Martin Hägglund

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• Professor
• Professor (Full) at Linköping University

Objectives External risk factors connected to club, team and coaching are believed to be important in the causation of hamstring injuries, but little is known about the preventive measures used. The objective was to analyse the association between preventive factors and hamstring muscle injury burden. Methods 14 teams participated in the Union of...

This study explored professional Judokas’ experiences of the anterior cruciate ligament (ACL) injury process, the consequences of the injury, and their perceptions of underlying factors contributing to the injury. Eleven professional Judokas treated with ACL reconstruction were interviewed using semi-structured interviews. Qualitative content analy...

Purpose To investigate the association between common measures of trunk and lower extremity range of motion (ROM), strength, the results of one‐leg jump tests at baseline and the incidence of subsequent substantial knee injuries in adolescent female football players. Methods Players were assessed at baseline regarding (1) ROM of trunk, hip, and an...

Purpose The objective was to describe the location, examination procedures, diagnoses, and treatment for gradual-onset Achilles tendon pain in male professional football (soccer) players. Patients and Methods Forty-seven teams were followed prospectively for at least one season from 2013/14 to 2017/18. Time-loss injuries were recorded by the teams...

Background Sex differences in patient-reported outcomes (PROs) are not well investigated after anterior cruciate ligament (ACL) reconstruction in football players. The aim was to study sex differences in player-related factors, ACL injury characteristics and PROs after primary ACL reconstruction in football players. Methods In this cross-sectional...

This study explored youth floorball players’ and coaches’ perspectives on using the injury prevention exercise programmes (IPEPs) Knee Control or Knee Control+ (Knee Control programmes) and how to overcome barriers to programme use. We used a qualitative design with eight semistructured focus group discussions, six with players, 11–17 years old (n...

Introduction Achieving sufficient adherence with injury prevention exercise programmes is a challenge. The aim was to explore how amateur football coaches experience the use of and support for injury prevention training using the Knee Control programmes as examples. Methods Semistructured interviews with 20 amateur football coaches around experien...

Amateur football coaches play a key role in preventing, assessing and treating pain among their players, as they are often the first point of contact and may be the main source of advice and guidance. The objective of this study was to explore amateur football coaches’ perceptions of pain during sports participation and their approach to pain manag...

Objectives Implementation of injury prevention exercise programmes (IPEPs) in sports is challenging, and behaviour change among players and coaches is essential for success. The aim was to describe players’ and coaches’ motivation and coaches’ goal pursuit when using IPEPs in amateur and youth football across a season. A secondary aim was to descri...

This study explored professional wrestlers’ experiences of the consequences of an anterior cruciate ligament (ACL) injury and their perception of whether the ACL injury could have been prevented. We interviewed 10 professional wrestlers (60% women, age range 21–34) treated with ACL reconstruction with semistructured interviews. Transcripts were ana...

Background Successful implementation of injury prevention exercise programmes (IPEPs) is necessary to maximise programme effectiveness. However, there is a lack of knowledge on how to reduce barriers to enable implementation and maintenance of IPEPs. Objective To describe players´ perceptions of the injury prevention exercise programmes, Knee Cont...

Background Studies indicate that inadequate dietary habits such as low meal frequency and intake of low-energy-dense foods are associated with injuries in adolescent athletes from weight-sensitive sports. This association has been less studied in team sports. Objective To investigate the association between meal frequency, meal timing and nutritio...

Background Prep-to-Play, an injury prevention program, was co-designed with the Australian Football League for women’s Australian Football. Online resources were distributed to coaches in 2019, but coaches reported low confidence to use Prep-to-Play. A supported implementation strategy was devised, to enhance Prep-to-Play use. Objective To compare...

Background The efficacy of injury prevention programs is clear, but their causal mechanisms are not. Better knowledge about why injury prevention programs work will improve implementation and guide further research. Objective To describe the proposed biomedical effect mechanisms in research on injury prevention programs in football and handball....

Background The knee is among the most injured locations in Olympic athletes. However, there remains a paucity of research regarding the potential differences in knee injury incidence between various groups of Olympic athletes. Objective To study the knee injury incidence in Swedish Olympic athletes and compare between subgroups of athletes. Desig...

Background Long-term prospective health surveillance provides the backbone to inform and evaluate preventive interventions in sports. Research on year-round injury and illness occurrence in Olympic level athletes is scarce. Objective To study the prevalence and incidence of injury and illness in Swedish Olympic athletes. Design Prospective cohort...

Introduction Players in women’s elite football teams appear to have a lower risk for sustaining injuries compared to players in men’s elite teams, especially during matches. Between-study comparisons are, however, difficult to interpret because of different designs/definitions. The objective of this study was to investigate potential differences in...

Objectives We evaluated the implementation of Prep-to-Play PRO, an injury prevention programme for women’s elite Australian Football League (AFLW). Methods The Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) of Prep-to-Play PRO were assessed based on the proportion of AFLW players and/or staff who: were aware of the program...

Objective Injuries in women’s football (soccer) have scarcely been investigated, and no study has been conducted in the highest competitive level involving club teams from different countries. Our aim was to investigate the time-loss injury epidemiology and characteristics among women’s elite football players over four seasons. Methods 596 players...

Objectives This cross-sectional study aimed to describe dietary habits in Swedish adolescent handball players and differences with respect to sex and school grade. Methods Participants in the Swedish Handball Cohort answered a web-survey assessing adherence to sports nutrition recommendations for meal frequency and meal timing, and the Nordic Nutr...

Background Different functional performance tests are used to assess patients in the clinic and before return to sport (RTS), where the rehabilitation goal is to reach good strength and jumping ability. A limb symmetry index of ≥ 90% is a common target in rehabilitation before RTS. The aim of this short communication is to use data from our 2-year...

Objectives The aim of our study was to explore the contextual factors that affect the implementation of football injury prevention initiatives and the provision of effective injury management in the Irish Women’s National League (WNL). Methods We used a criterion-based purposive sampling approach to recruit coaches (n=7), players (n=17) and medica...

Background Playing football involves a high risk of anterior cruciate ligament (ACL) injuries and these may affect knee function and activity level. Objectives To measure changes in self-reported knee function, activity level, and satisfaction with knee function and activity level in female football players with or without an ACL-reconstructed kne...

Background Adoption of injury prevention exercise programmes (IPEPs) in team sports is contingent on behaviour change among coaches. The aim was to study motivation and goal-pursuit in IPEP use among coaches of amateur football players. Methods A cross-sectional study using web-based questionnaires was administered to coaches in one Swedish region...

Purpose To describe the injury prevalence, injury pattern, and potential baseline risk factors for injuries in male and female adolescent and adult amateur football players. Methods This prospective study followed adolescent and adult amateur football players over one season March–October 2020. The study was completed by 462 players (130 men, age...

Background To manage injuries effectively, players, head coaches, and medical personnel need to have excellent knowledge, attitudes, and behaviours in relation to the identification of risk factors for injuries, the implementation of injury prevention initiatives, as well as the implementation of effective injury management strategies. Understandin...

Background Injury prevention exercise programmes (IPEPs) efficaciously reduce injuries. However, it is challenging to achieve sufficient adherence across a season. The main aim was to describe adherence to IPEPs in three groups of coaches and players partaking in a cluster randomised trial. Secondary aims were to describe perceptions of IPEPs, use...

Purpose: To describe injury incidence, time trends in injury incidence, and injury characteristics among Swedish Olympic athletes over 22 years based on insurance data, as a first step to inform injury preventive measures among Olympic athletes. Methods: The cohort comprised 762 elite athletes (54% males; age 26.5 ± 5.9 years) in 38 sports in th...

Objective: To study the side hop test regarding validity, reliability, and quality in relation to sex, age and ACL-reconstruction in soccer players. Design: Cohort study. Participants: 117 females with a primary ACL-reconstruction, and 119 females, 46 males (age 16-26 years), 49 girls and 66 boys (age 13-16 years) without injury. Main outcome...

Background The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework can be used for evaluation of implementation initiatives in sports injury prevention. The aim was to evaluate the implementation of the injury prevention exercise programme Knee Control+ among amateur clubs and coaches in one regional football district...

Background Studies evaluating risk factors for sustaining an anterior cruciate ligament (ACL) injury have different, sometimes contrasting, results. Different follow-up times and statistical approaches may be a reason for these differences. The aim of this study was to explore if different follow-up times and statistical approaches, classification...

Background Youth participation in team ball sports is associated with a risk of both acute and gradual onset injuries but today there are several efficacious injury prevention exercise programmes (IPEPs). However, there is limited research about how to implement those programmes and the perceived barriers and facilitators among end-users. Objectiv...

Background Normative values of lifestyle characteristics in adolescent female football players may be used by clinicians and coaches to take actions because the potential important for well-being, performance on the pitch, and risk of injury. The aim was to report descriptive characteristics of lifestyle factors in adolescent female football player...

Objectives To: (1) describe hamstring injury incidence and burden in male professional football players over 21 seasons (2001/02 to 2021/22); (2) analyse the time-trends of hamstring muscle injuries over the most recent eight seasons (2014/15 to 2021/22); and (3) describe hamstring injury location, mechanism and recurrence rate. Methods 3909 playe...

Background Studies on football and the coronavirus disease 2019 (COVID-19) have mainly focused on the lockdown consequences for player fitness, the resumption of football training, and how to safely restart the league play, but injury data are scarce. Objective To describe the injury incidence and injury burden in men’s professional football teams...

Background The risk of injury in adolescent handball is high, and shoulder and knee injuries are among the most frequent and burdensome. The Swedish Knee Control programme reduced the risk of anterior cruciate ligament injuries in female youth football players and traumatic knee injuries in male and female youth floorball players. However, to date,...

Objectives To investigate risk factors for injury and illness in female and male youth floorball players (12–17 years) during a 26-week floorball season. Design Prospective cohort study. Setting Recreational youth sport. Participants 471 players (142 females) 12-17 years. Main outcome measures Weekly survey including questions about stress, sle...

Objective: To evaluate the preventive efficacy of an extended version of the Knee Control injury prevention exercise programme (IPEP) compared with an adductor strength programme and to a comparison group using a self-selected IPEP in amateur adolescent and adult male and female football players. Methods: Two-armed cluster-randomised trial with...

Objective: To review the literature to establish overall, match and training injury incidence rates (IIRs) in senior (≥18 years of age) women's football (amateur club, elite club and international). Design: Systematic review and meta-analysis of overall, match and training IIRs in senior women's football, stratified by injury location, type and...

Objective To study normative values of range of motion (ROM), strength, and functional performance and investigate changes over 1 year in adolescent female football players. Design Cross-sectional. Participants 418 adolescent female football players aged 12–17 years. Main outcome measures The physical characteristic assessments included (1) ROM...

Introduction Due to the increase in participation and risk of anterior cruciate ligament (ACL) injuries and concussion in women’s Australian Football, an injury prevention programme (Prep-to-Play) was codesigned with consumers (eg, coaches, players) and stakeholders (eg, the Australian Football League). The impact of supported and unsupported inter...

Background To manage injuries effectively, players, head coaches and medical personnel need to have excellent knowledge, attitudes and behaviours in relation to the identification of risk factors for injury, the implementation of injury prevention initiatives, and the implementation of effective injury management strategies. Understanding the injur...

Objectives The primary objective was to study the adoption of the NHE programme in European football teams in the 2020/21 season and to compare it to the previous study. A second objective was to compare hamstring injury rates between teams that used the NHE programme in the team training and teams that used the NHE only for players with previous o...

Purpose To study the epidemiology and return to play characteristics of anterior and posterior ankle impingement syndromes (AAIS and PAIS) over 18 consecutive seasons in male professional soccer players. Methods Between the 2001–2002 and 2018–2019 seasons, 120 European soccer teams were followed prospectively for various seasons. Time loss injurie...

Objective To provide consensus on how to plan, organize and implement exercise-based injury prevention program (IPP) in sports. Design Delphi. Setting LimeSurvey platform. Participants Experienced sports physical therapists from the International Federation of Sports Physical Therapy member countries. Main outcome measures Factors related to sp...

Objectives to compare neuromuscular control and hop performance between youth and adult male and female football players. Design Cross-sectional study. Participants 119 youth players (13–16 years; 68 males) and 88 adult players (17–26 years; 44 males). Main outcome measures Neuromuscular control assessed with drop vertical jump (DVJ) and tuck ju...

Introduction: Football is a popular sport among young females worldwide, but studies concerning injuries in female players are scarce compared with male players. The aim of this study is to identify risk factors for injury in adolescent female football players. Methods and analysis: The Karolinska football Injury Cohort (KIC) is an ongoing longitu...

Synopsis: There is an absence of high-quality evidence to support rehabilitation and return-to-sport decisions following shoulder injuries in athletes. The Athlete Shoulder Consensus Group was convened to lead a consensus process that aimed to produce best-practice guidance for clinicians, athletes, and coaches for managing shoulder injuries in sp...

Objective To describe weekly illness prevalence and illness symptoms by sex in youth floorball players during one season. Design Prospective cohort study. Setting Players who were registered to play community level floorball during the 2017–2018 season (26 weeks) in two provinces in southern Sweden. Participants 471 youth players aged 12–17 year...

Background Over the past two decades, sports medicine research has developed innovative and proven interventions for injury prevention in athletes. Intervention effectiveness of any injury prevention exercise programme (IPEP) is influenced by both utilisation and exercise fidelity, but this has rarely been evaluated in previous randomised controlle...

Background Floorball is a popular sport among Scandinavian youth. However, insufficient data hinders the development of focused injury prevention strategies in floorball. Objective Describe the motivations for floorball participation as well as injury prevention expectations, injury risk perceptions and the prevalence of health problems in youth p...

We investigated the pattern of injuries in elite‐level women’s football in Ireland, during a two‐season prospective injury surveillance study in the Women’s National League (WNL). Seven out of the eight clubs (271 players) in the WNL were followed prospectively during the 2018 and 2019 seasons. The injury incidence rate in matches (19.2/1000 h) was...

Background: A new anterior cruciate ligament (ACL) injury after ACL reconstruction is a feared outcome. Purpose: To study the risk of new knee injuries in female soccer players 5 to 10 years after primary unilateral ACL reconstruction and to compare players who returned to soccer with (1) players who did not return and (2) knee-healthy soccer pl...

Purpose Evaluate team and player compliance with the Knee Control injury prevention exercise programme, study the association between player compliance and injury rates, and compare coach demographics, baseline prevention expectancies, and programme utilisation between teams with high and low compliance. Methods Prospective one-season cohort study...

Background The risk of a second anterior cruciate ligament (ACL) injury when participating in pivoting sports after ACL reconstruction is high. Risk factors associated with a second ACL injury are complex. Purpose To investigate the combinations of various clinical risk factors associated with second ACL injury in female soccer players with a prim...

Background Various tests have been developed to evaluate athletes’ functional performance and for use as screening tools for injury prediction. Further validation of their accuracy to predict injury is needed. Purpose To investigate the validity of predetermined cutoffs used to differentiate between high- and low-risk players in different function...

Background Studies on subsequent anterior cruciate ligament (ACL) ruptures and career length in male professional football players after ACL reconstruction (ACLR) are scarce. Aim To investigate the second ACL injury rate, potential predictors of second ACL injury and the career length after ACLR. Study design Prospective cohort study. Setting Me...

Objectives To investigate intra- and interrater reliability of the subjective assessments of filmed DVJ and TJA in youth male and female soccer players and to compare subjective assessment of the DVJ with two-dimensional movement analysis. Design Cross-sectional study. Participants 115 soccer players (66 boys, 49 girls) mean age 14 ± 1 (range 13–...

Objective Describe a consecutive cohort of people with a non-surgically treated ACL injury and evaluate correlations between functional performance and patient reported outcome measures (PROMs). Design Cross-sectional. Participants Sixty-eight individuals (38 males, 18–45 years old) 2–5 years after ACL injury. Main outcome measures Tegner Activi...

Background Increased performance from injury prevention exercise programmes (IPEPs) may affect injury risks positively and support the implementation of IPEPs. The primary aim was to study the performance effects of injury prevention exercises from two different IPEPs, the Knee Control IPEP and the further developed Knee Control+ IPEP, in youth mal...

Kvinnor har en väldokumenterad ökad risk att drabbas av främre korsbandsskada i fotboll jämfört med män. Under säsongen 2012 drabbades hela 18 spelare i Damallsvenskans 12 lag av främre korsbandsskada och under första halvåret 2013 drabbades ytterligare tio spelare, så-ledes 28 främre korsbandsskador på 18 månader. Efterföljande år har det glädjand...

Purpose: This study aimed at evaluating the correlation between seven different performance tests and two neuromuscular control tests in youth football players and to evaluate the influence of sex and age groups on test results. Methods: One-hundred and fifteen football players (66 boys, 49 girls) mean age 14 ± 0.7 (range 13-16) years from youth...

Background: There is limited epidemiological information on injury rates and injury mechanisms for lateral collateral ligament (LCL) and posterior cruciate ligament (PCL) injuries in male professional soccer. In addition, time trends and lay-off times for these injuries have not yet been determined. Aim: To determine injury rates and circumstanc...

Background: The tuck jump assessment was developed to identify players at risk for anterior cruciate ligament (ACL) injuries or gauge a player's progress through rehabilitation after ACL reconstruction. A tuck jump score of ≥ 6 out of 10 has been labeled poor and thought to identify players with high risk landing patterns. Purpose: The purpose o...

Coding in sports medicine generally uses sports-specific coding systems rather than the International Classification of Diseases (ICD), because of superior applicability to the profile of injury and illness presentations in sport. New categories for coding were agreed on in the ‘International Olympic Committee (IOC) consensus statement: Methods for...

Injury and illness surveillance, and epidemiological studies, are fundamental elements of concerted efforts to protect the health of the athlete. To encourage consistency in the definitions and methodology used, and to enable data across studies to be compared, research groups have published 11 sport-specific or setting-specific consensus statement...

Background Injury and illness surveillance, and epidemiological studies, are fundamental elements of concerted efforts to protect the health of the athlete. To encourage consistency in the definitions and methodology used, and to enable data across studies to be compared, research groups have published 11 sport- or setting-specific consensus statem...

Objective To study whether an injury prevention exercise programme would reduce the number of injuries in youth floorball players. Methods 81 youth community level floorball teams (48 clusters=clubs) with female and male players (12–17 years) were cluster-randomised into an intervention or control group. Intervention group coaches were instructed...

Objectives: Describe the exercise fidelity and utilisation fidelity of the Knee Control injury prevention exercise programme (IPEP) in youth floorball alongside an intervention RCT. Design: Observation study METHODS: 20 floorball team training groups (12 male, 8 female, age 12-17 years) from the intervention arm of an RCT were included. The Knee...

Purpose To examine differences between men and women football players in clinically feasible jumping measures. Methods Female football players (N = 46, ages 16–25) were matched based on age, training frequency, and playing position with 46 male players. All players performed the tuck jump and drop vertical jump (DVJ). DVJ was assessed quantitative...

Purpose To evaluate changes in jump-landing technique in football-playing boys and girls after 8 weeks of injury prevention training. Methods Four boys’ and four girls’ teams (mean age 14.1 ± 0.8 years) were instructed to use either the original Knee Control injury prevention exercise programme (IPEP) or a further developed IPEP, Knee Control + ,...

Background It has been hypothesised that injury risk after return to play following an injury absence is influenced by the amount of training completed before return to competition. Aim To analyse if the number of completed training sessions between return to play and the first subsequent match appearance was associated with the odds of injury in...

Background: To receive maximum benefits from injury prevention exercise programmes (IPEP) such as Knee Control, players need to perform the exercises as prescribed. But, exercise fidelity in IPEPs is seldom evaluated. We developed a checklist to assess exercise fidelity in the Knee Control IPEP, and the primary aim was to evaluate its inter-rater...

Purpose Describe the motivation for floorball participation, injury prevention expectations, injury risk perceptions and prevalence of health problems in youth floorball players at the start of the season. Methods This cross-sectional survey is part of a larger Sport Without Injury ProgrammE (SWIPE) project and provides baseline data before a clus...

Purpose: Medial collateral ligament (MCL) injury is the single most common traumatic knee injury in football. The purpose of this study was to study the epidemiology and mechanisms of MCL injury in men's professional football and to evaluate the diagnostic and treatment methods used. Methods: Fifty-one teams were followed prospectively between o...

Background A cruciate ligament (CL) injury is a severe injury in soccer. Neuromuscular training programs have a well-documented preventive effect, but there are few studies on the effectiveness of such a program at a national level. The Swedish Knee Control Program (KCP) was found to be effective in preventing CL injuries in youth female soccer pla...

Background:: Many patients with anterior cruciate ligament (ACL) reconstruction who return to sport suffer new ACL injuries or quit sports soon after returning. Purpose:: To prospectively follow a cohort of female soccer players with primary unilateral ACL reconstruction and matched knee-healthy controls from the same soccer teams to compare (1)...

Purpose To determine if female football players who had longer durations of rehabilitation, measured in months, after anterior cruciate ligament reconstruction would have lower tuck jump scores (fewer technique flaws) and smaller asymmetries during drop vertical jump landing. Methods One-hundred-and-seventeen female football players, aged 16–25 ye...

During the last 30 years we have witnessed significant progress in the field of football injury prevention. Large-scale randomised controlled trials (RCTs) have shown that exercise-based prevention programmes can substantially reduce the incidence of football injuries. But while it is commonly assumed that the positive results of these RCTs will au...

Introduction Anterior cruciate ligament (ACL) injury can result in joint instability, decreased functional performance, reduced physical activity and quality of life and an increased risk for post-traumatic osteoarthritis. Despite the development of new treatment techniques and extensive research, the complex and multifaceted nature of ACL injury a...

Handball players with ACL injury (whether treated surgically or non-surgically) must complete a high-quality, supervised, criterion-based rehabilitation programme with high adherence. The overarching goal of rehabilitation after ACL injury and/or surgery is to restore knee function so that the player can participate fully in all aspects of life, wi...

Foot and ankle injuries are among the most common injuries in handball, comprising between 15 and 35% of all injuries. Lateral ligament sprains of the ankle are most frequently seen and less commonly injuries to the syndesmosis, medial ligaments, peroneal tendons and midfoot sprains. High recurrence rates, residual symptoms and functional decrease...

Background Hip and groin injuries are common in men’s professional football, but the time-trend of these injuries is not known. Aim To investigate hip and groin injury rates, especially time-trends, in men’s professional football over 15 consecutive seasons. Study design Prospective cohort study. Setting Men’s professional football. Methods 47...

The aim of the study was to examine how players’ perceptions of sociocultural factors and intra- and interpersonal aspects of sporting experiences may have influenced the emotions, cognitions, and behaviours of elite female soccer players prior to the occurrence of ACL injuries. The research questions guiding the study were: (a) how did female elit...

The high injury rate among men’s professional football players is well-known. Therefore, the Union of European Football Associations (UEFA) launched an injury study already in 2001. This study, the UEFA Elite Club Injury Study (ECIS), currently includes data from a total of 51 clubs from 18 European countries with more than 14,000 registered injuri...

Introduction The Swedish Knee Control Program (KCP) was systematically implemented nationwide by the Swedish Football Association (FA) after being found efficacious to prevent ACL injuries in youth female football players. The aim of this study was to evaluate the effectiveness of the KCP in reducing acute knee and cruciate ligament (CL) injuries a...