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1. Introduction to epidemiology
2. Soccer injury epidemiology
3. Reliability of soccer injury epidemiology studies
4. Ekstrand and Gillquist propose stretching and strengthening
5. Keller et al advocate warm up and stretching
6. Hawkins and Fuller identify fatigue as a factor
7. Conclusion
8. References

Hawkins and Fuller (1999) examined the incidence of injury within professional football players in England, in a study that can be classified as observational epidemiology and is not strictly a correlational study. The authors tend to exceed the limitations of this type of research by drawing conclusions that infer cause and effect. This is not appropriate, as the observations merely show a relationship. The authors found a higher injury frequency in matches compared to training per 1000 hours of exposure. On the face of it, this data may falsely lead the reader to conclude that more injuries occur in matches but, given that training time to match time is approximately 7:1, more injuries actually occur during training.

Hawkins and Fuller (1999) also demonstrated that significantly more injuries occurred during the last fifteen minutes of each half, and that there were significantly more injuries in the second half compared to the first. The authors felt that this was due to fatigue, and advocated endurance training and carbohydrate intake to counter this problem. This hypothesis has good face validity and would be difficult to ethically research, which means it is difficult to falsify. As endurance training would have no serious ill effects on the player, it seems sensible and practical to introduce this as an aspect of the training program.

Conclusion >