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Project title

Subtitle

The medical section of the manual outlines the medical requirement when it comes to organsing AFC Competitions, with the main objective being to provide standardised medical care for players and other stakeholders.

AFC Website

AFC Competition Operations Manual Edition 2023 - Medical Infrastructure and Services across AFC Competitions

Standardised recording of injury and illness by team doctors. Project performed in partnership with Aspetar Sports Medicine Hospital. 

Injury and Illness Surveillance for AFC Champions League Clubs

Bahamas Football Association

Bahamas Football Association Concussion Guidelines and Procedures Protocol

Research protocol

Bolivian Football Federation

Altitude vs. Coast in South American Professional Football: Comprehensive Risk Assessment, Adaptations and Medical-Scientific Applications

Concussion guideline

A guideline that will guide the BFA structures around medical issues in football in effort to have a safe environment for optimal performance of the athletes. This is the first of the kind for the football association and it encompasses a multi-disciplinary model approach.

Botswana Football Association

BFA Medical Policy Document

Brazilian Football Confederation

Brazilian Football Confederation Concussion Questionnaire

A cross-sectional analytical study conducted among professional referees in Cameroon to assess their mental health status

Journal link

Cameroon Football Federation

Mental health of professional football referees in Cameroon: exploring challenges and developing support interventions

An interventional research designed to deliver AED training and provide first hand data on thr ECG of black African athletes

Preventing Sudden Cardiac Arrest in African Football: ECG Screening and CPR/AED Training in 2,000 Players

Development of a guideline on how to recognize symptoms, diagnose, test, treat, and document concussions. 

Cayman Islands Football Association

Sports-related concussion protocol

We are trying to identify the most relevant bio markers that could be useful for injury prevention in female football players. Different sub-projects are focused on neuromuscular, autonomic, and thermographic variables.

Colombian Football Federation

Develpment of a bio markers set to identify fatigue in female football players to prevent injuries 

Medical protocol for the teams participating in the CONMEBOL Copa América USA 2024

CONMEBOL website

CONMEBOL

Medical protocol for CONMEBOL Copa América USA 2024

Recommendations to prevent exertional heat stroke in soccer for teams participating in the CONMEBOL Copa América USA 2024

CONMEBOL-Website

Exertional Heat Stroke (EHS) in Soccer: Medical Recommendations

Leveraging the U13, U17, and U18 championships in men's and women's soccer to identify players with eating disorders. Detection will be conducted using forms such as the EAT-26 (Eating Attitudes Test) and the CHAD (Athlete's Eating Habits Questionnaire). 

Eating disorders in youth football

In official men's and women's football championships, knee injuries are monitored to identify those confirmed as ACL injuries a few days after a match. We attempt to track players and compare injuries between professional men's and women's football.

Anterior cruciate ligament injuries in men's and women's football in official CONMEBOL competitions

In official men's and women's football championships, muscle injuries are tracked to analyze differences between the sexes and look for relationships with age, city altitude, travel distance, and temperature.

Muscle injuries: Relationship with age, matches played, and sex in official CONMEBOL competitions

The CONMEBOL Medical Commission and Anti-Doping Unit conducted a cross-sectional exploratory descriptive study in footballers to understand the relationship between sociodemographic variables, knowledge and attitude towards doping and perfectionism in sport in football players.

Attitudes towards doping among young footballers: CONMEBOL evolution

In the four years of the study, 12,362 anti-doping controls were carried out in official CONMEBOL competitions and 22 (0.18%) positive analytical results in urine for boldenone or a consistent metabolite of exogenous origin were detected. 

Meat contamination with boldenone and its adverse effects on anti-doping controls

Since 2022, a prospective observational study of injuries occurring in professional men's soccer matches across two competitions over at least five years. We recorded injuries that led to player withdrawal, studied their frequency, diagnosis and location, and their relationship with season, travels, temperature and city altitude, as well as injuries in local and visiting players.

Effect of temperature and altitude on injuries in official CONMEBOL competitions

In Ecuadorian football, there is limited data on the incidence, mechanisms, and management of concussions. This research seeks to fill that gap, providing insights into how concussions occur, how they are managed, and proposing evidence-based strategies for prevention. Specific objectives are 1. Identify the frequency and types of concussions in Ecuadorian professional football players, 2. Analyze the mechanisms of injury leading to concussions, 3. Assess the effectiveness of current management protocols, 4. Develop recommendations for concussion prevention and monitoring.

Study outline

Ecuadorian Football Federation

Types of Concussion in Ecuadorian Football: Incidence, Management, and Prevention Strategies


Ecuador FA Website

Ecuadorian Football Federation- concussion guideline

A Cross-sectional study (mixed-methods approach) applied to the athletes of the Egyptian national football team during the months of September (2-10 Sep.), October(6-15 Oct.) and November(10-19 Nov.) 2024 specifically during the three camps, included six official matches (competitions) of the group stage qualifiers that will qualify for the African Cup of Nations 2025, to investigate and study the prevalence of analgesics and anti-inflammatory (AAI) medications (NSAIDs - Acetaminophen – Chymotrypsin - skeletal muscle relaxants ) use by Egyptian National football team athletes, through determine and focus on the type of treatment, time of treatment (pre-competition) and medical indications for analgesics and anti-inflammatory medicines.  Understanding the medical reasons, psychological motives, attitudes and behaviors related to use analgesics and anti-inflammatory (AAI) medications by the athletes of Egyptian National football team, and determine the extent to which athletes need follow-up and awareness regarding the use of analgesics and anti-inflammatory medicines. Identify and understand the level of acceptance of athletes to have sports pharmacist among medical team of the Egyptian National Football team, and their opinion on the importance of the presence of sports pharmacist to support and protect them regarding the use of medicines.

Egyptian Football Association

Use of NSAIDS among national team players during African cup of nations qualifiers

England Football website

England - The Football Association

If in doubt, sit them out. Concussion guidelines

Guidance on volume of heading in training for all age groups and all levels of football

FA website

FA  Heading Guidelines for Grassroots/Professional football

Document containing what is required medically, in football. It addresses medicals staff, equipment, medical room, PCMS, Anti-doping

Eswatini Football Association

Eswatini Football Association Medical Regulations/Guidleines

The primary hypothesis is that hybrid-training (football) combining endurance, high-intensity interval and resistance training improves general health status, blood glucose regulation and muscle metabolism, as well as wellbeing in patients with T2DM. An explorative hypothesis is that these changes occur irrespective of GLP-1 and SGLT-2 treatment.

Protocol

Faroe Islands Football Association 

The effect of complex exercise training on health status in patients with T2DM

The FIFA concussion protocols outline recommendations for diagnosis and management of concussions in football. One aimed at medical staff and the other at grassroots football. 

FIFA website - Suspect &  Protect

FIFA

FIFA Concussion Protocols

The purpose of this project is to provide cardiac screening recommendations for youth football globally. A Delphi project including a literature review, formulation of recommendations, and a structured voting process on key statements is carried out with a global expert panel consisting of paediatric cardiologists, sports cardiologists, and team physicians. 

Consensus protocol

Cardiac Screening Recommendations for Youth Football Players

The purpose of this project is to provide cardiac screening recommendations for adult football globally. The project will include a literature review, formulation of recommendations, global considerations from member assocations, and playersm and a structured voting process on key statements is carried out with a global expert panel consisting of sports cardiologists and team physicians. 

Cardiac Screening Recommendations for Adult Football Players

The purpose of this project is to investigate global cardiac screening practices among youth and adult elite male and female football players.

Global cardiac screening practices in football

The aim of this project is to develop expert-based, patient-specific, globally applicable practical clinical recommendations on the surgical management of knee cartilage injuries in football players using the RAND/UCLA Appropriateness Method. The project is carried out as a collaboration between International Cartilage Regeneration & Joint Preservation Society, FIFA, and Aspetar Orthopaedic and Sports Medicine Hospital. 

Consensus on the Surgical Management of Knee Cartilage Injuries in Football Players

The overall purpose of this project is to develop, implement and evaluate an evidence-based football-specific tool for on-pitch concussion assessment. The project is currently in development in collaboration with all confederations and will be open for involvement from 211 FIFA Member Associations.  

Project protocol

Systematic review protocol:

Development of a Standardised Football-Specific On-Pitch Concussion Assessment Tool 

The project aims to use video footage to review and analyse all head impacts occurring in FIFA tournaments. There is a focus on mechanisms and visible signs of concussion in football using a standardized approaches with continuous development to improve relevance and implementation in football. 

Protocol - FIFA World Cup Qatar 2022

Visible Signs of Concussion in Football 

The FIFA Emergency Care Manual outlines key information on the management of on-pitch emergencies in football. 

FIFA Website - FIFA Pitchside Emergency Care

FIFA Emergency Care Manual

This handbook is targeted at the stakeholders who will be involved in the implementation of medical services at FIFA Youth, Futsal, Beach Soccer and Club World Cups. Tournament medical services include the planning, organisation and delivery of medical care to players, team officials, FIFA officials and staff and spectators.

FIFA website:

FIFA Medical Handbook for Youth, Futsal, Beach Soccer, and Club World Cups

The injury spotter manual explains the process of reviewing head impacts and visible signs of potential concussion which is implemented in all FIFA football tournaments. 

FIFA Injury Spotter Manual

The aims of this study are firstly, to identify current practices and differences between football-specific concussion protocols globally. and secondly to reflect on the ethical considerations related to the development of concussion protocols that can safeguard player health and balance public health responsibilities with the athlete's autonomy, needs, and preferences. The research is carried out through KU Leuven Centre for Biomedical Ethics and Law within the Doctoral Training Network in Sports Ethics and Integrity (DAiSi)

Developing Ethical Guidelines for Return-to-Play after a Concussion in Football

The purpose of this project is to explore the incidence and mechanism of potential head injuries caused by the ball (which includes both headers and unintentional ball-to-head contact). To do this, we will use data collected by injury spotters at each FIFA World Cup as well as completing a video review to explore the specific mechanism of injury.

Potential Head Injuries in FIFA World Cup Tournaments caused by Ball-to-Head Contact

The purpose of this project is to capture data related to the IFAB Additional Permanent Concussion Substitution trial. The specific aims are: 1) To determine the incidence of head trauma and use of concussion substitutions in football competitions that are participating in the IFAB's Concussion Substitution Trial, 2) To evaluate the immediate severity of reported concussion signs and symptoms for football players with a confirmed or suspected concussion, 3) To evaluate the ability of neurocognitive assessments completed post-incident to inform the clinical diagnosis of concussion, and 4) To provide normal concussion assessment references values for use in football.

Research protocol - Concussion incidents

Research protocol - Baseline Reference Values

IFAB Additional Permanent Concussion Substitution Trial 

The purpose of this project is to create an open-source, online Heading Research Database to collate and summarise all existing published research on heading in football.

Research database protocol

Creation of a Heading in Football Research Database

This project aims to create a Heading in Football Research Overview using the Heading in Football Research Database. To do this 9 individual systematic reviews will be completed on topics including (the protocols for each review are available on PROSPERO): 
•	Heading incidence or load
•	Head impact magnitude
•	Heading technique and performance
•	Risk mitigation strategies
•	Heading as a mechanism of acute head/brain injury
•	Acute effects of heading (one session)
•	Medium effects of heading (>one session in active players)
•	Long-term effects of heading (retired players)
•	Non-human/theoretical/mathematical research

Heading in Football: Systematic reviews

A multistep project that aims to create an overview of heading incidence research. The project focuses on descriptors and definitions and attempts to create global agreement on these for use in heading research in the future.

Systematic review protocol

Delphi project protocol

Heading in Football: Descriptors and Definitions

This project will be investigating heading in football across different levels of the game including youth to adult, amateur and professional as well as males and females. It will contain a number of separate studies.

Heading Technique in Football: The Influence of Performance on Injury Prevention

This project contains a series of studies which aim to explore the incidence of heading, head impacts, and potential head injury situations in 1) FIFA World Cup tournaments from the 1990s until present day comparing men and women, 2) FIFA Beach Soccer World Cup, and 3) FIFA Futsal World Cup. The results will hopefully provide insights on headers, head impacts, and potential head injuries which can be used to inform risk mitigation strategies for players’ short and long-term brain health. For football initially, an automatic heading detection algorithm for video footgage review is developed through active machine learning. 

Headers, Head Impacts, and Potential Head injuries in FIFA Organised Tournaments including FIFA World Cup Matches, Beach Soccer, and Futsal

This project aims to explore which member associations have heading guidelines or coaching frameworks specifically related to developing heading skills

Heading guidelines and coaching frameworks

Surveillance of injuries and illnesses occurring among players at all FIFA tournaments. Details are recorded by team medical staff. Information collected includes injury location, type and circumstances, illness type (including mental health problems), and the resulting amount of time for which the players are unable to participate in football. Each team also records the amount of training and match play completed by each player during the tournament period.

Current protocol

Player Health Surveillance at FIFA Tournaments

This project aims to create and maintain an overview of all player health surveillance activities in football globally. An initial survey was conducted in February-April 2024 to collect information on surveillance activities in football, including the population (e.g., men’s or women’s football, youth and/or adult, level of competition), time frame, type of data collected, and data collection method. Connections with other surveillance-related organizations were also identified. The survey was distributed by e-mail to all confederations and FIFA member associations. It was also openly available online and advertised on social media and at football medicine conferences.  Following the survey, a snowball approach has been used to contact organisations that were cited as partners by survey respondents, as well as organisations known to the research group. 

FIFA Global Player Health Surveillance Stakeholder Mapping

This project involves a comprehensive systematic review on injury and illness epidemiology in football. Previous reviews of this topic have focused on specific competitive levels (e.g., professional) and are sex specific. This review will cover professional and amateur players, sex playing categories, beach soccer and futsal, as well as para football. By synthesising evidence across various demographics and disciplines, our review aims to provide a more encompassing understanding of injury and illness patterns in football. Moreover, current available reviews only include evidence up to 2018. By adopting a living review approach and continuously updating our synthesis, we will ensure that our findings reflect the latest evidence, enhancing their relevance and applicability to contemporary football contexts.

Descriptive Epidemiology of Injury and Illness in Football, Futsal, Beach Soccer, and Para Football -  A Living Systematic Review

The aim of this project is to create a comprehensive compendium for implementing player health surveillance in professional football, including a step-by-step framework, electronic tools, study manuals, report templates, and other practical materials. The project will draw on the experience of a large group of experts identified through FIFA’s Global Player Health Surveillance Mapping Project. The expert group will identify the guidance and tools necessary for surveillance implementation in a range of professional football contexts, then develop and refine the compendium through an iterative Delphi process. 

Implementing Player Health Surveillance in Football: A Delphi Study

The aim of this study is to identify key aspects for successful player health surveillance implementation in football leagues and tournaments, as well as potential barriers and facilitators. This will be a Delphi study involving surveillance leaders identified through FIFA's Global Player Health Surveillance Stakeholder Mapping project. 

Football Player Health Surveillance: Key Factors, Barriers and Facilitators for Effective and Sustainable Implementation  

This projects aims to bring together all leagues and associations that are currently conducting player health surveillance to create a global collaboration to map out players’ match workloads globally and investigate relationships between match workloads and injury outcomes.

Match workload and injury risk

FIFA officially launched a worldwide Sudden Death Registry in January 2014. The aim of this registry (FIFA-SDR) is to detect the frequency of sudden arrest/death during football and to identify their causes as precisely as possible. Thus, existing screening and preventive measures will be improved or supplemented to help to prevent some of these deaths in the future. The research and management of the registry is carried out by Saarland University in Germany.  

FIFA-SCD website

FIFA Sudden Death Registry

The aim of this project is to be able to analyse situations where players might be at higher risk of injury during matches using a standardised approach to detect and analyse injury inciting circumstances. This is achieved through the development of a medical coding in addition to the FIFA football language, which is applied to all FIFA football tournaments. 

Research protocol: FIFA World Cup Qatar 2022

Potential Injuries in Football - Medical Coding and the FIFA Football Language

This project aims to utilise existing surveillance datasets in professional football to identify relationships between the match load per season and player health at both team and individual level. The project will bring together surveillance researchers and data from multiple leagues globally. 

Match Load and Player Health in Professional Football

The project focuses on menstrual health in female players, examining how the menstrual cycle impacts sports training, performance, and participation. The project involves developing and validating a tool to assess menstrual health in a sporting context. 


Monitoring the Menstrual Cycle in Women’s Football: Implications for Female Health and Performance

In the last decade numerous high-profile players have started families, and successfully returned to elite-level football in the months after childbirth. However, decisions regarding football participation during pregnancy are complex and require a careful risk-management approach. The FIFA Female Athlete Project is developing two decision aids to support players from the grassroots to professional level in making decisions about football participation during and following pregnancy.

Protocol:

Decision aids to support football participation during and following pregnancy

We are conducting a series of online surveys to explore initial relationships that would serve as a foundational step to inform and guide future research surrounding the safety of football participation during and following pregnancy. This research project seeks to understand the relationship between:  1) Contact exposure during pregnancy on health outcomes (e.g., fetal safety); 2) Breastfeeding and injury risk; and 3) Player health history and health outcomes during/following pregnancy.

Navigating Maternal Health in Football: The Impact of Contact, Breastfeeding, and Low Energy Availability on Pregnancy and Postpartum Outcomes

This project contains a series of studies related to women's football. The first is a mixed methods study to explore the barriers and enablers for developing technical skills in women's football (including a quantitative survey and one-on-one interviews with women players and coaches of women and girls). The second part of the project focuses on heading in football and the role of performance in head injury prevention. This part of the project also includes a mixed method design as well as a video analysis of heading and head injury events in women's football across a range of ages (completed in association with UEFA Medical).

Technical Skills in Women’s Football

The document will include regulations and recommendations regarding  pre-competition medical checks, first aid requirements in matches, heading, mental health, and more

Finnish Football Association 

Regulations and guidelines for players health and wellbeing

Brain Health exercises

E-learning course for basics of equipment, injuries, first aid, injury prevention for parents and first aiders

E-learning link:

Basics of equipment, injuries, first aid, injury prevention

French FA website

French Football Federation

Concussion guidelines

Comparison between former professional football players and the general population (large scale) on the long term health effect of football

Website:

German Football Association

SoccHealth: a health status examination of former professional football (soccer) players within the German National Cohort

The project includes multiple activities to raise the awareness of the seriousness of head injuries

Website link

REFORM (EU ERASMUS project)

German FA website

HEAD INJURIES: An overview and specific medical recommendations for German professional football

This study was part of a collaborative PhD between the Saarland University, Germany and University of Health and allied Sciences, Ghana. ECGs and ECHOs were done for 289 male and female Ghanaian football players as part of their annual cardiovascular evaluation. The study findings revealed that Ghanaian black soccer players had exaggerated cardiovascular response to physical activity compared to their caucasian counterparts in similar studies.

Ghana Football Association

ECG and ECHO findings among Ghanaian football players

Guinean Football Federation

Protocole medicale sur les commotions cerebrales.

The Japan Football Association (JFA) launched the injury surveillance program (JFA-Survey) for the purpose of identifying the characteristics of injuries and illnesses in Japanese football and developing strategies for injury and illness prevention, and has been conducting injury and illness surveillance since 2019. The aim of this study was to investigate the characteristics of injury and illness in professional football players in J-League over the past six years between 2019 and 2024. The attendance record includes the number of minutes spent on each exposure (training and matches), along with the reasons for the players' absences (injury, illness, national team duty, and other). According to the methodology of the injury study program by the Union of European Football Associations (UEFA) and The Asian Football Confederation (AFC), the total hours spent on training and match activities, the quantity of each type and injury and illness location, and the duration of time required to return to play (days) as well as players characteristics such as anthropometric data and position played, were recorded. Injury incidence, illness incidence, injury burden and illness burden were calculated.

Japan Football Association

Trends in injuries and illnesses in the Japanese men's professional league

Fifth metatarsal fractures (MT-5) are common injuries in professional football players. While European leagues have been well-studied, data from Japan's professional football leagues are limited. This study aims to investigate the incidence, severity, and risk factors of MT-5 fractures in Japan’s professional football players. Using a retrospective cohort study design, data from JFA-injury surveillance programs will be analyzed. The study will document details such as injury mechanisms, player positions, and time lost due to injury, and calculate fracture incidence rates per 1000 hours of exposure. Comparisons with European data will be made to identify differences in injury patterns and risk factors.

Epidemiological Study of Fifth Metatarsal Fractures in Professional Football Players in Japan

This study aims to investigate the relationship between the incidence of HSIs and the implementation of the Nordic hamstring exercise in Japan’s professional football leagues.  The subjects of the study are teams participating in the epidemiological surveys conducted by the Japan Football Association (JFA) between 2022 and 2024. These surveys record daily training and match activities, as well as the occurrence of injuries, to calculate the incidence of hamstring strains. The implementation of the Nordic hamstring exercise will be assessed through a web-based questionnaire.

Effectiveness of the Nordic hamstring exercise to prevent hamstring injury in the Japan's men professional football league

Japan Football Association Concussion Protocol

JFA Website

This project aims to make a program that can be performed for all players prior to any competition to predict future injuries or muscle weakness. 

Health-related guidelines and medical research projects