See what's happening on Facebook Twitter YouTube Flickr

FIFPro-Worlds-players-union-mobile-logo

In his new blog, Dr. Vincent Gouttebarge discusses the risks of serious knee problems that professional footballers endure during and after their career as a player.

 

Dr. Vincent Gouttebarge, PhD: 

Just as elite athletes in other sports disciplines, professional football players are continually exposed during their careers to high energic load and intense physical activities such as sprinting, jumping and landing, sudden twisting and turning, sliding and dribbling. If this continuous exposure becomes excessive when compared to recovery time, health-related problems such as injuries, illnesses or mood disturbances may occur.

 

Contrast between short- and long-term health problems
In professional football, the occurrence during a career of acute, chronic and/or recurrent injuries of the musculoskeletal system (muscles, bones, ligaments) has been investigated worldwide for many decades . Studies have shown in particular that many professional football players suffer either during training or competition from injuries mainly involving hamstrings, knees and ankles. In contrast, the incidence of long-term health problems following a professional football career has scarcely been examined, which seems rather strange. Indeed, these long-term health problems are likely to influence the sustainable health, participation and functioning in work and daily life until old age, aspects that are essential to a high quality of life. In recent years, the few studies on this topic have suggested that a professional football career might cause negative long-term health effects, especially osteoarthritis of the knee.

 

 widthWhat is knee osteoarthritis?
Known worldwide as the leading cause of pain of the musculoskeletal system (muscles, bones, ligaments), osteoarthritis is a joint disease caused by the overuse of joint cartilage. Osteoarthritis results in irreversible cartilage change and damage in the affected knee that can lead to knee pain, stiffness, reduced function, instability, deformity, and activity impairments. Several aspects play a role in the occurrence of osteoarthritis, for instance age, obesity, joint injury, and intense physical loads on joints during occupational and sporting activities. Consequently, with regard to sustained exposure to activities involving the knee joints and the occurrence of knee injuries during their career, professional football players are likely to suffer in the long-term (after their career) from knee osteoarthritis.

 

What is the rate of knee osteoarthritis among former professional football players?
A study dated 2012 explored the recent scientific evidence about the rate of knee osteoarthritis among former professional football players. Only four scientific studies were available on how many former professional football players suffer from knee osteoarthritis, underlining the lack of research into negative long-term health effects as a consequence of a football career. Based on this recent overview, it was shown that from 40 to 80 % of former players having played professional football for 10 to 14 years (Slovenia, Tunisia, United Kingdom) suffered from knee osteoarthritis from 35 years of age. This rate of knee osteoarthritis can be considered high when compared to other groups from the same age as illustrated here below.

 

Comparison groups (age-matched Rate of knee osteoarthritis (%)
General population Australia 5-20
General population France 10-15
General population the Netherlands 20
General population United Kingdom 12.5-25
Construction workers 34
Manual workers 2
Mine workers 6
Former professional football players 40-80

 

What are the consequences of knee osteoarthritis for quality of life?
Only few scientific studies have explored whether former professional football players suffering from knee osteoarthritis are impaired during work or daily life activities because of their medical condition. More than 12 years ago, two surveys were conducted in the United Kingdom among 185 to 285 retired professional football players. Of these, 60 to 140 reported that they had been diagnosed with knee osteoarthritis at an average 35 years of age. Nearly 90 % of these former professional football players suffering from osteoarthritis reported having moderate or severe joint pain and discomfort, while around 65 % reported experiencing moderate or severe problems related to mobility and performing usual activities (work, study, house etc.). Furthermore, 37 % of these former players reported moderate or severe problems related to anxiety/depression due to their medical condition.

 

From these former professional football players suffering from knee osteoarthritis, 12 were interviewed by telephone in order to retrieve further information about the consequences of their medical condition. These players reported that knee osteoarthritis was very painful, constantly, caused restricted mobility, affected quality of life, and limited employment. In addition, they reported that knee osteoarthritis had negative consequences for mental well-being as it caused emotional distress.

 

 width

 

Knee osteoarthritis management
Programs aiming to help patients with their osteoarthritis (not exclusively knee osteoarthritis) management have been developed and applied in middle-aged (over 55 years old) patient populations. However, these programs are not suitable for the specific characteristics and needs of former professional football players. Despite that single strategies have been mentioned for osteoarthritis management in (former) professional athletes (Bennell 2012; Kirkendall 2012), a management program specifically meant for former professional football players suffering from knee osteoarthritis is lacking and should be developed, based, of course, on scientific evidence. Currently I am focussing my attention on the development of such management programs in consultation with FIFPro.

 

What about the ankle joint?
With regard to sustained exposure to activities involving the ankle joints and the high rate of ankle injuries in professional football, the question arises whether former players might be at risk for ankle osteoarthritis in the long-term. This question will be explored in a later blog. 

 

Key points

  • Despite the lack of scientific studies, it has been suggested that a professional football career may cause negative long-term health effects, especially osteoarthritis of the knee.
  • 40 to 80 % of former players having played professional football for 10 to 14 years suffer from knee osteoarthritis from 35 years of age.
  • This rate of knee osteoarthritis among former players can be acknowledged as high when compared to other groups from the same age (general population from 5 to 25 %; construction workers 34 %; manual workers 2 %).
  • 65 to nearly 90 % of former professional football players suffering from osteoarthritis reported having moderate or severe problems related to joint pain, discomfort and impaired mobility.
  • 37 % of former professional football players suffering from osteoarthritis reported moderate or severe problems related to anxiety/depression because of their medical condition.
     

 

 

 

Former professional football player Dr. Vincent Gouttebarge is senior researcher at the Coronel Institute of Occupational Health from the Academic Medical Centre in Amsterdam (the Netherlands), and is co-owner of Vintta, a research and consultancy unit for sports health.