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The relationship between the frequency of football practice during skeletal growth and the presence of a cam deformity in adult elite football players
  1. Igor Tak1,2,
  2. Adam Weir3,
  3. Rob Langhout4,
  4. Jan Hendrik Waarsing5,
  5. Janine Stubbe6,7,
  6. Gino Kerkhoffs2,
  7. Rintje Agricola5
  1. 1Sports Rehabilitation and Manual Therapy Department, Physiotherapy Utrecht Oost, Utrecht, The Netherlands
  2. 2Department of Orthopaedics and Sports Traumatology, Academic Medical Centre Amsterdam, Amsterdam, The Netherlands
  3. 3Sports Medicine Department, Sports Groin Pain Centre, Aspetar Hospital, Doha, Qatar
  4. 4Private Practice Physiotherapy Dukenburg, Nijmegen, The Netherlands
  5. 5Department of Orthopaedics, Erasmus University Medical Centre, Rotterdam, The Netherlands
  6. 6Amsterdam University of Applied Sciences, School of Sports & Nutrition, Amsterdam, The Netherlands.
  7. 7Codarts University for the Arts, Rotterdam, The Netherlands
  1. Correspondence to Igor Tak, Sports Rehabilitation and Manual Therapy Department, Physiotherapy Utrecht Oost, Utrecht 3581 WD, The Netherlands; igor.tak{at}gmail.com

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.

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