A PEEK BEHIND THE STUDY … WITH LAWRENCE MAYHEW

Lawrence Mayhew, Mark Johnson, Peter Francis, Christoph Lutter, Ali Alali, Gareth Jones. Incidence of injury in adult elite women’s football: a systematic review and meta-analysis. 

The full article can be found here.

 

Tell us more about yourself and the author team
@mayhewlawrence

 

I am a senior lecturer in Physiotherapy Sports & Exercise Medicine at Leeds Beckett University (UK) and currently undertaking a PhD investigating the Epidemiology of Injury in Women’s Football. I have worked in Women’s Football for the past 10 years as a physiotherapist within the England Women’s Talent Pathway. I am a Football Association (FA) Medical Faculty member teaching on the FAs Pitchside trauma courses at St Georges Park (UK). At Leeds Beckett University, I am a member of the Musculoskeletal Health Research Group, the Centre for Human Performance and the Centre for Pain Research.

My co-authors on the study were Dr Gareth Jones, Prof. Mark I. Johnson and Dr Christoph Lutter.

 

Mark Johnson

 

Mark is Professor of Pain and Analgesia and Director of the Centre for Pain Research at Leeds Beckett. Mark has published numerous research articles and book chapters on the science of pain. He has international standing for his research on non-pharmacological approaches to manage pain, including TENS, acupuncture, low-level laser therapy, mirror therapy and kinesiology taping. Mark is an experienced Cochrane reviewer, and he provided methodological expertise for the study.
Christopher Lutter

 

Chris is a board-certified Orthopaedic surgeon at the Department of Orthopaedic Surgery at the University of Rostock, Germany. His clinical focus is sports orthopaedics, including surgical treatment of knee and shoulder injuries and extremity axial correction. His scientific work focuses on overuse injuries and injuries in competitive and recreational sports and injury prevention.
Gareth Jones

 

Gareth is a Physiotherapist and researcher specialising in musculoskeletal injury management for sporting and non-sporting populations. His research focuses on the epidemiology of injury in football and rock climbing, the development of preventative injury strategies, and the evaluation of load. He is a member of the Scientific Committee for the International Rock Climbing Research Association. Gareth is also a core member of the Musculoskeletal Health Research Group and the Centre for Pain Research at Leeds Beckett University.

 

What is the story behind your study?

I became aware that injury rates varied across women’s football, and I wanted to understand why. I constituted a research team that I believed had the expertise to explore this. When scoping the literature, we found differences and similarities between the methods used for recording and reporting injury, illness and training and match exposure. At the time, there was no pooled estimate of the incidence rate of adult elite women’s football, nor was there a recent review characterizing the nature and location of injuries in this cohort.

The exponential rise in the professionalism and success of women’s football meant a need to assess these areas of practise/research. The primary aim of our systematic review was to estimate the incidence of injury (overall, match and training) in elite adult women’s football. A secondary aim was to characterise the nature and anatomical location of injuries.

 

In your own words, what did you find?

We estimated the incidence rate in match play to be higher than training (domestic club football) and overall rates to be higher in tournament football than domestic football.

We observed that terminology to describe injury definitions were inconsistent, although criteria to determine injuries, such as time-loss and the need for medical attention, were stable, thus enabling us to have confidence in our injury tallies by injury site and type. Some studies used a team level calculation to estimate training and match exposure and the injury incidence rate. This is a recognized method of recording exposure, but it was not clear in studies the methodological steps taken to mitigate against errors in exposure reporting using this approach.

We found substantial heterogeneity between the studies, so we decided not to conduct further sub-group meta-analyses (as recommended by Cochrane). Our discussion of findings focused on the reasons for the heterogeneity.

 

What was the main challenge you faced in your study?

This was the first time that I led a team to conduct a systematic review. I found writing our study challenging, especially communicating the Methodology, Results and Discussion sections succinctly and within the word limit. We wanted to translate the findings into recommendations for practitioners working in women’s football injury surveillance.

 

If there is one take-home message from your study, what would that be?

Practitioners and researchers working across women’s football injury surveillance should consider standardising injury and illness definitions, medical reporting of injuries, and accurate match and training exposure recording. If practitioners come across limitations, issues or difficulties in these procedures, then report these issues clearly and discuss how these limitations influence the findings.

Critical appraisal of research improves the quality and certainty of research findings. As an early career researcher, I have learned to embrace criticism as part of day-to-day research activity. The fear of being wrong is something that I use to drive diligence, and being fearless of external scrutiny enables me to continuously enhance the quality of my research.

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