A recent study published in the journal Rheumatology by Oxford University Press highlights a concerning trend among retired UK male professional football players. The research indicates that those who suffered foot or ankle injuries during their careers are more prone to developing osteoarthritis after retirement. Moreover, players who frequently received cortisone injections for their injuries reported even higher rates of osteoarthritis.
Professional football, known for its high-speed and contact nature, inherently carries a significant risk of injury. Foot and ankle injuries are notably prevalent, with ankle sprains and metatarsal fractures being the most common. These injuries are more likely to occur during matches than in practice due to the sport’s intense physical demands, including rapid direction changes and competitive play. Such joint injuries can lead to pain, swelling, and damage to the articular cartilage, potentially resulting in chronic pain or disability due to osteoarthritis.
Injury Prevalence and Treatment Concerns
Injury is a widespread issue among male professional footballers, with nearly 25% experiencing foot or ankle injuries during their careers. The use of injection therapies, such as corticosteroids, local anesthetics, platelet-rich plasma, and hyaluronic acid, remains a controversial topic. Although these treatments can alleviate pain and expedite a player’s return to the field, their long-term side effects and effectiveness are debated.
While injections can mask pain and allow for quicker recovery, they may also obscure underlying joint damage, potentially accelerating joint deterioration. The physical demands of professional football, coupled with frequent injections, could exacerbate cartilage damage.
Research Findings and Expert Insights
The study, conducted between August 2020 and October 2021, examined retired UK male football players regarding cases diagnosed by general practitioners with foot or ankle osteoarthritis or those who underwent forefoot or ankle surgery post-retirement. Out of 424 retired players studied, 73% of those with osteoarthritis reported prior foot or ankle injuries, and 75% had received corticosteroid injections during their careers.
“Our findings clearly show that a significant foot or ankle injury during a player’s career is a major, modifiable risk factor of osteoarthritis late in life,” said the study’s chief investigator, Weiya Zhang.
While the study associates corticosteroid injections with higher osteoarthritis rates, it cautions against directly attributing injections to increased osteoarthritis risk. Injections are typically administered post-injury, which may confound their link to osteoarthritis. However, retired players with osteoarthritis reported a higher frequency of injections into a single ankle, often exceeding four per season, surpassing medical recommendations.
Implications and Future Directions
The findings underscore the need for a reevaluation of treatment protocols for professional football injuries, particularly concerning the use of injection therapies. As the sport continues to evolve, balancing immediate performance needs with long-term health outcomes becomes crucial.
Experts suggest that alternative treatment methods and preventive strategies should be explored to mitigate the risk of osteoarthritis among players. This could involve enhanced rehabilitation programs, improved protective gear, and a focus on injury prevention during training.
The research paper, titled “Injury and local injection and the risk of foot/ankle osteoarthritis: a case-control study in retired UK male professional footballers,” is accessible at https://doi.org/10.1093/rheumatology/keaf518.
For further inquiries, contact Weiya Zhang, Professor of Epidemiology, Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UNITED KINGDOM.
