Skip to main content
Log in

„Stay and play“ im Fußball

Die Kunst, den Spieler spielfähig zu halten

“Stay and play” in football

Art of keeping players fit to play

  • Leitthema
  • Published:
Der Unfallchirurg Aims and scope Submit manuscript

Zusammenfassung

Die wissenschaftliche Literatur bietet viele Publikationen über die Behandlung und das Return-to-play von schweren Verletzungen im Fußball, speziell bei Verletzungen mit Operationsbedarf. Über die Behandlung leichter Verletzungen wie Muskelzerrungen, Sprunggelenkdistorsionen oder Prellungen gibt es wenige Literaturberichte, und oft besteht ein niedriges Evidenzlevel, obwohl diese die häufigsten Verletzungstypen darstellen. Auch Leitlinien zu Behandlung und Return-to-play bei kleineren Verletzungen fehlen größtenteils. Insofern hängen die Zeit der Fußballpause und das Timing des Return-to-play nach leichten Verletzungen von der Erfahrung und den Fertigkeiten des verantwortlichen medizinischen Teams ab. Um ein Stay & play auf dem Spielfeld nach leichten Verletzungen zu erreichen, benötigt das medizinische Team ein breites Wissen und Erfahrung in der interdisziplinären Fußballmedizin. Dies umfasst Kenntnisse zu Präventionsstrategien, Akutmanagement am Spielfeldrand, klinischer und manueller Diagnostik, Geweberegeneration, symptomatischer und konservativer Therapie sowie Return-to-play-Entscheidungen. Stay & play-Strategien unterliegen auf praktischer und wissenschaftlicher Ebene keinem klaren Konsens bei Verletzungsdefinitionen, dem Portfolio an Diagnostik- und Therapiemöglichkeiten sowie den Stay & play-Kriterien. Dieser Beitrag präsentiert daher erste Schritte einer Bewertung von Stay & play-Strategien nach leichten Verletzungen, um zukünftig den praktischen Alltag, die Ausbildung und die wissenschaftliche Forschung in diesem Bereich zu vereinheitlichen und zu verbessern.

Abstract

Many publications about the treatment and return to play after severe football injuries are available from the scientific literature, particularly about injuries requiring surgery. In contrast, less severe football injuries, such as muscle strains, ankle sprains and contusions, are less well addressed in the literature although these represent the most frequent type of injury. Additionally, such reports often have a low level of evidence and guidelines on treatment and the return to play process are very rare. Thus, the time away from football and the timing of return to play after minor injuries depends on the experience and skills of the responsible medical team. To achieve the aim of stay and play on the field, the medical team should be highly knowledgeable in interdisciplinary football medicine, prevention strategies, first aid on the field, clinical and manual diagnostics, tissue regeneration, symptomatic and conservative treatment as well as in return to play decision-making. No consensus exists on stay and play procedures neither on the practical level nor on the scientific level regarding injury definition, the diagnostic and treatment options and stay and play criteria. Therefore, this article presents the first steps for assessing stay and play strategies after minor injuries to standardize and improve practical routine, education and scientific research.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3
Abb. 4

Literatur

  1. Askling CM, Tengvar M, Thorstensson A (2013) Acute hamstring injuries in Swedish elite football: a prospective randomised controlled clinical trial comparing two rehabilitation protocols. Br J Sports Med 47(15):953–959

    Article  PubMed  Google Scholar 

  2. Best R, Mauch F, Böhle C, Huth J, Brüggemann P (2014) Residual mechanical effectiveness of external ankle tape before and after competitive professional soccer performance. Clin J Sport Med 24(1):51–57

    Article  PubMed  Google Scholar 

  3. Bleakley CM, O’Connor S, Tully MA, Rocke LG, Macauley DC, McDonough SM (2007) The PRICE study (Protection Rest Ice Compression Elevation): design of a randomised controlled trial comparing standard versus cryokinetic ice applications in the management of acute ankle sprain [ISRCTN13903946. BMC Musculoskelet Disord 8:125

    Article  PubMed  PubMed Central  Google Scholar 

  4. Bleakley CM, Glasgow P, MacAuley DC (2012) PRICE needs updating, should we call the POLICE? Br J Sports Med 46(4):220–221

    Article  PubMed  CAS  Google Scholar 

  5. Diaz de leon-Miranda E, Redondo-Aquino G, Bueno-Olmos ME, Arriaga-Paez MA, Rodriguez-Cabrera R, Torres-Gonzalez R (2007) Associated factors to severe sport injuries. Rev Med Inst Mex Seguro Soc 45:47–52

    PubMed  Google Scholar 

  6. Eder K, Hoffmann H (2014) Physikalische und physiotherapeutische Maßnahmen und Rehabilitation. In: Mueller-Wohlfahrt HW, Ueblacker P, Hensel L (Hrsg) Muscle injuries in sports. Thieme, Stuttgart, New York

    Google Scholar 

  7. Ekstrand J, Hägglund M, Törnqvist H, Kristenson K, Bengtsson H, Magnusson H, Waldén M (2013) Upper extremity injuries in male elite football players. Knee Surg Sports Traumatol Arthrosc 21(7):1626–1632

    Article  PubMed  Google Scholar 

  8. Elattar O, Choi HR, Dills VD, Busconi B (2016) Groin injuries (athletic pubalgia) and return-to-play. Sports Health 8(4):313–323

    Article  PubMed  PubMed Central  Google Scholar 

  9. Frankewycz B, Krutsch W, Weber J, Ernstberger A, Nerlich M, Pfeifer CG (2017) Rehabilitation of Achilles tendon ruptures: is early functional rehabilitation daily routine? Arch Orthop Trauma Surg 137(3):333–340

    Article  PubMed  CAS  Google Scholar 

  10. Fuller CW, Walker J (2006) Quantifying the functional rehabilitation of injured football players. Br J Sports Med 40(2):151–157

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  11. Fuller CW, Ekstrand J, Junge A, Andersen TE, Bahr R, Dvorak J, Hägglund M, McCrory P, Meeuwisse WH (2006) Consensus statement on injury definitions and data collection procedures in studies of football (soccer) injuries. Br J Sports Med 40(3):193–201

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  12. Gajhede-Knudsen M, Ekstrand J, Magnusson H, Maffulli N (2013) Recurrence of Achilles tendon injuries in elite male football players is more common after early return-to-play: an 11-year follow-up of the UEFA Champions League injury study. Br J Sports Med 47(12):763–768

    Article  PubMed  Google Scholar 

  13. Hart D, Funk L (2015) Serious shoulder injuries in professional soccer: return to participation after surgery. Knee Surg Sports Traumatol Arthrosc 23(7):2123–2129

    Article  PubMed  Google Scholar 

  14. Hung KKC, Graham CA, Lo RSL, Leung YK, Leung LY, Man SY, Woo WK, Cattermole GN, Rainer TH (2018) Oral paracetamol and/or ibuprofen for treating pain after soft tissue injuries: Single centre double-blind, randomised controlled clinical trial. PLoS ONE. https://doi.org/10.1371/journal.pone.0192043

    Article  PubMed  PubMed Central  Google Scholar 

  15. Junge A, Langevoort G, Pipe A, Peytavin A, Wong F, Mountjoy M, Beltrami G, Holzgraefe CR, Dvorak J (2006) Injuries in team sport tournaments during the 2004 Olympic games. Am J Sports Med 34:565–576

    Article  PubMed  Google Scholar 

  16. Kerr ZY, Collins CL, Pommering TL, Field S, Comstock RD (2011) Dislocation/separation injuries among US high school athletes in 9 selected sports: 2005–2009. Clin J Sport Med 21:101–108

    Article  PubMed  Google Scholar 

  17. Koch M, Zellner J, Berner A, Grechenig S, Krutsch V, Nerlich M, Angele P, Krutsch W (2016) Influence of preparation and football skill level on injury incidence during an amateur football tournament. Arch Orthop Trauma Surg 136(3):353–360

    Article  PubMed  Google Scholar 

  18. Krutsch V, Gesslein M, Loose O, Weber J, Nerlich M, Gaensslen A, Bonkowsky V, Krutsch W (2017) Injury mechanism of midfacial fractures in football causes in over 40 % typical neurological symptoms of minor brain injuries. Knee Surg Sports Traumatol Arthrosc. https://doi.org/10.1007/s00167-017-4431-z

    Article  PubMed  Google Scholar 

  19. Krutsch W, Voss A, Gerling S, Grechenig S, Nerlich M, Angele P (2014) First aid on field management in youth football. Arch Orthop Trauma Surg 134(9):1301–1309

    Article  PubMed  Google Scholar 

  20. Krutsch W, Zeman F, Zellner J, Pfeifer C, Nerlich M, Angele P (2016) Increase in ACL and PCL injuries after implementation of a new professional football league. Knee Surg Sports Traumatol Arthrosc 24(7):2271–2279

    Article  PubMed  Google Scholar 

  21. Latham AJ, Goodwin PC, Stirling B, Budgen A (2017) Ankle syndesmosis repair and rehabilitation in professional rugby league players: a case series report. BMJ Open Sport Exerc Med. https://doi.org/10.1136/bmjsem-2016-000175

    Article  PubMed  PubMed Central  Google Scholar 

  22. Moen MH, Reurink G, Weir A, Tol JL, Maas M, Goudswaard GJ (2014) Predicting return-to-play after hamstring injuries. Br J Sports Med 48(18):1358–1363

    Article  PubMed  CAS  Google Scholar 

  23. Oztekin HH, Boya H, Ozcan O, Zeren B, Pinar P (2009) Foot and ankle injuries and time lost from play in professional soccer players. Foot (Edinb) 19(1):22–28

    Article  Google Scholar 

  24. Paoloni JA, Milne C, Orchard J, Hamilton B (2009) Non-steroidal anti-inflammatory drugs in sports medicine: guidelines for practical but sensible use. Br J Sports Med 43(11):863–865

    Article  PubMed  CAS  Google Scholar 

  25. Pedret C, Rodas G, Balius R, Capdevila L, Bossy M, Vernooij RW, Alomar X (2015) Return-to-play after soleus muscle injuries. Orthop J Sports Med. https://doi.org/10.1177/2325967115595802

    Article  PubMed  PubMed Central  Google Scholar 

  26. Schöberl M, Prantl L, Loose O, Zellner J, Angele P, Zeman F, Spreitzer M, Nerlich M, Krutsch W (2017) Non-surgical treatment of pubic overload and groin pain in amateur football players: a prospective double-blinded randomised controlled study. Knee Surg Sports Traumatol Arthrosc. https://doi.org/10.1007/s00167-017-4423-z

    Article  PubMed  Google Scholar 

  27. Smith RM, Conn AK (2009) Prehospital care – scoop and run or stay and play? Injury 40(Suppl 4):23–26

    Article  Google Scholar 

  28. Tscholl P, Feddermann N, Junge A, Dvorak J (2009) The use and abuse of painkillers in international soccer: data from 6 FIFA tournaments for female and youth players. Am J Sports Med 37(2):260–265

    Article  PubMed  Google Scholar 

  29. Zeng C, Wei J, Persson MSM, Sarmanova A, Doherty M, Xie D, Wang Y, Li X, Li J, Long H, Lei G, Zhang W (2018) Relative efficacy and safety of topical non-steroidal anti-inflammatory drugs for osteoarthritis: a systematic review and network meta-analysis of randomised controlled trials and observational studies. Br J Sports Med. https://doi.org/10.1136/bjsports-2017-098043

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Werner Krutsch.

Ethics declarations

Interessenkonflikt

W. Krutsch, K. Eder, V. Krutsch und T. Meyer geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

Additional information

Redaktion

W. Krutsch, Regensburg

S. Weber-Spickschen, Hannover

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Krutsch, W., Eder, K., Krutsch, V. et al. „Stay and play“ im Fußball. Unfallchirurg 121, 433–440 (2018). https://doi.org/10.1007/s00113-018-0487-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00113-018-0487-6

Schlüsselwörter

Keywords

Navigation