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==Health issues== {{multiple image | align = left | total_width = | footer = | image1 = Cristiano Ronaldo 20120609 (crop).jpg | width1 = 142 | height1 = 240 | alt1 = | caption1 = [[Cristiano Ronaldo]], an example of a "lean and muscular" men's association football player | image2 = Faith Ikidi (crop).jpg | width2 = 156 | height2 = 260 | alt2 = | caption2 = [[Faith Ikidi]], an example of a "lean and muscular" women's association football player | direction = }} An Irish 2002 study of association and Gaelic football players characterized players as "lean and muscular with a reasonably high level of capacity in all areas of physical performance".<ref>{{cite journal | last1 = Strudwick | first1 = A. | last2 = Reilly | first2 = T. | last3 = Doran | first3 = D. | title = Anthropometric and fitness profiles of elite players in two football codes | journal = The Journal of Sports Medicine and Physical Fitness | volume = 42 | issue = 2 | pages = 239–242 | pmid = 12032422 | date = June 2002 }}</ref> The opposite is the case for American football, where obesity could be the cause of grave health problems.<ref>{{cite news|last=Korth|first=Joanne|date=29 January 2006|title=Sports: A huge problem: Strength isn't enough: NFL linemen have to be so big, their health may be at risk|work=[[Tampa Bay Times]]|publisher=[[Times Publishing Company]]|url=http://www.sptimes.com/2006/01/29/Sports/A_huge_problem.shtml|url-status=dead|archive-url=https://web.archive.org/web/20080203200027/http://www.sptimes.com/2006/01/29/Sports/A_huge_problem.shtml|archive-date=February 3, 2008}}</ref> A 2000 study documented injuries sustained by Czech [association] football players at all levels:<ref>{{cite journal | last1 = Chomiak| first1 = Jiri | last2 = Junge | first2 = Astrid | last3 = Peterson | first3 = Lars | last4 = Dvorak | first4 = Jiri | title = Severe injuries in football players: influencing factors | journal = [[American Journal of Sports Medicine]] | volume = 28 | issue = s5 | pages = s58–s68 | doi = 10.1177/28.suppl_5.S-58 | pmid = 11032109 | date =September 2000 | s2cid = 20055504 }}</ref> {{Blockquote|Trauma was the cause of 81.5% of the injuries, and overuse was the cause of 18.5%. Joint sprains predominated (30%), followed by fractures (16%), muscle strains (15%), ligament ruptures (12%), meniscal tears and contusions (8%), and other injuries. Injuries to the knee were most prevalent (29%), followed by injuries to the ankle (19%) and spine (9%). More injuries occurred during games (59%) than in practice.}}<ref>{{Cite web|title=Preventing Football Injuries|url=http://www.stopsportsinjuries.org/STOP/Prevent_Injuries/Football_Skating_Injury_Prevention.aspx|url-status=live|archive-url=https://web.archive.org/web/20161117070040/http://www.stopsportsinjuries.org/STOP/Prevent_Injuries/Football_Skating_Injury_Prevention.aspx|archive-date=17 November 2016|access-date=16 November 2016|website=www.sportsmd.com}}</ref> Patellar tendinitis (knee pain) is considered an injury that comes from overexertion, which also happens to other athletes of virtually every sport. It is a common problem that football players develop and can usually be treated by a quadriceps strengthening program. Jumping activities place particularly high strains on the tendon and with repetitive jumping, tearing and injury of the tendon can occur. The chronic injury and healing response results in inflammation and localized pain.<ref>{{Cite web|url=http://www.sportsmd.com/knee-injuries/patellar-tendonitis/|title=Patellar Tendonitis – SportsMD|website=www.sportsmd.com|date=January 2015|access-date=16 November 2016}}</ref> Although levels of depression and pain in retired football players are on par with the societal average,<ref>{{cite journal | last1 = Schwenk | first1 = T.L. | last2 = Gorenflo | first2 = D.W. | last3 = Dopp | first3 = R.R. | last4 = Hipple | first4 = E. | title = Depression and pain in retired professional football players | journal = Medicine and Science in Sports and Exercise | volume = 39 | issue = 4 | pages = 599–605 | pmid = 17414796 | date = April 2007 | url = http://www.medscape.com/viewarticle/555786 | doi=10.1249/mss.0b013e31802fa679| doi-access = free }}</ref> some players suffer from post-retirement chronic injuries. Head injuries are a particular concern. ===Life expectancy=== Studies have long shown former American football [[NFL]] players have a longer life expectancy than the general public or males with a similar age and race distribution, but a higher rate of cardiovascular issues.<ref>{{cite journal |last1=Baron |first1=Sherry |last2=Rinsky |first2=Robert |title=Health hazard evaluation report: HETA-88-085, National Football League players mortality study. |journal=National Institute for Occupational Safety and Health |date=1994-01-10 |url=https://www.cdc.gov/niosh/nioshtic-2/20022075.html |access-date=10 July 2022}}</ref> A study comparing the deaths of former [[Major League Baseball]] players found baseball players lived longer still, perhaps suggesting a [[Healthy user bias|"healthy worker" bias]] where NFL athletes lived less long than they would otherwise have, despite their longer than average life expectancy.<ref>{{cite web |last1=Meredith |first1=Wadman |title=Former football pros die at a faster rate than baseball veterans |url=https://www.science.org/content/article/former-football-pros-die-faster-rate-baseball-veterans-and-reasons-are-surprising |publisher=Science|access-date=10 July 2022}}</ref> A 2009 review of the evidence in the American Journal of Medicine concluded the existing evidence "did not suggest an increased mortality" but does "suggest increased cardiovascular risk..., particularly the heavier linemen."<ref>{{cite journal |title=Early Cardiovascular Mortality in Professional Football Players: Fact or Fiction? |journal=American Journal of Medicine |date=1 September 2009 |volume=122 |issue=9 |doi=10.1016/j.amjmed.2009.03.027 |url=https://www.amjmed.com/article/S0002-9343(09)00441-0/fulltext |access-date=10 July 2022|last1=Selden |first1=Michael A. |last2=Helzberg |first2=John H. |last3=Waeckerle |first3=Joseph F. |pages=811–814 |pmid=19699372 |url-access=subscription }}</ref> In [[association football]], a 2011 German study found that German national team players lived 1.9 years less than the general male population.<ref>{{cite journal | last1 = Kuss | first1 = Oliver | last2 = Kluttig | first2 = Alexander | last3 = Greiser | first3 = Karin H. | title = Longevity of soccer players: an investigation of all German internationals from 1908 to 2006 | journal = Scandinavian Journal of Medicine & Science in Sports | volume = 21 | issue = 6 | pages = e260–e265 | doi = 10.1111/j.1600-0838.2010.01269.x | pmid = 21435018 | date = December 2011 | s2cid = 30783906 }} [http://www.oliverkuss.de/science/publications/Kuss_Longevity_of_Soccer_Players_An_Investigation_of_all_German_Internationals_from_1908-2006.pdf Pdf.]</ref> {{blockquote|Football players participating in international matches for Germany have reduced longevity compared to the general population. This disadvantage was the larger, the earlier the international football player started his international career. This finding is in line with the current knowledge of life expectancy in major athletes, especially those from other team sports|sign=|source=}} A 1983 study of rugby players found that the life expectancy of [[New Zealand national rugby union team|All Blacks]] was the same as for the general population.<ref>{{Cite journal | pmid = 6578423 | year = 1983 | last1 = Beaglehole | first1 = R. | last2 = Stewart | first2 = A. | title = The longevity of international rugby players | journal = The New Zealand Medical Journal | volume = 96 | issue = 735 | pages = 513–515 | url = https://www.nzma.org.nz/journal | access-date = 24 September 2015 | archive-date = 26 March 2019 | archive-url = https://web.archive.org/web/20190326083117/https://www.nzma.org.nz/journal/read-the-journal/all-issues/2010-2019/2012/vol-125-no-1361/cc-hayes | url-status = dead }}</ref> Australian rules footballers have lower death rates than the general population.<ref>{{Cite journal |last1=Orchard |first1=JW |author-link=John Orchard (doctor) |last2=Orchard |first2=JJ |last3=Semsarian |first3=C |last4=La Gerche |first4=A |last5=Driscoll |first5=T |date=2022 |title=Reduced death rates of elite Australian rules footballers compared to age-matched general population |url=https://www.jsams.org/article/S1440-2440(22)00214-6/fulltext |journal=Journal of Science and Medicine in Sport|volume=25 |issue=9 |pages=710–714 |doi=10.1016/j.jsams.2022.08.003 |pmid=35999145 |s2cid=251479792 |url-access=subscription }}</ref> ===Head=== {{multiple image | align = right | total_width = | footer = | image1 = England Women's Vs USA (16365797348) (cropped).jpg | width1 = | height1 = 160 | alt1 = [[Abby Wambach]], a retired player known for scoring header goals | caption1 = [[Abby Wambach]], a retired player known for scoring header goals | image2 = Kopfbälle.jpg | width2 = 159 | height2 = 160 | alt2 = Heading of the ball in association football can increase the risk of chronic brain damage. | caption2 = Heading of the ball in association football can increase the risk of chronic brain damage. }} American football players are prone to head injuries such as [[concussion]]s. In later life, this increases the risk of dementia<ref>{{cite journal | last1 = Guskiewicz | first1 = Kevin M. | title = Association between recurrent concussion and late-life cognitive impairment in retired professional football players | journal = [[Neurosurgery (journal)|Neurosurgery]] | volume = 57 | issue = 4 | pages = 719–726 | pmid = 16239884 | doi = 10.1227/01.NEU.0000175725.75780.DD | date = October 2005 | s2cid = 2473241 |display-authors=etal}}</ref> and [[Alzheimer's]].<ref>{{cite web | last = Ritter | first = Jim | title = Research: Football players may be more vulnerable to Alzheimer's | url = http://loyolahealth.org/about-us/newswire/research-football-players-may-be-more-vulnerable-alzheimers | publisher = Loyola University Health System | date = 18 July 2011 | access-date = 5 November 2011 | url-status = dead | archive-url = https://web.archive.org/web/20111208154129/http://loyolahealth.org/about-us/newswire/research-football-players-may-be-more-vulnerable-alzheimers | archive-date = 8 December 2011 | df = dmy-all }}</ref> Professional American football players self-reporting concussions are at greater risk for having depressive episodes later in life compared with those retired players self-reporting no concussions.<ref>{{cite journal | last1 = Kerr | first1 = Zachary Y. | last2 = Marshall | first2 = Stephen W. | last3 = Harding | first3 = Herndon P. Jr. | last4 = Guskiewicz | first4 = Kevin M. | title = Nine-year risk of depression diagnosis increases with increasing self-reported concussions in retired professional football players | journal = [[American Journal of Sports Medicine]] | volume = 40 | issue = 10 | pages = 2206–2212 | pmid = 22922518 | doi = 10.1177/0363546512456193 | date = October 2012 | s2cid = 25752165 }}</ref><ref>{{cite news|url=https://www.cbc.ca/sports/football/dynasty-to-death-cbc-s-fifth-estate-examines-head-injuries-in-football-1.725631|title=Dynasty to death: CBC's Fifth Estate examines head injuries in football|date=19 November 2008|work=cbc.ca}}</ref> Probably due to the repeated trauma associated with heading balls, professional association football has been suggested to increase the incidence of [[amyotrophic lateral sclerosis]].<ref>{{cite journal | last1 = Chiò | first1 = Adriano | last2 = Benzi | first2 = Gianmartino | last3 = Dossena | first3 = Maurizia | last4 = Mutani | first4 = Roberto | last5 = Mora | first5 = Gabriele | title = Severely increased risk of amyotrophic lateral sclerosis among Italian professional football players | journal = [[Brain (journal)|Brain]] | volume = 128 | issue = 3 | pages = 472–476 | pmid = 15634730 | doi = 10.1093/brain/awh373 | date = January 2005 | doi-access = free }}</ref> In a 1987 study of former Norwegian association football national team players, one third of the players were found to have central cerebral [[atrophy]], ''i.e.'' brain damage.<ref>{{cite journal | last1 = Sortland | first1 = O. | last2 = Tysvaer | first2 = A.T. | title = Brain damage in former association football players: an evaluation by cerebral computed tomography | journal = Neuroradiology | volume = 31 | issue = 1 | pages = 44–48 | pmid = 2717003 | doi = 10.1007/BF00342029 | date = March 1989| s2cid = 21039119 | url = https://link.springer.com/article/10.1007/BF00342029| url-access = subscription }}</ref> A 1999 study connected soccer to chronic traumatic head injury (CTHI):<ref>{{cite journal | last1 = Matser | first1 = Erik J.T. | last2 = Kessels | first2 = Alphons G. | last3 = Lezak | first3 = Muriel D. | last4 = Jordan | first4 = Barry D. | last5 = Troost | first5 = Jaap | title = Neuropsychological impairment in amateur soccer players | journal = [[JAMA (journal)|JAMA]] | volume = 282 | issue = 10 | pages = 971–973 | pmid = 10485683 | doi = 10.1001/jama.282.10.971 | date = September 1999 | s2cid = 22772205 | doi-access = }} (free access)</ref> {{blockquote|[P]articipation in amateur association football in general and concussion specifically is associated with impaired performance in memory and planning functions. Due to the worldwide popularity of soccer, these observations may have important public health implications}} ===Knee=== [[Anterior cruciate ligament]]s are particularly vulnerable in most types of football due to injuries that can be sustained during [[Tackle (football move)|tackles]]. ===Hip=== An increased incidence of [[osteoarthritis]] in the [[hip joint]] has been found in retired football players.<ref>{{cite journal | last1 = Klünder | first1 = Kurt B. | last2 = Ruda | first2 = Bjarne | last3 = Hansen | first3 = Jørgen | title = Osteoarthritis of the hip and knee joint in retired football players | journal = Acta Orthopaedica Scandinavica | volume = 51 | issue = 1–6 | pages = 925–927 | pmid = 7211298 | doi = 10.3109/17453678008990896 | date = December 1980 | doi-access = free }}</ref> ===Muscles=== A 2012 study of association football injuries found that 19% of all injuries were muscle injuries, of which 54% affected the thigh muscles.<ref>{{Cite book|doi=10.1007/978-3-642-15630-4_111|chapter=Thigh Muscle Injuries in Professional Football Players: A Seven Year Follow-Up of the UEFA Injury Study|journal=Sports Injuries Prevention, Diagnosis, Treatment and Rehabilitation |pages=871–875|year=2012|last1=Ekstrand|first1=Jan|title=Sports Injuries|isbn=978-3-642-15629-8}}</ref> ===Sleep and psychological functioning=== In a 2009 study, association football was found to be associated with favourable sleep patterns and psychological functioning in adolescent male football players.<ref>{{cite journal | last1 = Brand | first1 = Serge | last2 = Beck | first2 = Johannes | last3 = Gerber | first3 = Markus | last4 = Hatzinger | first4 = Martin | last5 = Holsboer-Trachsler | first5 = Edith | title = 'Football is good for your sleep': favorable sleep patterns and psychological functioning of adolescent male intense football players compared to controls | journal = [[Journal of Health Psychology]] | volume = 14 | issue = 8 | pages = 1144–1155 | pmid = 19858334 | doi = 10.1177/1359105309342602 | date = November 2009 | s2cid = 10312855 }}</ref> The rate of suicide among NFL vets has been found to be 59% lower than in the general population.<ref name=Epstein>{{cite magazine | last = Epstein | first = David | title = Dead wrong: two studies refute reports in the media about former NFL players' life expectancy | url = https://www.si.com/vault/2012/05/21/106194121/dead-wrong | magazine = [[Sports Illustrated]] | publisher = [[Time Inc.]] | date = 21 May 2012 }}</ref> ===FIFA response=== In 2012, [[FIFA]] released a paper intended to identify key risk factors for association football players.<ref>{{cite journal | last1 = Fuller | first1 = Colin W. | last2 = Junge | first2 = Astrid | last3 = Dvorak | first3 = Jiri | title = Risk management: FIFA's approach for protecting the health of football players | journal = [[British Journal of Sports Medicine]] | volume = 46 | issue = 1 | pages = 11–17 | doi = 10.1136/bjsports-2011-090634 | pmid = 22143999 | date = January 2012 | pmc = 3254133 }}</ref>
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