Contrastingly, Ezzat et al demonstrated in a cross-sectional study of 12 407 12-19 year-old that no significant association was found between being overweight and sports injury, but a protective effect was seen between obesity and sports injury instead. In a systematic review of sport climbing and bouldering by Woolings et al, higher BMI was reported to be associated with a higher risk of injury in one of the included studies but not found in two of the other included studies. The current literature has revealed conflicting data of how body composition is correlated with sporting injuries in and within various populations. What is theoretically and evidentially more certain is that the adult body composition is different from the youth body composition. This study is essential in preliminarily identifying the correlation between preseason body composition and injuries throughout the season in adult male professional football players.
The findings of this study suggest that players of decreased body mass, BMI, waist circumference, total BMD and mean embedded structures should focus on increasing these variables during the preseason (not excessively) or have personalised training tailored as a injury prevention regime. Taylor et al demonstrated in a systematic review and meta-analysis of lower extremity injury prevention in basketball that injury prevention regimes significantly reduced the incidence of general lower extremity injuries and ankle sprains but not anterior cruciate ligament ruptures. Sadisgursky et al similarly demonstrated in a systematic review that an injury prevention regime such as the FIFA 11+ has been effective in the prevention of injuries. These injury prevention regimes should perhaps be strongly implemented for players of decreased body mass, BMI, waist circumference, total BMD and mean embedded structures in the preseason, considering the notable findings of the current study.
There were several limitations to this study. Data were retrospectively extracted, and clinical record-keeping quality was dependent on the clinicians and coaches with the database access. The study was of a small sample size with players that were recruited from a single team. Therefore, the study sample size may not accurately represent all adult male professional football players or the general population. Body composition measurements may have been measured more often throughout the season to provide regularly updated data points and provide further data on changes from the pre-season baseline. This could have accounted for the possibility of deconditioning over the close season. The use of ultrasound, although performed by a single fully trained operator, could be dependent on operator proficiency. The force of contact injuries sustained was unable to be quantified. Stronger forces experienced may have an increased susceptibility to injury resulting in confounding bias. The strength of the study was that no players were lost to follow-up and this, minimised selection bias.