Clinical Journal of Sport Medicine最新文献

{"title":"Heat Stroke and Pregnancy.","authors":"Zackary Bailey, David Evans, Collin Hu, Rebecca Caro, Francis O'Connor","doi":"10.1097/JSM.0000000000001406","DOIUrl":"10.1097/JSM.0000000000001406","url":null,"abstract":"<p><strong>Abstract: </strong>A 33-year-old woman participating in a physically high-intensity event experienced a heat injury and was incidentally found to be pregnant. Other contributing factors to the heat injury were the event taking place during the hottest month of the year, consumption of creatine and preworkout supplements, and abstaining from breakfast on the day of the event. She suffered heat stroke with AST and ALTs reaching 8k and CK peak of 36k. The concern for acute liver failure prompted discussions for a possible liver transplant, ultimately not required. Viability of the pregnancy was indeterminable during admission. Follow-up after discharge revealed quadriceps soreness with light activity, CK levels peaking to 5k, and ALT/AST increased to 1062/234 roughly a month after her admission. BUN and Cr were slightly elevated on presentation to ED (23 and 1.8), normalizing with 3L of IVF before admission. UA unremarkable. With continued rest, the patient's symptoms resolved; CK, AST, and ALT normalized; and her pregnancy is proceeding normally. The patient is considered high risk for dehydration, shock liver, and repeat heat injury during her first delivery. This is due to increased CK/AST/ALT levels with moderate walking for 1 h. In addition, the patient meets criteria for heat tolerance testing to determine risk of future heat injuries.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":"621-622"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145984333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brief Report: The Effect of Environmental Distractions on Preseason SCAT6 Cognitive Performance.","authors":"Alyssa Lickfeld, Joseph R Tousignant, Scott Dinse, Simran Singh, John J Leddy, Mohammad N Haider, Haley M Chizuk","doi":"10.1097/JSM.0000000000001434","DOIUrl":"10.1097/JSM.0000000000001434","url":null,"abstract":"<p><strong>Objective: </strong>To assess the effect of environmental distractions on the cognitive subcomponents of the Sport Concussion Assessment Tool 6 (SCAT6).</p><p><strong>Design: </strong>Retrospective chart review.</p><p><strong>Setting: </strong>Baseline testing completed during preseason physical examinations (PPEs) in an athletic training room.</p><p><strong>Participants: </strong>Ninety male youth ice hockey players (13-18 years).</p><p><strong>Independent variables: </strong>Noise, distractions, and observed participant attention recorded by the certified athletic trainer (AT).</p><p><strong>Main outcome measures: </strong>Total cognitive score; subcomponent SCAT6 scores, including orientation, immediate memory, digits backwards, and the months backward scores; total concentration score; and delayed recall score.</p><p><strong>Results: </strong>The months in reverse order score was significantly associated with whether the testing environment was quiet, that is, louder environments were associated with greater time to complete the task ( P = 0.040). The concentration score was significantly associated with whether the participant was observed to have paid attention ( P = 0.005). The total cognitive score correlated significantly with whether the participant was observed to be paying attention, that is, lower scores were associated with lower reported attention ( P = 0.017).</p><p><strong>Conclusions: </strong>Preseason SCAT6 testing ideally should be administered in a quiet, distraction-free environment whenever possible.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":"616-618"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Neck Pain and Disability in Patients With Concussion: A Survey Study.","authors":"Meenakshi Sundaram, Clair Smith, Charity G Patterson, Anthony P Kontos, Michael McCrea, Michael J Schneider, Jeffrey King","doi":"10.1097/JSM.0000000000001446","DOIUrl":"10.1097/JSM.0000000000001446","url":null,"abstract":"<p><strong>Objective: </strong>A subset of patients with concussion report neck pain that may increase the likelihood of persistent postconcussive symptoms, but the prevalence of comorbid neck pain with concussion has not been well studied. Hence, the primary objective of this study was to define the prevalence of comorbid neck pain and disability in patients after concussion.</p><p><strong>Design: </strong>A cross-sectional electronic survey.</p><p><strong>Setting: </strong>Two different academic medical center concussion clinics.</p><p><strong>Participants: </strong>A convenience sample of adult (age ≥18 years) concussion patients with a Glasgow Coma Score of 13 to 15 and presenting at the concussion clinic. No other specific exclusion criteria.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>Survey questions on demographics, concussion-related clinical history, neck pain, neck-related disability, and headache.</p><p><strong>Resultsintotal,: </strong>299 adults completed the one-time anonymous survey. In total, 183 respondents (61%) reported having comorbid neck pain, with a mean numeric pain score of 5.0 ± 2 (0-10 range) and a mean neck disability index score of 38%. In total, 68% of respondents with neck pain reported the upper cervical region as the most frequent location of pain. The subset of respondents reporting neck pain with headache were more likely to report their headache radiating forward (40%; OR 4.58, CI, 2.39-8.77) and getting worse with pushing the neck (19%; OR 11.62, CI 2.73-49.55) or with movements of the head and neck (39%; OR 3.71, CI, 1.99-6.90).</p><p><strong>Conclusions: </strong>The findings of this study reveal a high prevalence of comorbid neck pain with moderate levels of pain and disability in patients with concussion.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":"547-553"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anterior and Posterior Dynamic Hip Ultrasonography Measures of Femoroacetabular Translation in Professional Ballet Dancers.","authors":"Philip Montana, Heather Southwick, Bridget Quinn, Olivia Elie, Danielle L Cook, Pierre d'Hemecourt, Hung M Le, Andrea Stracciolini","doi":"10.1097/JSM.0000000000001392","DOIUrl":"10.1097/JSM.0000000000001392","url":null,"abstract":"<p><strong>Objectives: </strong>To determine population values of femoroacetabular translation using dynamic hip ultrasonography (DHUS) in professional ballet dancers.</p><p><strong>Design: </strong>Cross-sectional cohort.</p><p><strong>Setting: </strong>Three ballet companies.</p><p><strong>Participants: </strong>Ninety professional ballet dancers.</p><p><strong>Interventions: </strong>Dynamic hip ultrasonography was performed (12 images/dancer, 1080 images). Biometrics included Trochanteric Prominence Angle Test and Beighton Score.</p><p><strong>Main outcome measures: </strong>Anterior and posterior DHUS measures were documented, and femoroacetabular translation was calculated.</p><p><strong>Results: </strong>Anterior exam mean values for female dancers in neutral (N), neutral flexed (NF), and extension external rotation (EER) positions were 4.3 ± 2.05, 9.4 ± 2.61, and 11.4 ± 2.83, respectively, and anterior translation 2.1 ± 2.08; for posterior exam, posterior neutral, posterior flexion adduction internal rotation, and posterior stand positions showed a median value (interquartile range [IQR]) 0 (0-2) and mean values of 11.7 ± 4.89 and 8.8 ± 4.63, respectively, and posterior femoroacetabular translation 10.4 ± 4.62. Ultrasound measures for male dancers' anterior exam showed 5.5 ± 2.86, 10.9 ± 2.82, and 12.9 ± 2.78 and anterior translation 1.9 ± 1.62, and posterior exam measures showed median (IQR) 0 (0-3) and mean 11.3 ± 4.69 and 10.1 ± 5.36 and posterior femoroacetabular translation 9.6 ± 3.82. Differences by sex were found in N and NF positions: male dancers had greater translation versus female dancers in the left ( P = 0.03 and P = 0.03, respectively) and right hips ( P = 0.02 and P = 0.004, respectively). Males had greater EER in the right hip compared with females ( P < 0.001).</p><p><strong>Conclusions: </strong>Dynamic hip ultrasonography determined population values in professional ballet dancers. Sex-based differences among dancers were found.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":"567-574"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146112484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dysfunction of Dynamic Elbow Valgus Stability After Repetitive Pitching: Risk Factors for Throwing Elbow Injury in College Baseball Pitchers.","authors":"Jun Sakata, Tatsuhiro Suzuki, Masaki Akeda, Tadahiro Sakai","doi":"10.1097/JSM.0000000000001382","DOIUrl":"10.1097/JSM.0000000000001382","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate whether flexor digitorum superficialis (FDS) dysfunction could serve as a risk factor of throwing elbow injuries.</p><p><strong>Design: </strong>This prospective cohort study recruited 31 male college baseball pitchers from June 2022 to May 2023.</p><p><strong>Setting: </strong>A set of college baseball pitchers of male sex participated in this study and measurements were taken before and after pitching 30 and 50 pitches.</p><p><strong>Participants: </strong>This study included 31 male college baseball pitchers.</p><p><strong>Assessment of risk factors: </strong>Using ultrasonography, the presence of an intra-articular ring-down artifact (RDA) was assessed with 4 different conditions: at rest, under gravity valgus load, and under elbow gravity valgus stress with either the contraction of the third and fourth digits or of the second and fifth digits.</p><p><strong>Main outcome measures: </strong>Each participant threw 50 fastballs at a distance of 18.44 m from the pitcher's plate toward a catcher. These measurements were taken before pitching and after 30 and 50 pitches, and all elbow injuries during the study period resulting in medical evaluation or missed participation were considered as the primary outcome.</p><p><strong>Results: </strong>Nine pitchers (29%) experienced throwing elbow injuries. Cox regression analysis indicated that the presence of the RDA under valgus stress with FDS contraction involving the second and fifth digits was a significant risk factor for throwing elbow injury (hazard ratio: 5.4; P = 0.018).</p><p><strong>Conclusions: </strong>Dysfunction in the deep layer of the FDS may serve as a risk factor of throwing elbow injury in college baseball pitchers after throwing 50 pitches.</p><p><strong>Level of evidence: </strong>Diagnostic, level 2.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":"561-566"},"PeriodicalIF":2.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changing the Game: Artificial Intelligence in Sports Medicine and Sports Surgery.","authors":"Ali Ridha, Salam Ismael, Rawan Al-Rubaye, Nicola Maffulli, Deiary Kader","doi":"10.1097/JSM.0000000000001507","DOIUrl":"https://doi.org/10.1097/JSM.0000000000001507","url":null,"abstract":"","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148825152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-Guided Diagnostic Injections for Neurogenic Thoracic Outlet Syndrome: An Outcomes-Based Cohort Study.","authors":"Farah S Hussain, James Gardner, Kirk A Easley, Eric R Wagner, Robert L Bowers","doi":"10.1097/JSM.0000000000001506","DOIUrl":"10.1097/JSM.0000000000001506","url":null,"abstract":"<p><strong>Objective: </strong>Neurogenic thoracic outlet syndrome (NTOS) is an underrecognized problem causing chronic upper extremity symptoms from brachial plexus compression, often affecting overhead athletes. This study evaluated the utility of ultrasound-guided (USG) diagnostic injections for NTOS.</p><p><strong>Design: </strong>This was a retrospective chart review.</p><p><strong>Setting: </strong>This study was conducted at a single institution.</p><p><strong>Patients: </strong>In total, 203 patients (121 female, 81 male, and 1 nonbinary) with suspected NTOS underwent USG diagnostic blocks. Forty-five were athletes, including 42 overhead athletes.</p><p><strong>Intervention: </strong>A single sports medicine physician performed USG diagnostic injections targeting the pectoralis minor (PM), anterior and middle scalenes, suprascapular nerve (SSN), or quadrilateral space.</p><p><strong>Main outcome measures: </strong>Patients reported symptomatic relief >50%.</p><p><strong>Results: </strong>PM blocks were positive in 125/186 (67%) cases and scalene blocks in 85/130 (65%). SSN and quadrilateral space blocks were positive in 34/76 (44%) and 4/11 (36%), respectively. Among 95 nonathletes receiving both PM and scalene blocks, greatest relief was reported with scalene in 40 (42%) and PM in 31 (32.6%), 8 (8.4%) improved with both, 10 (10.5%) with neither, and 6 unreported (6.3%). Among athletes, 36/42 (85.7%) had positive PM blocks and 13/20 (65%) had positive scalene blocks. SSN and quadrilateral space blocks were positive in 9/14 (64%) and 1/3 (33%), respectively. Of 22 athletes receiving both PM and scalene blocks, 16 (73%) reported greatest relief with PM, 4 (18%) with scalene, and 2 (9%) with neither.</p><p><strong>Conclusions: </strong>PM blocks produced symptom relief comparable with scalene blocks in the general population and were the most effective diagnostic injection in athletes. These results suggest the PM is a more prominent symptom generator in NTOS than previously recognized, particularly in athletes.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Independent Predictors of Mental Health and Quality of Life in Elite Youth Soccer Players.","authors":"Sakar Gupta, Kristin Haraldsdottir, Jennifer Sanfilippo-Nackers, Ian Staresinic, Scott Anderson, Andrew Watson","doi":"10.1097/JSM.0000000000001501","DOIUrl":"https://doi.org/10.1097/JSM.0000000000001501","url":null,"abstract":"<p><strong>Objective: </strong>To identify the independent predictors of mental health and quality of life (QOL) among elite youth soccer athletes.</p><p><strong>Design: </strong>Cross-sectional observational study.</p><p><strong>Setting: </strong>Study materials were distributed to the Elite Clubs National League (ECNL) clubs through an online survey.</p><p><strong>Participants: </strong>668 adolescent athletes aged 13 to 18 years.</p><p><strong>Assessment of risk factors: </strong>Independent variables included age, sex, previous week sleep duration, athletic identity (AI), previous injury, and racial/ethnic minority status.</p><p><strong>Main outcome measures: </strong>Main outcome measures were anxiety (Generalized Anxiety Disorder-7), depression (Patient Health Questionnaire-9), and QOL (PedsQL). Separate multivariable regression models evaluated independent predictors of each outcome.</p><p><strong>Results: </strong>Independent predictors of anxiety were age (β = 0.28 ± 0.072, P < 0.001), female sex (β = -1.7±-0.40, P < 0.001), sleep (β = -0.88 ± 0.16, P < 0.001), AI (β = 0.11±-0.034, P = 0.002), and injury (β = 1.2±-0.37, P = 0.001), but not racial/ethnic minority status (β = 0.35 ± 0.39, P = 0.37). Independent predictors of depression included age (β = 0.29 ± 0.070, P < 0.001), female sex (β = -1.4 ± 0.41, P < 0.001), sleep (β = -1.2 ± 0.16, P < 0.001), injury (β = 0.88 ± 0.37, P = 0.019), and racial/ethnic minority status (β = 0.81 ± 0.40, P = 0.004), but not AI (β = 0.049 ± 0.035, P = 0.16). Independent predictors of QOL were age (β = -0.60 ± 0.19, P = 0.001), sleep (β = 2.6 ± 0.43, P < 0.001), injury (β = -3.7 ± 0.98, P < 0.001), and AI (β = -0.22 ± 0.092, P = 0.016), but not sex (β = 1.8 ± 1.1, P = 0.10) or racial/ethnic minority status (β = -1.5 ± 1.0, P = 0.16). In all models, sleep had the greatest relative importance (38%-56%).</p><p><strong>Conclusions: </strong>Among youth soccer athletes, greater age, female sex, previous injury, and less sleep were independent predictors of anxiety and depression, whereas greater age, previous injury, less sleep, and higher AI predicted lower QOL. Sleep emerged as the strongest modifiable factor, highlighting its importance in psychosocial wellbeing, to the extent that sleep contributes to these outcomes.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148700975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sport-Related Concussion Prevention Programs in Soccer: A Scoping Review Using the RE-AIM Framework.","authors":"Souhail Chebbi, Karim Chamari, Abdulaziz Farooq, Khaled Trabelsi, Raouf N Rekik, Noureddine Gharbi, Haitham Jahrami, Montassar Tabben, Hamdi Chtourou, Louis Holtzhausen","doi":"10.1097/JSM.0000000000001504","DOIUrl":"https://doi.org/10.1097/JSM.0000000000001504","url":null,"abstract":"<p><strong>Objective: </strong>To map and evaluate the implementation of soccer concussion prevention programs and identify barriers and facilitators across all demographics using the RE-AIM framework.</p><p><strong>Data source: </strong>A scoping review was conducted in accordance with PRISMA-ScR guidelines. The protocol was registered on the Open Science Framework (10.17605/OSF.IO/DBT8M). Studies were eligible if they reported quantitative outcomes of concussion-related programs implemented in soccer settings. Searches were conducted in 6 electronic databases and gray literature, with the search period limited to 2010 to 2025. Data extraction was completed independently by 2 reviewers. Program characteristics and outcomes were mapped to the 5 RE-AIM dimensions: Reach, Effectiveness, Adoption, Implementation, and Maintenance. Risk of bias was assessed using the ROBINS-I tool.</p><p><strong>Main results: </strong>Fourteen studies met inclusion criteria, primarily from the United States (n = 7) and the United Kingdom (n = 4). Interventions focused on concussion education, baseline neurocognitive testing, guideline implementation, and neuromuscular or neck-strengthening exercises. All studies reported Reach, and most demonstrated short-term improvements in knowledge or recognition (Effectiveness). Adoption and Implementation were inconsistently reported, often limited by organizational and resource constraints. Maintenance was the least addressed dimension, with minimal long-term follow-up and no standardized outcomes beyond 6 months. Evidence for reduced concussion incidence was limited.</p><p><strong>Conclusions: </strong>Concussion programs in soccer seem to produce short-term benefits but remain inadequately evaluated in adoption, implementation, fidelity, and sustainability. Future research should prioritize longitudinal designs and comprehensive RE-AIM reporting to support scalable and sustainable concussion program implementation strategies.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148677428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance Verses Prevention? An Exploration of Elite Coaches' Attitudes Toward Heading and the Implementation of English Heading Guidelines.","authors":"Joseph Evans, Richard Weiler, Kerry Peek, Caroline Bolling, Keith D Parry, Osman H Ahmed","doi":"10.1097/JSM.0000000000001505","DOIUrl":"https://doi.org/10.1097/JSM.0000000000001505","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the perceptions and attitudes of professional coaches from an English Premier League club toward heading and the Football Association's Heading Guidelines.</p><p><strong>Design: </strong>This qualitative study used an interpretivist philosophical paradigm. A focus group interview was conducted and analyzed using 6-stage thematic analysis approach.</p><p><strong>Setting: </strong>A Premier League football club in England.</p><p><strong>Patient or participants: </strong>Five male professional coaches.</p><p><strong>Assessment of risk factor: </strong>Related risk of heading in football had been discussed which included safety risks of heading and long-term implications of heading.</p><p><strong>Main outcome measures: </strong>Coaches' perceptions of heading in football and existing heading guidelines in England.</p><p><strong>Results: </strong>Three main themes emerged: (1) How bad is heading? Concerns were raised about the risk of heading on neurodegenerative diseases, with coaches questioning the evidence and comparing risks with other sports; (2) How coaching influences heading in football. This theme highlighted the coaches' perceptions on the importance of heading for certain positions and career progression, and the perceived neglect of heading technique development; and (3) How coaches implement the guidelines, with this theme revealing mixed attitudes toward guideline adherence, with suggestions for safer heading practices and concerns about the guidelines' impact on training and games.</p><p><strong>Conclusion: </strong>Coaches expressed scepticism about the need for Heading Guidelines due to limited evidence on long-term brain health. They emphasized the importance of educating coaches on research evidence as it becomes available, and involving multiple stakeholders in player safety. Effective implementation requires addressing coaches' perceptions and ensuring better communication and education on the guidelines' rationale and benefits. The study highlights the need for improved communication and education to increase buy-in and adoption of Heading Guidelines, considering both coaches' perspectives and the scientific evidence base.</p>","PeriodicalId":10355,"journal":{"name":"Clinical Journal of Sport Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148599845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}