations have considered gene–environment interactions—in particular, whether specific genes may be sensitive to mechanical loading from physical activity and the outcome of such an interaction for BMD and potential injury risk. Therefore, this review considers the importance of physical activity on BMD, genetic associations with BMD and how subsequent investigation requires consideration of the interaction between these determinants. Future research using well-defined independent cohorts such as elite athletes, who experience much greater mechanical stress than most, to study such phenotypes, can provide a greater understanding of these factors as well as the biological underpinnings of such a physiologically “extreme” population. Subsequently, modification of training, exercise or rehabilitation programmes based on genetic characteristics could have substantial implications in both the sporting and public health domains once the fundamental research has been conducted successfully.