Sergio Jiménez-Rubio

Background: Neuromuscular training is widely implemented in professional football to enhance performance and reduce injury risk. Although unstable surfaces are commonly used for proprioceptive and rehabilitation purposes, limited evidence supports their effectiveness in improving sport-specific force production and stability in elite athletes. This study aimed to compare the effects of multicomponent neuromuscular training performed on stable versus unstable surfaces on unilateral force production, mobility, and agility in elite male soccer players. Methods: Twenty-seven professional male soccer players from the Spanish first division were randomly assigned to either a stable surface group (SSG; n = 14) or an unstable surface group (USG; n = 13). Both groups completed a 10-week intervention in addition to their regular training routines. Pre- and post-intervention assessments included dorsiflexion range of motion (DFt), Y-Balance Test (YBT), single-leg countermovement jump (SLCMJ), single-leg hop for distance (SLH), side-hop (SH), Speedy Jump (SpJ), Agility T-test (TT), and the Lower Extremity Functional Test (LEFT). A two-way repeated-measures ANOVA and Hedges’ g effect sizes were used for statistical analysis. Results: The SSG showed significant improvements in most performance variables, including DFt, YBT, SLH, SH, SpJ, TT, and LEFT (percent change range: 1.6% to 9.8%; Hedges’ g ranging from 0.52 to 2.57). The USG showed limited improvements, with significant changes only in LEFT (percent change = 1.18%; Hedges’ g = 0.53). Notably, the stable surface group demonstrated enhanced force production and agility, particularly in the non-dominant limb. Conclusions: Multicomponent neuromuscular training on stable surfaces appears more effective than training on unstable surfaces for improving unilateral strength, mobility, and agility in elite soccer players. These findings suggest that stable surface training may provide superior performance benefits and should be considered a priority in high-performance environments.

Return to play (RTP) decision making in professional soccer is crucial for minimising re-injury risk, reducing financial burdens on clubs, and optimising player performance. Despite its significance, there is a lack of objective criteria and consensus on RTP for adductor longus injuries, one of the most common muscle injuries in soccer. The aim of the present consensus was to validate an RTP protocol based on clinical, functional, and performance criteria through expert evaluation. This study hypothesises that a validated RTP protocol for adductor longus injuries will enhance decision making, reduce re-injury rates, and improve player performance upon return. An observational survey was designed to validate an RTP protocol through an expert panel. A total of 63 injury-management professionals (strength and conditioning coaches, physiotherapists, doctors, and rehabilitation fitness coaches) with an average experience of 12.02 ± 6.87 years participated in validating a 20-criteria RTP protocol. The protocol, divided into clinical, functional, and performance criteria, was assessed using a 5-point Likert scale. Aiken’s V coefficient was calculated for content validity, with criteria validated if Aiken’s V ≥ 0.75. Out of 20 initial RTP criteria, 14 were validated by the expert panel, with Aiken’s V ranging from 0.77 to 0.94 (overall range: 0.61–0.98). Key validated criteria included pain on palpation, flexibility, imaging, athlete feedback, strength assessments, movement quality, pre-injury GPS data, and performance under simulated match conditions. Criteria such as the Copenhagen adduction exercise and specific agility tests were not validated. The expert-validated RTP protocol for adductor longus injuries provides a structured approach to decision making, potentially reducing re-injury risk, improving rehabilitation strategies, and enhancing player performance. These findings could be integrated into clinical sports-medicine practices to enhance rehabilitation effectiveness and RTP decisions in professional soccer.

Context: Adductor longus muscle strains are one of the most common injuries occurring in intermittent sports such as soccer. Objective: The purpose of this study was to know the effect of a specific rehabilitation and reconditioning program, which was previously validated, after adductor longus injury in professional soccer players. Methods: A specific rehabilitation and reconditioning program was applied to 11 injured male professional soccer players. Participants: Eleven male professional soccer players (age = 29.18 [4.45] y; height = 179.64 [4.97] cm; mass = 75.33 [3.84] kg). Interventions: In the first place, the days taken to return to full team training and to return to competition (RTP) was analyzed; second, the most important performance parameters were analyzed and compared in the preinjury match (PRE) and after the return to competition at 2 different points in time (RTP1–RTP2). Results: The return to full team training recorded was 11.91 (1.92) days and the RTP was 15.36 (3.04) days. Match performance parameters showed significant improvements after injury. Significant improvements were observed during RTP2, in the variables of high-speed running (P = .002), very high-speed running (P = .006), acceleration (>3 m/s²; P = .048), and high metabolic load distance (P = .009). Conclusion: The results allow us to conclude that this program was very effective, as it allowed the players to obtain similar and/or higher performance values in a reduced period of time after the injury.

The aim of this study was to evaluate the effect of an Athletic Performance Program, performed in addition to teams’ regular training routines, on match performance variables in professional football players. Twenty-nine professional football players (age=27.21±4.95 years; body mass=79.56±5.21 kg) of the Spanish First Division (LaLiga) underwent a 10-week training program focused on the development of mobility, stability, strength, and multidirectional running skills. The APP included 5 indoor sessions per week and on-field micro-dosing stimulus in addition to regular training practices. Match performance variables obtained with GPS devices during official matches and jump performance were measured before and after the APP. The APP increased peak running speed (31.1±1.4 vs 32.1±1.0 km/h, P < 0.001, d=1.88), the number of sprints (0.14±0.03 vs 0.16±0.03 sprint/min, P< 0.001, d=1.44) and the sprint distance (6.45±1.43 vs 8.35±1.22 m/min P< 0.001, d=2.49) during the matches. The intervention also increased countermovement jump height (34.1±2.7vs 35.8±2.5 cm, P< 0.001, d=2.20). The APP was effective to improve intense actions during competitive match play in professional football players. Strength and conditioning coaches may consider the use of multicomponent physical training programs included in the usual training week to enhance players’ match running at high intensity.

This study aimed to assess the effects of a multicomponent training program (ProSAS) on selected measures of physical fitness and joint injuries in Spanish male professional soccer players. Twenty-six professional soccer players (age: 25.2 ± 3.1 years) were randomly assigned to either the experimental (EG; n = 16) or control group (CG; n = 10). Y-balance test (YBT), Single leg countermovement jump (SLCMJ), Single leg hop for distance test (SLH), Side-hop test (SH), Speedy jump test (SpJ), Agility T-test (TT) and Lower extremity functional test (LEFT) were performed before and after an 8-weeks training period. Additionally, any joint injury occurring during the intervention period were recorded. Significant improvements in the EG in all tests (p = 0.001 to p = 0.014), except for SLCMJ (p = 0.632) with the dominant leg were observed. CG displayed decreases in SLCMJ with the non-dominant leg (p = 0.014), SH for both legs (p = 0.001 to p = 0.050), TT (p = 0.005), and LEFT (p = 0.001). Inter-groups differences revealed better results for the EG in all variables (p = 0.001 to p = 0.008) except from SLCMJd (p = 0.555). Moreover, the EG exhibited lower joint injury incidence and burden compared to the CG (p < 0.05). These findings suggest that the ProSAS is an effective multicomponent program to improve variables related to risk of joint injuries, and consequently, to reduce the incidence and burden of these injuries in professional soccer players.

The first division of Spanish professional football (LaLiga) was suspended for 12 weeks as part of the policies enforced by health authorities during the first wave of COVID-19. During this period, players were confined to home for 8 weeks, followed by a club-based retraining period of 4 weeks. Afterwards, LaLiga’s teams completed 11 matches, with approximately 3 days of recovery between matches, to finish the competition. The aim of this investigation was to determine whether there is a difference in mean injury incidence in LaLiga players between the pre-lockdown period and post-lockdown period. A total of 277 players belonging to 11 teams competing in LaLiga were monitored during the 2019–2020 season. Injury incidence in the 27 matchdays completed before the lockdown was compared to the last 11 matchdays completed after the resumption of the competition. In comparison to the period before the suspension, the resumption of the championship did not significantly affect the injury incidence (4.2 vs. 5.4 injuries per 1000 h of exposure, p = 0.338). Injury incidence before suspension and after resumption of the competition was similar for muscle (2.6 vs. 3.4 injuries per 1000 h of exposure, p = 0.152) and ligament injuries (0.8 vs. 0.4 injuries per 1000 h of exposure, p = 0.062). The resumption of the competition also did not modify the distribution of injury according to body location (p = 0.948), injury type (p = 0.766), mode of onset (p = 0.614), severity (p = 0.065), or player position (p = 0.295). In summary, mean injury incidence in LaLiga players was similar before and after the lockdown. It is probable that the conditioning strategy adopted by clubs before the resumption of LaLiga and the adaptation of some in-game regulations helped to avoid an increased injury rate after the lockdown.

Context: The high rates of adductor injuries and reinjuries in soccer have suggested that the current rehabilitation programs may be insufficient; therefore, there is a need to create prevention and reconditioning programs to prepare athletes for the specific demands of the sport. Objective: The aim of this study is to validate a rehab and reconditioning program (RRP) for adductor injuries through a panel of experts and determine the effectiveness of this program through its application in professional soccer. Design: A 20-item RRP was developed, which was validated by a panel of experts anonymously and then applied to 12 injured male professional soccer players. Setting: Soccer pitch and indoor gym. Participants: Eight rehabilitation fitness coaches (age = 33.25 [2.49] y) and 8 academic researchers (age = 38.50 [3.74] y) with PhDs in sports science and/or physiotherapy. The RRP was applied to 12 male professional players (age = 23.75 [4.97] y; height = 180.56 [8.41] cm; mass = 76.89 [3.43] kg) of the Spanish First and Second Division (La Liga). Interventions: The experts validated an indoor and on-field reconditioning program, which was based on strengthening the injured muscle and retraining conditional capacities with the aim of reducing the risk of reinjury. Main Outcome Measures: Aiken V for each item of the program and number of days taken by the players to return to full team training. Results: The experts evaluated all items of the program very highly as seen from Aiken V values between 0.77 and 0.94 (range: 0.61–0.98) for all drills, and the return to training was in 13.08 (±1.42) days. Conclusion: This RRP following an injury to the adductor longus was validated by injury experts, and initial results suggested that it could permit a faster return to team training.

Rectus femoris muscle strains are one of the most common injuries occurring in sports such as soccer. The purpose of this study was to describe the safety and feasibility of a combination of percutaneous needle electrolysis (PNE) and a specific rehab and reconditioning program (RRP) following an injury to the rectus femoris in professional soccer players. Thirteen professional soccer players received PNE treatment 48 h after a grade II rectus femoris muscle injury, followed by a the RRP 24 h later. Assessment of recovery from injury was done by registering the days taken to return to train (RTT), return to play (RTP), and structural and functional progress of the injured muscle was registered through ultrasound imaging and match-GPS parameters. Also, adverse events and reinjuries were recorded in the follow up period of twenty weeks. The RTT registered was 15.62 ± 1.80 days and RTP was 20.15 ± 2.79 days. After fourteen days, the ultrasound image showed optimal repair. Match-GPS parameters were similar before and after injury. There were no relapses nor were any serious adverse effects reported during the 20-week follow-up after the RTP. A combination of PNE and a specific RRP facilitated a faster RTP in previously injured professional soccer players enabling them to sustain performance and avoid reinjuries.

Context: Although there are multiple, validated return-to-play programs following hamstring strain injuries, no studies have evaluated their changes in match performance parameters. Objectives: The aim of this study was twofold as follows: (1) to determine the changes in match-based physical performance parameters in professional soccer players before and after sustaining a hamstring strain injury and undergoing a soccer-specific rehabilitation program and (2) to observe the progress of these performance parameters 6 to 10 weeks after the player returned from injury. Design: Prospective, quasi-experimental longitudinal study. Setting: Soccer playing and training grounds. Participants: Nineteen players suffering a hamstring strain injury from 2 male professional teams playing in the Spanish professional football league (La Liga) were followed during the 2015–2016, 2016–2017, and 2017–2018 seasons. Intervention: Participation in on-field training program following a hamstring injury. Main Outcome Measures: Match global positioning system data were collected in the following stages: prior to injury (PRE), after return to play (RTP), program, and 6 to 10 weeks following RTP (C2). Peak velocities and distances ran at sprint velocities showed most likely improvements in C2 versus PRE, and very likely improvements in RTP versus PRE. Results: The distances ran at high and very high intensities, the average velocity, and work-to-rest ratio showed very likely improvements in C2 versus RTP and likely improvements in RTP versus PRE. Likely improvements were observed for all variables in C2 versus RTP. The authors’ results showed an improvement of physical performance during competitive match after RTP, compared with PRE. There was a steady progression in the progress, and in 8 months following RTP, there was no injury reported in the players. Conclusions: The current findings may indicate that the hamstring muscle complex not only recovered completely from the injury but could also withstand a greater training and match load reducing the risk of reinjury.

This case series follows the treatment protocol after a grade 2 injury to the proximal semitendinosus muscle using US-guided Percutaneous Needle Electrolysis (PNE) and Rehab & Reconditioning program (RRP) in two professional soccer players. The injury was diagnosed using magnetic resonance imaging (MRI) and ultrasound imaging. The players received one session of PNE 48 hours after the injury. The indoor's phase of the RRP started 24 hours after the PNE technique and then the player proceeded to perform an on-field's phase, following which the players returned to train with the team. The effectiveness of the program was measured by comparing the match-performance data collected through Global Positioning System (GPS) in two matches before and five matches after injury and with ultrasound imaging analyzing the evolution of the muscle injury. No adverse effects were identified during or after the US-Guided PNE technique. Both players missed a single competitive game because of injury (layoff= 16 and 14 days). The GPS variables studied showed similar values before and after injury. PNE and PRR protocol improves the results of the initial phase of muscle repair and reduces the time to return to training and return to play, maintaining the GPS parameters that the players need in high performance.