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Br J Sports Med. 2015 May;49(9):630-4. doi: 10.1136/bjsports-2014-094130. Epub 2015 Jan 7.

The relationship between the frequency of football practice during skeletal growth and the presence of a cam deformity in adult elite football players.

Author information

1
Sports Rehabilitation and Manual Therapy Department, Physiotherapy Utrecht Oost, Utrecht, The Netherlands Department of Orthopaedics and Sports Traumatology, Academic Medical Centre Amsterdam, Amsterdam, The Netherlands.
2
Sports Medicine Department, Sports Groin Pain Centre, Aspetar Hospital, Doha, Qatar.
3
Private Practice Physiotherapy Dukenburg, Nijmegen, The Netherlands.
4
Department of Orthopaedics, Erasmus University Medical Centre, Rotterdam, The Netherlands.
5
Amsterdam University of Applied Sciences, School of Sports & Nutrition, Amsterdam, The Netherlands. Codarts University for the Arts, Rotterdam, The Netherlands.
6
Department of Orthopaedics and Sports Traumatology, Academic Medical Centre Amsterdam, Amsterdam, The Netherlands.

Abstract

BACKGROUND/AIM:

Cam deformity (CD) is likely a bony adaptation in response to high-impact sports practice during skeletal growth. We ascertained whether a dose-response relationship exists between the frequency of football practice during skeletal growth and the presence of a CD in adulthood, and if the age at which a football player starts playing football is associated with the presence of a CD in adulthood.

METHODS:

Prevalence of a CD (α angle>60°) and a pathological CD (α angle>78°) was studied using standardised anteroposterior (AP) and frog-leg lateral (FLL) radiographs that were obtained during seasonal screening. The age of starting to play football with a low frequency (LF; ≤3 times/week) and high frequency (HF; ≥4 times/week) was retrospectively assessed. The differences in prevalence of a CD per hip, in either view, between groups were calculated by logistic regression with generalised estimating equations.

RESULTS:

63 players (mean(±SD) age 23.1(±4.2) years) participated, yielding 126 hips for analysis. The prevalence of a CD in the FLL was 40% (n=82) in players who started playing HF football from the age of 12 years or above, and 64% (n=44) in those playing HF football before the age of 12 years (p=0.042). This was also true for a pathological CD (12% vs 30%, p=0.038). The AP views revealed no difference.

CONCLUSIONS:

Our results indicate a probable dose-response relationship between the frequency of football practice during skeletal growth and the development of a CD, which should be confirmed in future prospective studies.

KEYWORDS:

Bone; Growth; Hip; Radiology; Risk factor

PMID:
25568331
DOI:
10.1136/bjsports-2014-094130
[Indexed for MEDLINE]

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