Considerations and best practices for elite football officials return to play after COVID-19 confinement

To examine muscle and blood metabolites during soccer match play and relate it to possible changes in sprint performance. Thirty-one Danish fourth division players took part in three friendly games. Blood samples were collected frequently during the game, and muscle biopsies were taken before and after the game as well as immediately after an intense period in each half. The players performed five 30-m sprints interspersed by 25-s recovery periods before the game and immediately after each half (N=11) or after an intense exercise period in each half (N=20). Muscle lactate was 15.9+/-1.9 and 16.9+/-2.3 mmol.kg d.w. during the first and second halves, respectively, with blood lactate being 6.0+/-0.4 and 5.0+/-0.4 mM, respectively. Muscle lactate was not correlated with blood lactate (r=0.06-0.25, P>0.05). Muscle glycogen decreased (P<0.05) from 449+/-23 to 255+/-22 mmol.kg d.w. during the game, with 47+/-7% of the muscle fibers being completely or almost empty of glycogen after the game. Blood glucose remained elevated during the game, whereas plasma FFA increased (P<0.05) from 0.45+/-0.05 to 1.37+/-0.23 mM. Mean sprint time was unaltered after the first half, but longer (P<0.05) after the game (2.8+/-0.7%) as well as after intense periods in the first (1.6+/-0.6%) and second halves (3.6+/-0.5%). The decline in sprint performance during the game was not correlated with muscle lactate, muscle pH, or total glycogen content. Sprint performance is reduced both temporarily during a game and at the end of a soccer game. The latter finding may be explained by low glycogen levels in individual muscle fibers. Blood lactate is a poor indicator of muscle lactate during soccer match play.

Athletes participating in elite sports are exposed to high training loads and increasingly saturated competition calendars. Emerging evidence indicates that poor load management is a major risk factor for injury. The International Olympic Committee convened an expert group to review the scientific evidence for the relationship of load (defined broadly to include rapid changes in training and competition load, competition calendar congestion, psychological load and travel) and health outcomes in sport. We summarise the results linking load to risk of injury in athletes, and provide athletes, coaches and support staff with practical guidelines to manage load in sport. This consensus statement includes guidelines for (1) prescription of training and competition load, as well as for (2) monitoring of training, competition and psychological load, athlete well-being and injury. In the process, we identified research priorities.