INTRODUCTION

Football, is generally considered as the most engaging sport globally, with lots of players, coaches,
and fans engaged in its strong and physically taxing nature. In India, football is experiencing more
involvement particularly among younger athletes, and also in educational institutions and
universities. Mewar University, which is located in Rajasthan, India, is an institution that supports
sports activities. In the same way as the University continues to improve its sports base and
encourage extra students to participate in competitive football, the incidence of injuries within this
group has become a rising interest1.

Football is an outdoor game played by two opposing teams of 11 players. It is the most popular
collision/contact sport.
FIFA is the world governing body for football.
Football injuries mainly affect the lower limbs.
Most frequent locations are ankle, knee and thighs.
Sprains, strains and contusions are most commonest type.
About 2/3 of injuries are caused by action of another player (contact injuries).
Overuse injuries account for 9-34% of all injuries2.

Sports-related injuries most likely can’t be prevented from happening especially in high- paced sports
like football and basketball and this injuries can range from mere strain to fractures which may
require surgery and a lengthy rehabilitation. Football players, especially those playing at the
collegiate level, are more likely to sustain injuries because of the physical strain that practices and
games place on their bodies3.

This research concentrates on the trends of injuries persistent by the male football players at Mewar
University those who suffer from pain, imbalance, weak muscular strength and proprioception,
present with ankle instability4.

Ankle sprains make up about 15% of all athletic injuries, with a reported 23,000 ankle ligament
injuries occurring each day in the United States. They are particularly common in basketball,
volleyball, football, soccer, modem dance, and ballet. Most patients fully recover, but an estimated
20 to 40% develop chronic symptoms of pain and instability5.

It is estimated by 10 ankle sprain occur per 1000 exposure inversion injuries are at least four times
more common than eversion due to the relative instability of the lateral joint and weakness of the
lateral ligament compare to medial ligament6.

Injury Trends in Football

The injury trends in football can differ seriously depending on a different type of factors, which may
include the age of the player and the players experience and also severity of the training and
competition and also environmental conditions like the condition of the playing surface. Wide level
of research has revealed that injury patterns reveals football as a one of the most threatening sport.
Most particularly when players engage in some competitive matches. Research has revealed that
male football players normally sustain acute injuries like fractures, muscle strains, sprain, contusion
which normally occurs in the lower extremity (like the knees, ankles, and hamstrings)are the most
damaged part in the body7.
Muscle injuries are the most common type encountered and can be as a result of contusions, muscle
tears, lacerations, ischaemia.
Contusion- These are caused by direct trauma and are part and parcel of contact sport. The contact
can cause muscle fiber disruption, leading to bleeding and pain in varying severity
Muscle tear- Injury is caused by overstretching the muscle, and this happens during an eccentric
contraction
Laceration- Muscle lacerations in football are usually associated with contact with footwear. It is
mandatory that all players’ boots are checked by the referee before they take the field of play.
Ischaemia usually occurs as a result of pressure build up in a muscle compartment8.

It is estimated that 20 to 40% of patients with ankle sprains develop long-term sequelae such as pain,
swelling, or instability9.

Ankel ligaments lesions

Injury mechanism- Allowing a larger range of inversion than eversion, makes inversion sprains more
common than eversion sprains. Most common is a supination sprain, a movement combination of
inversion, internal rotation of the foot, and plantar flexion with the subtalar joint adducting and
inverting. This usually happens when the athlete’s center of gravity is shifted over the lateral border
of the weight- bearing leg, causing the ankle to roll inward at high velocity
The anterior talofibular ligament (ATFL) is often injured during plantarflexion whereas the
calcaneofibular ligament (CFL) is often injured during dorsiflexion.

Acute lateral ligament injury

In the acute setting most athletes recall having “rolled over” the outside of the ankle.
Clinically the most important features of physical examination are swelling, hematoma, and pain on
palpation.

The anterior drawer test and palpation cannot be correctly performed due to pain10.

Chronic ankle instability (CAI) typically occurs after lateral ankle sprains. This condition is categorized
as one of the most common musculoskeletal disorders during sports activities11.

Marked evidence shows that neuromuscular training programs are effective for improving measures
of performance. The benefits of a program designed for performance enhancement often include
increased power, agility, and speed12.

NT could be defined as an intervention enhancing unconscious motor responses by stimulating both

afferent signals and central mechanisms responsible for dynamic joint control. This is based on
providing adequate information to mechanoreceptors so that the integration of muscle responses is
more efficient. For this, this training uses balance, proprioception, and strength exercises on stable
and unstable surfaces. It has been reported that NT can contribute tothe improvement of physical
performance in athletes, such as postural stability, in both static and dynamic dimensions.
Additionally, it has been shown that NT can decrease the risk of lower extremity injuries in athletic
individuals, and can be used for preventive purposes in relation to these injuries.

the use of effective NT programs that focus on multiple components such as dynamic stability,
strength, plyometrics, coordination, speed, agility,and fatigue resistance. These programs are
beneficial inboth preventing injury and significantly improving athlete performance. In addition, they
help mitigate the loss of motor skillsthat can occur because of long-term injury and its long-term
negative consequences. Therefore, NT is not only beneficial for the recovery of traumatic injuries but
can also generate adaptations in the organism specific to the postural mechanisms required in
sports, thus reducing the risk factors associated with sports practice. This review managed to identify
that NT is effective in reducing the risk of injury insoccer players; however, the literature has mainly
addressed lower extremity injuries. Therefore, it may be necessary for future investigations to focus
on the upper extremity and trunk. Likewise, it was determined that NT has a potential impact on
improving physical performance, with the variables of strength, power, speed, agility, and balance
being the most studied13.

Agility, speed, and leg muscle power are considered highly important for every football player. The
purpose of this study was to determine the effectiveness of speed, agility, and quickness (SAQ)
training in increasing the speed, agility, and leg power of football athletes14.

Football, with its dynamic nature, requires players to make instantaneous decisions in rapidly
changing situations on the field. As such, reaction time (RT) is a key parameter in evaluating football
players. Another critical factor influencing an athlete's performance and overall health is sleep, as its
deprivation can significantly impair skills and physical capacity15.

Balance is known as an important factor in many athletic skills which its weakness is related to some
injuries such as ankle or knee instability or pain in knee16.

Football is a high-intensity sport that demands high levels of muscle strength and endurance, which
are significant predictors of athletic performance in football. Flexi-Bar training is more effective than
traditional core training in enhancing core endurance, dynamic balance, and hop performance in
college-level football players17.

Balance and plyometric exercise effectively improve balance performance, ankle mobility, peak and
explosive leg muscle strength in young football players. This intervention should be considered for
inclusion in regular training to improve functional mobility in young footballers18.

While muscular strength is a main component of health-related fitness, its development during
adolescence in football player19.

Advantage of preventing injuries

Football injuries leads to a crucial effect on players either physically or emotionally, and also injuries
such as tendinitis and stress fracture which may be caused due to repeated training and also playing
for a long period of time without any rest or proper recovery from previous illness, Some conditions
(acute injuries) such as fractures, dislocation and sprains as a result of high- intensity game
occurrence. The injuries can limit in their severeness though the minor injuries can harm the players
strength for long period of time, and also get in the way their everyday life and playing career.

Additionally, prevention of injury in football is demanding not only for supporting player’s current
performance and also for constant athletic development. Constant repetition of injury that is not
well treated can result to chronic condition which makes an athlete’s career shorter and also weaken
their ability to perform at their peak. As a result, understanding injury patterns and identifying risk
factors is critical for putting effective injury prevention methods into place. Their goal includes
enhancement of training procedure, modify condition scheme ,essential warm-up and cool-down
routines and also using proper equipment and footwear20.