KENYA. Onywera Vincent, Njororai Simiyu, Wamukoya Edwin and Andanje Mwisukha, Kenyatta University, P. O. Box 43844, ABSTRACT

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Page n ANALYSIS OF ACUTE INJURIES INCURRED BY SOCCER PLAYERS DURING THE 2001 MOl GOLDEN CUP SOCCER TOURNAMENT IN KENYA Onywera Vincent, Njororai Simiyu, Wamukoya Edwin and Andanje Mwisukha, Kenyatta

1 Page n ANALYSIS OF ACUTE INJURIES INCURRED BY SOCCER PLAYERS DURING THE 2001 MOl GOLDEN CUP SOCCER TOURNAMENT IN KENYA Onywera Vincent, Njororai Simiyu, Wamukoya Edwin and Andanje Mwisukha, Kenyatta University, P. O. Box 43844, NAIROBI ABSTRACT Irrespective of the nature, cause and mechanism, injuries are a serous hazard in many sports. Injuries hamper the players' performance both in training and competition, disrupt the conditioning process and thus prevent them from realizing their playing potential. However, with surveil/once of injuries, preventive, treatment and rehabilitation measures can be formulated. This study investigated injuries that led either to a temporary stoppage of the game and/or substitution of a player during the preliminary phase of the 2001 Moi Golden Cup Soccer Tournament in Kenya. A total of 15 matches were played in the preliminary phase. Each match was observed by three independent research assistants who observed and recorded the injuries in a protocol sheet. Forty-three (43) injuries were registered during this phase. The majority of the injuries affected soft tissues (67.8%). The most serous injuries were dislocations and fractures. The lower part of the body suffered more injuries. Opponents were the main agents of injuries (56.8%). Most injuries occurred in the offensive part of the field (44.2%). The majority of injuries affected attackers (44.2%) compared to defenders and mid fielders. The home team suffered more injuries (67.4%) compared to the away team. The losing team recorded more injuries (51 %) than the winning team. Given that most injuries were caused by opponents, it is recommended that team officials emphasize the use of protective gear as' well as effective physical conditioning of their respective team players. There is also need to' replicate the study on more comprehensive scales at international levels. Key Words: Acute Injuries, Preliminary phase_ Soccer.

2 VOLUME 1, ISSUE 1 Page 73 Introduction Socceris the most popular game in the world and In spite of all the above, there is no published study on occurrences of injuries to players among has more than 40 million participants (Kristian, soccer teams in Kenya. It is in the light of this that 1996). It is a dynamic and collision sport that exposes players to many dangerous situations and possible injuries. Specificgame situations in soccer such as tackling, heading, running/dribbling and turning expose players to injuries (Wekesa, 1995). Because of this study focused on ana lysing the nature, anatomical distribution, contextual occurrences and an aetiology of injuries in relation to the players positions among Kenya's male soccer teams during the 2001 Moi Golden Cup Soccer Tournament. thehigh number of soccer injuries during matches, Materials and Methods traumatology and epidemiology have become objectsof major medical interest. Irrespective of the nature, cause and mechanism, injuriesare a serious hazard in many sports (Fox, 1981) and prevent them from realizing their athletic potential (Reilly & Stirling, 1990). Major breakthroughs in the scientific analysis and interpretation of the causes of sports injuries are anticipated from studies by individual physicians, and teams composed of physicians, trainers, coaches, physical educators and athletic directors. Findings from such studies, if used effectively, allow for the maintenance of meanil)9ful records and statistics concerning the aetiology, nature and their prevention of sports injuries(requa,et. ai., 1993). Many researchers agree that surveillance of injuries during training and competition assists in understanding their Thirty (30) matches were scheduled for the Tournament. To manage this research, twentyfour (24) matches were selected for this study. These matches represented 80% of the total population. All the matches were played outdoors on natural surface during the days with temperatures varying between 24 0 ( and 27 0 ( and a relative humidity of 38%- 48%. Data were collected using a soccer match observation chart which had been previously used in other sports (Asembo et at; 1994). All injuries which led either to a temporary stoppage of the match or first aid attention were considered in relation to their nature, site, time and aetiology of injuries; part of the pitch where the injury occurred as well as injuries incurred by the home and away teams. The researchers strategically positioned characteristicsand goes a long way in helping to themselves on the touchline to collect data and formulate effective preventive, treatment and each of them collected data independently. The rehabilitative measures (Ekstrand, 1994; Reilly & inter-observer agreement was set at 90%. Using Hardikar, 1984; 1995). Wekesa, Asembo and Njororai, the soccer match observation chart, and his assistants ana lysed the flow of the game taking

3 - not of the above variables for both teams. As soon as an injury occurred, a tally was made in the appropriate column. In case any doubts, the team doctors or trainers were consulted immediately after V'OLUME 1 ISSUE 1 Page' the match. The data was computed in terms of frequencies and percentages. Tables and pie charts were drawn to present the collected data. Chi-square was computed at level of significance. Results Table 1 summarizes injuries incurred at various phases of the Tournament. A total of 102 injuries. 44 (43.14%) of the preliminary phase, 32(31.37%) at the first second round phose and 26(25.49%) at the post quarter phase were registered. This gives an average of 34(33.3%) tnjuries per zone, 4.3 injuries per team, phase and (0.39%) injuries per player. The number of injuries decreased from 44(43.14%) in the preliminary phase to 32 (31.37%) in the first and second round phase and finally to 26(25.49%) in the post quarter phase. Table 1: Injuries at various phases of the tournament Phase Preliminary First and second Quarter final, semi- Irotal [phase round phase final and final phase df 1X2 Remarks No. of injuries incurred 144(43.14%) 32 (31.37%) ~6 (25.49%) 102 (100%) ~ Not significa Total 144(43.14%)32 (31.37%) ~6 (25.49%) 102 (100%)

4 nume 1, ISSUE 1 Page 7S Figure 1: Summary of injuries during the Tournamenmt r' 43.14% 31.37% 8 Injuries incurred in the prelimiary phase o Injuries incurred in the post quarter phase mj Injuries incured in the first and second phase Positionsof play versus injuries of soccer players are summarized in Table 2. Strikers were the most vulnerableto injuries 35 (34.31 %), followed by defenders (31(30.39%), then mid-fielders 28 (27.45%) and finally goal-keepers 8 (7.34%). Table7: Position of play versus injuries of soccer players during the tournament lposition Goal keepers!defenders Midfielders!Forwards ltotals df ~2 Remarks No. of injuries Significant ncurred (7.84%) (30.41%) (27.5%) (34.3%) (100%) 3 Total 8 31 ~ , 7.8% 30.4% (27.5%) (34.3%) (100%) p~ 0.05; X (

5 VOLUME 1, ISSUE 1 Page! Figure 2: Position of play verses injuries incurred during the Tournament E] Goalkeepers 11Defenders D Midfielders DForwards 27.5% AetiQ!~~ical factors of injuries incurred by players during the tournament are summarized in Table 3. The opponent was the most frequent cause of injury 50 (49%), followed by surface of play 27 (26.5%) then the ball 15 (14.7%) followed by others 9(8.83%) and finally the goal post caused only 1 (0.98%) injury. Table 3: etiological Aetiological fadors of injuries incurred by players during the tournament Surface df emarks requency (14'.'7%) (49%) (26.5%) (0.98%) (8.82%) (100%) 4 7l.34 Significant Total % 49% 26.5% 0.98% % The mechanisms of injuries during the tournament are summarized in Table 4. Most injuries were as a result of being kicked by opponents 28 (27.5%), followed by falling %) then collision lead to 22 (21.6%) lnjurles. followed by being hit by ball 15 (14.7%). Other mechanisms lead to 9 (8.8%) injuries and lastly injuries caused by hitting the goalpost were the least 1 (0.98%).

6 VOLUME 1. ISSUE Page 7i Table 4: The mechanism of injuries during the tournament ~echanism of Hit by Falling Kicked by Hit goal Other Total df X2 Remarks injury ball opponent post rrequency (14.7%) (26.5%) (21.6%) (0.98%) (8.82%) (100%) Significant rotal % 26.5% (21.6%) 0.98% % p~o.05; X2 ~ Figure4: Mechanism of injuries during the Tournament 8.8% 14.7% 27.5% 26.5% 21.6% DlBall III Falling 0 Collision 0 Kicked by opponent II Hit by goalpost 0 Other Thedistribution of injuries in relation to the three zones of the soccer pitch is summarized in Table 5. Most injuries. occurred in the offensive zone (37 (36.3%) followed by defensive zone 35 (34.3%) and, construction zone recorded the least number of injuries 30 (29.4%). Table 5: Distribution of injuries in relation to the three zones of the soccer pitch tz,one Defensive Construction Offensive Total df X2 Remarks zone zone zone ~njury distribution (34.3%) (29.4%) (36.3%) (100%) Significant [rotal (34.3%) (29.4%) (36.3%) (100%) p:s:0.05;x2 ~ 5.99

7 volume 1, ISSUE 1 Page n Figure 5: Distribution of injuries in relation to the three zones of the soccer pitch o Defens ive Zone II!!Construction Zone o Offensive Zone 29.4% Table 6 shows the nature and number of injuries at different phases of the tournament. Most of the injuries were confusions 49(48%), muscle cramps 10 (9.8%), bruises 9 (8.8%), abrasions 7 (6.9%), strain 2 (2%) and lacerations 2 (2%) sprains were 16 (15.7%), dislocations 6 (5.95%) concussions (0 (0%) and fractures 1 (1%). Thus the majority of the injuries affected soft tissues 79 (77.5%) followed by injuries caused due to joint instability 22 (21.6% and fracture 1 (0.98%). Table 6: Nature of injuries at different phases of Tournament Nature of Injuries Preliminary 1 8t and 2 nd Post-Quarter Total df '1.. 2 Remarks Phase round Phase Phase Soft tissue injuries [Not Significant Confusions Strain Bruise ,. Abrasion ~uscle cramp Laceration [rotal ljoint instability Sprain 8 5 3!Dislocation rrotal IFracture 1-0 Concussion Total Total Ip:S;0.05;'1.. 2 ;::: % 31.37% 25.49% 100% (

8 VOLUME 1, ISSUE 1 Page 79 Figure6: Nature of injuries during the Tournament 13Soft issue Injuries IiiJoint Instability o Fractures The study found that most players were substituted because of injuries at the preliminary phase (62.96%) compared to the first and second round phase (22.22%) and post-quarter phase (14%). This can be attributed to the high intensity and competitiveness manifested in their quest to qualify to the next round of the tournament. This state of affairs can also be as a result of the high level of sportsmanship displayed by players as the tournament advanced. Table 7: Players substituted because of injuries during the tournament,. Phase Preliminary 1 8t and 2 nd Round Post-quarter Total df X2 Remarks Phase Phase Phase Players substituted Significant because of injuries (62.96%) (22.22%) (14.81%) (100%) Total (62.96%) (22.2%) (14.8%) (100%) ps;o.05; X2 ~ 5.99

9 VOLUME 1. ISSUE 1 Figure 7: Players substituted because of injuries 14.81% % 121 Players substituted in the preliminary phase III Players substituted in the first and second phase o players substituted in the post quarter phase Table 8 summarizes the number of injuries incurred by the home and away teams. Away teams incurred more injuries 58 (56.9%) compared to the home teams, which incurred %) injuries. Table 8: Number of injuries incurred by the home and away teams Teams Injuries Home teams Away teams Total df X2 Remarks Soft tissue injuries Not Significant oint instability 7 16 racture Concussion Total 1 p:::':o.05; X2 ~ 3.84

10 IOLUME 1, ISSUE 1 Page 81 Figure9. The number of injuries incurred by the winning and losing teams!illinjuries incurred by home teams III Injuries incurred by away teams 43.1% 56.9% Table 9. Wining teams incurred more injuries 58 (56.9%) compared to the losing teams which incurred injuries. Away teams incurred more injuries (56.9%) compared to home teams which incurred injuries (43.1 %). Table 9: Number of injuries incurred by the winning and losing teams Teams Winning Losing teams Total df "I; Remarks njuries, teams Soft tissue injuries Not Significant ~oint instability Fracture Concussion 0 Total (53%) (47%) (100%) d ::;0.05; X2 ~ 3.84

11 - VOLUME 1, ISSUE 1 Pug< Figure 9: Injuries incurred by the winning and losing teams 47% ffillnjuries incurred by winning teams m Injuries incurred teams by the losing 53% Table 10: Anatomical distribution of the injuries during the Tournament Site of boys Frequency Percentage df "/.2 Remarks LOWER LIMB Significant Hip 5 Thigh 25 Knees 8 Lower leg 19 Ankle 10 Total % TRUNK Back 2 ChestlRib area 1 Abdomen 1 Total 4 3.9% Upper limb Shoulder' 3 Elbow 4 Wrist 3 Palm 4 Total HEAD Foreground 6 Chick 1 Backhead 2 Partial 9 Total TOTAL % d ~ 0.05; X2;::: 7.81

12 VOLUME I, ISSUE 1 Page 83 Table 11 summarizes the number of injuries in the first and second half of the matches played during the tournament. More injuries were incurred in the first half (69) as compared injuries incurred in the second half(33). Table 11: Number of injuries in the first and second halves of the matches played during the tournament Levelof match First half Second half Total df X2 Remarks -'-',,'""> No. of injuries Significant (67.6%) (32.4%) (100%) Total "..., 69 -'-' 102 (67.6%) (32.4%) (100%) Figure11: Injuries incurred in the first and second halves of the Tournament [J Injuries incurred in the first halves IIIiIlnjures incurred in the second halves Discussion A total of 102 injuries were recorded during this studyout of which 79 (77%) were soft tissue injuries... Contusionscaused 48% of the injuries followed by musclecramps (9.8%), bruises (8.8%), abrasions (6.9%) and finally lacerations and strain led to 1.9% ecch. Sprain accounted for 15.6% while dislocationscaused5.8% of the total injuries. Fractures caused0.98%. Thesefindings are close to Inklaar et al., (1988) who recorded 80% soft tissue injuries in soccer. However, Ellison's (1993) findings of 49% sprain, 25 % fractures and 17% distortions are contrary tc these findings. These findings also tally wit~ Asembo et ), Ellison (1993) and Watsor (1986) who reported more serious injuries such a! dislocations and fractures. These injuries could be attributed to the intensity, mode of competition, poor playing surfaces as well as poor conditioning. Other injuries were purely accidental. A knockoui tournament is normally associated with tension competitiveness and fear ~ losing. In addition, the level of officiating is very crucial-poor officiati~ can lead to a high rate of injuries (Watson, 1995).

13 Page M served that 60.43% of the injuries affected the caused 0.98% of the injuries. These findings are lower body while % affected the upper body. Wekesa et al. (1993) also found that 60% and 40% of injuries affected lower and upper body respectively. The lower limb suffered % close to Albert's (1993) observation that in outdoor soccer, the percentage of injuries resulting from player to player contacted were accounted for 43%. These findings also tally which is closer to the 55% observed by Wekesa with Watson's (1995) findings attributing 48% of et al (1993) and 42.35% observed by Asembo the injuries to opponents. Wekesa, et al (1993) et al (1995) and 43% observed by Raschka et however, got different observation where 70% al. (1988). These findings supports Watson's (1995) and Fox's (1981) observation that the lower limbs are the commonest site of injuries in soccer and hockey respectively. The current study is in agreement with Asembo et al. (1995) study which noted that play in most intense in the offensive zone especially the goal area. In this study forwards incurred most injuries 34.3%, defenders 30.4%, midfielders 27.5% and goalkeepers 7.8%. Asembo et al. (1994) findings of 48.4% injuries for midfielders, 29 % forwards and 22.6% for defenders are contrary to these observations. More injuries occurred in the first half (67.6%) compared to the second half which registered (32.4%) injuries. T}iese findings tally with Asembo et al (1994) findings of 17% injuries in the first half and 14 % in the second half. Injury rates were highest between the 26 th and 44 th minute contrary to Asembo et. al. (1994) observation of 16 th and 30 th minutes. During the tournament opponents caused 49% of the injuries followed by the surface 26.5%, ball 14.7%, other 8.32% and finally the goalpost of the injuries were caused by opponent. The injuries blamed on the individual may be due to inadequate warm-up, poor officiating, rough play, or poor fitness. These factors are likely to cause injury (Ekstrand, 1994; Reilly, 1994bj Reilly and Stirling, 1990; Renstroem, 1994). Foul play is said to be responsible for one-third of injuries in soccer (Ekstrand and Gillquist, 1983j Keller, et a; 1987) and is the most important cause of injury in school sport (Watson, 1986). Two studies of soccer both attributed 25% of injuries to playing surfaces (Sulliva et ai, 1980j Ekstrand and Gillquit, 1983). Injuries caused by the playing surface were attributed to the bad state of the surface. References Asembo, J. M. (1994). Injuries Observed During Hockey Tournament in Kenya. Meclicus, 13(11/12) Asembo, J. M. Njororai, W.W.S and Wekesa, M. (1995). Injury Pattern During Team Handball Competitions in East Africa. Eas African Medical Journal Vol. 7S No Ekstrand, J. (1994). Injuries in Soccer: Prevention, Clinical Practice of Sports Injury Prevention and Care. Enc:yclopaedia 01 Sports M~~l~in,e Vol. S. London Blackwell Scientific Publlcotlon (

14 rlume 1. ISSUE 1 Ekstrand, J and Gillquist, J. (1983). Soccer Injuries and their Mechanism: A Prospective Study. Medicine and Science in Sports and Exercise 15: Inkloar,H. (1986). An Experimental Soccer Injury Prevention Programme. Proceedings of Councilof Europe 3rd Meeting. Papendal, Netherlands. Fox, (1981) Sports Fitness and Sports Injuries. London:Faber and Faber Kristian,T. (1996). The Avoidability of Soccer Injuries,. International Journal of Sports Medicine 4: Raschka, C. and Mares, H. (1988). Epidemiological Characteristics of Soccer Injuries and Proposed Programmes for their Prevention in Schleswig-Holstein. Scienceand Football II. E and EN Spon. Germany Requa,R. K.; DeAvilla, L. N. and Garrick, J. G. (1993). Injuries in Recreational Activities. American Journal of Sports Medicine. 21: Reilly,T. and Hardiker, R. (1981). Somatotype and Injuries in Adult Student Rugby Football. Journal of Sports Medicine, 21, Reilly, T. and Stirling A. (1990). Flexibility, Warm-up and Injuries in Mature Games Players. Kinanthropometry IV. London: E. 6nd FN Spon (pp ). Watson, A.W.S. (1995). Physical Fitness and Athletic Performance. New York: LongmanPublishers. Wekesa,M.; Asembo, J. M. and Njororai, W.W.S (1995). Aone Year Prospective Study of Soccer Injuries in the Kenyan National Team. African Journal of Health Sciences 1995:2:

THE EFFECT OF THE OFFSIDE RULE ABOLITION ON SELECTED OFFENSIVE ACTIONS, FOULS AND INJURIES IN FIELD HOCKEY

African Journal for Physical, Health Education, Recreation and Dance (AJPHERD) 1998 Vol. 4 no. I pp. 9-22 THE EFFECT OF THE OFFSIDE RULE ABOLITION ON SELECTED OFFENSIVE ACTIONS, FOULS AND INJURIES IN FIELD