VOETBAL MEDISCH SYMPOSIUM 2020

DE BEHANDELING VAN VOETBALBLESSURES 

PRAKTISCHE WETENSCHAP

OP DE KNVB CAMPUS IN ZEIST VINDT KOMEND JAAR OPNIEUW HET VOETBALMEDISCH SYMPOSIUM PLAATS.

HET SYMPOSIUM IS DÉ PLEK OM COLLEGA’S BINNEN HET VOETBALMEDISCHE DOMEIN TE ONTMOETEN OF KENNIS OP TE DOEN VAN GERENOMMEERDE EXPERTS. EN DIE NIEUWSTE INNOVATIES TE ZIEN OP HET GEBIED VAN VOETBALMEDISCHE EN FYSIEKE PRESTATIES.

NA VORIG JAAR DE DIAGNOSTIEK VAN VOETBALBLESSURES BELICHT TE HEBBEN, ROLT DE BAL DIT JAAR VERDER NAAR DE BEHANDELING VAN VOETBALBLESSURES. HET INHOUDELIJKE PROGRAMMA BIEDT OPNIEUW SPREKERS DIE ZICH ONDERSCHEIDEN IN ZOWEL DE DAGELIJKSE ZORG VOOR DE VOETBALLERS ALS OP WETENSCHAPPELIJK GEBIED.

Ja, ik wil mij aanmelden!

VOETBAL MEDISCHE WORKSHOP 2020

(VELD)REVALIDATIE NA EEN VOETBALBLESSURE

OP 4 MAART ZAL ER WEDEROM EEN WORKSHOP PLAATS VINDEN BIJ HET KNVB VOETBAL MEDISCH CENTRUM. 
OOK DIT JAAR BELOOFD HET EEN OCHTENDVULLEND PROGRAMMA TE ZIJN WAAR VOORNAMELIJK (SPORT)FYSIOTHERAPEUTEN HUN KENNIS MEE KUNNEN UITBREIDEN.

TIJDENS DE WORKSHOP ZAL MATT TABERNER ZIJN KENNIS EN EXPERTICE MET DE DEELNEMERS GAAN DELEN. MATT TABERNER IS EEN ERVAREN CLINICUS DIE AL JAREN EINDVERANTWOORDELIJK IS VOOR DE REVALIDATIE VAN TOPVOETBALLERS IN DE PREMIER LEAGUE. ZIJN FOCUS LIGT VOORNAMELIJK OP FYSIEKE ONTWIKKELING EN PRESTATIES. TEVENS IS HIJ DE ONTWIKKELAAR VAN HET ‘CONTROL-CHAOS CONTINUUM’.

DIT FRAMEWORK, WELKE VIJF FASES BESCHRIJFT HOE DE VELDREVALIDATIE NA EEN VOETBALBLESSURE OPGEBOUWD KAN WORDEN, STAAT CENTRAAL BINNEN DE WORKSHOP. DE THEORETISCHE ACHTERGROND,
DE TOEPASSING EN HET PRAKTISCHE ASPECT ZULLEN ALLEN AAN BOD KOMEN TIJDENS DE WORKSHOP.

JA, IK WIL MIJ AANMELDEN!

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These guys are the best when it comes to style and have great attention to detail. 

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MODEL, FRANCE

These guys are the best when it comes to style and have great attention to detail. 

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MODEL, FRANCE

Nick van der Horst

Meet the soccerdoc

Nick van der Horst behaalde zijn diploma fysiotherapie in 2007 aan de Hogeschool Utrecht. Hij werkte 10 jaar lang als sportfysiotherapeut/echografist/docent bij het Academie Instituut te Utrecht. Daarna heeft hij de overstap gemaakt naar waar zijn hart ligt, het professionele voetbal. Hij heeft twee jaar als sportfysiotherapeut en hoofd van de medische staf bij Go Ahead Eagles in Deventer gewerkt. Momenteel is is Nick werkzaam bij de KNVB. Zijn onderzoeks-activiteiten zijn gefocust op de voetbal-medische zorg. In 2017 behaalde hij zijn doctoraal na het verdedigen van zijn proefschrift ‘Prevention of hamstring injuries in male soccer’.

Blogger: Raúl Gómez
Blogger: Raúl Gómez

“These players are not fit. They need to run more during training.”  How many times have we heard this after witnessing a soccer team lose a game? Although soccer is very physically demanding, the idea that running more solves all problems is far from the truth. Football primarily depends on technical and tactical skills, with decision-making playing a crucial role.

I believe that the primary goal of training is to enhance the team’s game model, which encompasses tactical, technical, and physical aspects that are inseparable due to the nature of the game. This involves developing collective behaviors that enable the team to surpass the opposition when attacking and withstand them when defending.

Is it possible to achieve comparable improvements through training based on the team’s game model instead of isolated running training?

Bucheit et al. (2024), in their article “The 11 evidence-informed and inferred principles of microcycle periodization in football”, state the following:

“While metrics such as High-Speed Running distance and maximal speed exposures provide insights into performance and injury risks, they should not detract from the primary goal of football training: to enhance player interactions and the development of dynamic in-game scenarios through ball play.[…] It advocates for the crafting of training sessions that organically incorporate locomotor “targets” within a football-specific framework (as running is an integral part of football by definition), eliminating the necessity for isolated running drills.”

The belief that the game itself is not a valid tool to improve footballers’ physical capacity is a misconception inherited from traditional forms of periodization in other disciplines. Although certain forms of training contribute to maximizing footballers’ performance, we must not lose sight of the essence of the game.

In 2019, Kunz et al. compared the effects of high-intensity interval training (HIIT) with those of Small-Sided Games (SSG) on physical parameters in young soccer players. They concluded that SSG and HIIT result in similar improvements in several variables related to running performance. This conclusion aligns with the results of a systematic review by Hill-Haas et al. in 2011, supporting this notion.

The results regarding the improvement of neuromuscular parameters are contradictory. Some authors, such as Kunz et al. (2019) and Clemente et al. (2021), did not find effective SSGs for improving RSA, sprint, or jump. 

However, others, such as Eniseler et al. (2017), did show significant improvements in RSA after an SSG-based training program. The variability of the game, the heterogeneity in the study populations, and the differences in the design of the training programs could be the causes of these differences. With an adequate design, improvements in these physical qualities can also be achieved.

Maximum speed training with SSG seems more complex due to the unpredictable and uncontrolled nature of the game. This can lead to some soccer players overtraining while others may undertrain (Gualtieri et al., 2023).

It’s important to remember that the amount of time a player spends with the ball is crucial. In a study by Eniseler et al. (2017), one group of young football players focused their training on small-sided games (SSG), while the other group trained with linear sprints and changes of direction.

The SSG group completed a total of 5111 actions with the ball, while the other group DID NOT PERFORM ANY actions with the ball during that part of the training. As a result, the SSG group showed twice as much improvement in a short-pass test compared to the other group.

When appropriately designed, SSG are an effective tool for enhancing cardiovascular and neuromuscular fitness in football players while improving their technical and tactical skills specific to the team’s game model. However, it is important to note that other alternative methods may be more effective for improving maximum speed actions (Zhi Yong et al., 2023), as they offer simpler control and quantification.

How do different variables in task design impact the internal and external training load?

Pitch size and number of players are the variables that have the most significant impact on the physical, physiological, and technical-tactical demands (Castellano & Casamichana, 2019).

Castellano and Casamichana (2019) propose a model that focuses on the primary actions within the game based on the interaction between players and pitch size. They introduce the concept of relative area per player (RAPP), calculated as the pitch size (in m2) divided by the number of players. The model is divided into three conditional qualities:

Strength: Tasks involving a high number of accelerations, decelerations, and changes of direction with a small number of players and a small RAPP.

Endurance: High-intensity tasks at a cardiovascular level. A high RAPP and a small number of players are used.

Speed: Tasks focused on high-speed running actions. This requires sufficient space and time. Therefore, these exercises will involve a high number of players and a high RAPP.

Tabel1 SoccerDoc EU

Tabel 1. Different game formats according to space and number of players (Castellano & Casamichana, 2019)

Depending on the session’s objective and the task, these two variables can be combined, as shown in Table 1, to have a more significant impact on certain specific qualities. Castellano and Casamichana (2019) not only recommend using SSG, but also Medium and Large-Sided Games. In smaller spaces, the number of accelerations and decelerations will increase, while the distance covered at high speed will decrease (Clemente et al., 2022). As the RAPP increases, the players’ physical and physiological load and perceived effort (RPE) also increase (Casamichana & Castellano, 2010). Depending on our objective, there are also several variables that we can modify and will influence the actions during the game.

Game format
Coaches often use situations of numerical advantage or disadvantage to achieve specific tactical goals. In 2010, Hill-Haas et al. studied the impact of using teams with an equal number of players (3 vs 3 and 5 vs 5) compared to teams with an unequal number of players (3 vs 4 and 5 vs 6). They found that the total distance covered by the equal teams was greater than that of the teams with the higher number of players. The players in the outnumbered teams reported higher RPE compared to the teams with more players.

Inclusion of floaters
Hill-Haas et al. (2010) found that in smaller spaces, the floaters covered a greater total distance, whereas in larger spaces, they completed a greater number of high-intensity runs (>18 km/h).

Asian et al. (2022) conducted a study to investigate the correlation between the position of the floaters (Figure 1) and the internal and external training load in a 4 vs 4 + 2 task among semi-professional soccer players. The study found that regular players experienced higher internal and external loads in all formats. Additionally, floaters in the inside and outside positions had higher internal and external loads compared to those in the zone and square positions, with the inside position being the most demanding. The authors concluded that adding floaters to the task could be an effective strategy for reducing the training load on these players, and it may be used as an active recovery or with players in the process of returning to play.

Image 1 SoccerDoc

Image 1. SSG Design by Asian et al. (2022)

In match simulation tasks, the inclusion of floaters can mean a greater reduction in intensity than in tasks with the objective of maintaining possession of the ball (Lacome, et al., 2017).

Inclusion of goalkeepers
It’s quite surprising that there’s very little research evaluating the impact of including goalkeepers on the internal and external training load in soccer.
The only study directly investigating this found that including goalkeepers reduces the intensity of the physiological responses and the distances covered at high intensity. The authors suggest that this might be because including goalkeepers leads to more passes and shots on goal, which can slow down the pace of the task and increase the time the ball is out of play (Koklu, et al., 2015).

Training regime
Casamichana et al. (2013) studied the difference between interval and continuous training regimes. They found that both formats are effective for achieving high intensity in the task. However, the total distance covered was greater in the intermittent game formats, as were the distances covered at speeds greater than 13km/h. On the other hand, RPE and maximum heart rate (HR) may be higher in the continuous format (Hill-Haas et al., 2011).

If the primary goal of training is to elicit greater cardiovascular responses, longer game formats should be utilized, whereas, if the primary goal is to promote high-intensity actions, game formats should be shorter (Casamichana et al., 2014).

Rest duration
In a recent study by de Dios et al. (2024), it was found that short rests (1-2 minutes) increased the RPE of soccer players, while long rests (4 minutes) led to an increase in the number of accelerations and decelerations. Another study by Branquinho et al. (2021) observed that long rests increased actions at maximum speed, while short rests tended to promote greater physical demands, both internal and external.

Short rest periods usually result in higher internal demands and a higher RPE, whereas longer rest periods tend to favor an increase in high-intensity and speed actions. However, the effect of rest on the training load is largely determined by the duration of each repetition and the design of the task. The use of the work:rest ratio can be helpful in quantifying this variable.

Rules modification
The modification of certain rules during tasks is a common practice aimed at influencing team behavior. Offside is a frequently modified rule, but it appears to have no effect on the HR of footballers during SSG (Custódio, et al., 2022).

Halouani et al. (2017) investigated the effect of different ways of scoring goals in SSG on young football players. The study’s findings indicated that using an area at the end of each half of the field where players had to control and stop the ball in order to score resulted in greater physiological responses (HR, RPE, and lactate levels) compared to using small goals. Including the rule that all players must be in the opponent’s half for the goal to count has been shown to increase maximum HR and blood lactate levels (Hill-Haas, et al., 2010).

Number of ball touches
Casamichana et al. (2014) discussed the results of several studies showing an increase in intensity in several physical parameters when the allowed number of touches was reduced. However, their study yielded different results. By allowing only two touches in a possession game (12-min; 6 vs. 6; RAPP of 245 m2), in the first 6 minutes, it was observed that players spent more time at an intensity level below 80% of their maximum HR. In the second 6 minutes of the game, there was a significant decline in running performance in the group without a limit on ball touches, while in the group with a limit, an increase was observed in the amount of time that players spent in the high-intensity zone (>90% of their maximum HR). Fatigue and the technical-tactical skills of the players can greatly influence this variable.

Type of marking
Research has shown that man-marking leads to increased distance covered at moderate and high intensity, as well as a higher number of high-intensity accelerations. However, it does not appear to significantly affect the physiological demands (Casamichana, et al., 2015).

Conclusion
If the tasks are designed correctly, football players can achieve optimal fitness with a training program based on the collective game model. However, special attention should be paid to maximum-speed running, which is crucial for performance and injury prevention but very difficult to control due to the unpredictable nature of the game. In this case, other additional forms of training might be beneficial.

One of the key attributes that distinguishes great football players is their capacity to make correct decisions incredibly fast. It is impossible to develop this capacity if, during training, we simply hand everything to the players without requiring them to make any decisions. Even though sports sciences attempt to control every aspect, football will always retain that uncontrollable element that makes it ‘the beautiful game’.

References

Asian, J. et al., 2022. The influence of floater position on the load of soccer players during a 4 vs 4 +2 game. Kinesiology, 54(1), pp. 82-91.

Branquinho, L. et al., 2021. Effects of different recovery times on internal and external load during Small-Sided Games in soccer. Sports Health, 13(4), pp. 321-324.

Casamichana, D. & Castellano, J., 2010. Time–motion, heart rate, perceptual and motor behaviour demands in small-sides soccer games: Effects of pitch size. Journal of Sports Sciences, p. 1615–1623.

Casamichana, D., Castellano, J. & Dellal, A., 2013. Influence of different training regimes on physical and physiological demands during small-sided soccer games: Continuous vs intermittent format. Journal of Strength and Conditioning Research, 27(3), pp. 690-697.

Casamichana, D., San Román, J., Castellano, J. & Calleja, J., 2015. Influence of the Type of Marking and the Number of Players on Physiological and Physical Demands During Sided Games in Soccer. Journal of Human Kinetics, Volume 47, pp. 259-268.

Casamichana, D., Suarez, L., Castellano, J. & San Román, J., 2014. Effect of Number of Touches and Exercise Duration on the Kinematic Profile and Heart Rate Response During Small-Sided Games in Soccer. Journal of Human Kinetics volume, Volume 41, pp. 113-123.

Castellano, J. & Casamichana, D., 2019. El arte de planificar en fútbol. s.l.:Futboldelibro.

Clemente, F. M. et al., 2021. A Meta-Analytical Comparison of the Effects of Small-Sided Games vs. Running-Based High-Intensity Interval Training on Soccer Players’ Repeated-Sprint Ability. International Journal of Enviromental Research and Public Health.

Clemente, F. M. et al., 2022. Physiological and locomotor demands during small‑sided games are related to match demands and physical fitness? A study conducted on youth soccer players. BMC Sports Science, Medicine and Rehabilitation.

Custódio, I. et al., 2022. Effect of Small-Sided Games with and without the Offside Rule on Young Soccer Players: Reliability of Physiological Demands. International Journal of Enviromental Research and Public Health, Volume 19.

de Dios, V., Padrón, A., Miguel Lorenzo, M. & Rey, E., 2024. Effects of Different Recovery Duration on External and Internal Load Measures during Bouts of Small-Sided Games. Journal of Human Kinetics, Volume 90, pp. 151-159.

Eniseler, N., Şahan, Ç., Özcan, I. & Dinler, K., 2017. High-Intensity Small-Sided Games versus Repeated Sprint Training in Junior Soccer Players. Journal of Human Kinetics.

Fradua, L. et al., 2013. Designing small-sided games for training tactical aspects in soccer: Extrapolating pitch sizes from full-size professional matches. Journal of Sports Sciences, p. 573–581.

Gualtieri, A., Rampinini, E., Dello Iacono, A. & Beato, M., 2023. High-speed running and sprinting in professional adult soccer: Current thresholds definition, match demands and trainingstrategies. A systematic review. Frontiers in Sports and Active Living.

Halouani, J. et al., 2017. Soccer small-sided games in young players: Rule modification to induce higher physiological responses. Biology of Sport, 2(2).

Hill-Haas, S., Coutts, A., Dawson, B. & Rowsell, G., 2010. Time motion characteristics and physiological responses of small sided games in elite youth players: The influence of player number and rule changes. Journal of Strength and Conditioning Research, 24(8), p. 2149–2156.

Hill-Haas, S., Dawson, B., Impellizzeri, F. & Coutts, A., 2011. Physiology of Small-Sided Games Training in Football. Sports Medicine, pp. 199-220.

Koklu, Y., Sert, O., Alemdaroglu, U. & Arslan, Y., 2015. Comparison of the physiological responses and time motion characteristics of young soccer players in Small-Sided Games: The effect of goalkeeper. Journal of Strength and Conditioning Research, 29(4), pp. 964-971.

Kunz, P., Engel, F. A., Holmberg, H.-C. & Sperlich, B., 2019. A Meta-Comparison of the Effects of High-Intensity Interval Training to Those of Small-Sided Games and Other Training Protocols on Parameters Related to the Physiology and Performance of Youth Soccer Players. Sports Medicine.

Lacome, M., Simpson, B., Cholley, Y. & Buchheit, M., 2017. Locomotor and Heart Rate Responses of Floaters During Small-Sided Games in Elite Soccer Players: Effect of Pitch Size and Inclusion of Goal Keepers. International Journal of Sports Physiology and Performance, 13(5), pp. 1-13.

Zhi Yong, Z. et al., 2023. A Meta-analysis of the Effects of High-Intensity Interval Training and Small-Sided Games on Sprint Performance in Adolescents. Strength and Conditioning Journal, pp. 587-597.