A football player or footballer is a sportsperson who plays one of the different types of football. The main types of football are association football, American football, Canadian football, Australian rules football, Gaelic football, rugby league, and rugby union.
It has been estimated that there are 250 million association football players in the world, [1] and many play other forms of football.
Jean-Pierre Papin has described football as a "universal language". [2] Footballers across the world and at almost any level may regularly attract large crowds of spectators, and players are the focal points of widespread social phenomena such as association football culture.
Footballers generally begin as amateurs and the best players progress to become professional players. Normally they start at a youth team (any local team) and from there, based on skill and talent, scouts offer contracts. Once signed, some learn to play better football and a few advance to the senior or professional teams.
Pay in some top men's leagues is significantly higher than in other jobs. Players in the Premier League earn an average of $3 million per year. [3] In the wealthiest clubs in European football leagues, men earn an average $7.19 million per year. [4] The best players of those clubs can earn up to $260 million per year. [5]
However, only a fraction of men's professional football players are paid at this level. Wages may be somewhat more moderate in other divisions and leagues. For example, the average annual salary for footballers in Major League Soccer (MLS) is $530,262 as of May 2023. [6]
Average salaries in women's leagues are far lower. For example, players in the National Women's Soccer League (NWSL), which started in 2012, earn an average of $54,000 per year as of May 2022. [7] For the first time in 2022, the NWSL guaranteed players a living wage. The minimum salary in 2023 is $36,400 to ensure players do not need second or third jobs to survive. [8]
A minority of retired footballers continue working full-time in football, for instance as football managers. A 1979 study reported that former first-team ballplayers were over-represented as top-ranking executives in their companies and had greater income mobility than second-teamers and reserves. [9] However, some experience chronic health issues, see below.
In association football, there are four traditional types of specialties (positions): goalkeepers (goalies), defenders (full-backs), midfielders (half-backs), and forwards (attackers). Special purpose positions include such performers as sweepers, stoppers, second forwards (under-attackers), wingers, insiders, etc.
The American football teams' positions are categorized by a form of play where each of them has its spectrum of positions. Those are offensive, defensive, and special teams.
Research shows that association football players who take less than 200 milliseconds after the referee blows their whistle to make a penalty kick are significantly less likely to score than those who take over a second. [16] [17]
An Irish 2002 study of association and Gaelic football players characterized players as "lean and muscular with a reasonably high level of capacity in all areas of physical performance". [18] The opposite is the case for American football, where obesity could be the cause of grave health problems. [19]
A 2000 study documented injuries sustained by Czech [association] football players at all levels: [20]
Trauma was the cause of 81.5% of the injuries, and overuse was the cause of 18.5%. Joint sprains predominated (30%), followed by fractures (16%), muscle strains (15%), ligament ruptures (12%), meniscal tears and contusions (8%), and other injuries. Injuries to the knee were most prevalent (29%), followed by injuries to the ankle (19%) and spine (9%). More injuries occurred during games (59%) than in practice.
[21] Patellar tendinitis (knee pain) is considered an injury that comes from overexertion, which also happens to other athletes of virtually every sport. It is a common problem that football players develop and can usually be treated by a quadriceps strengthening program. Jumping activities place particularly high strains on the tendon and with repetitive jumping, tearing and injury of the tendon can occur. The chronic injury and healing response results in inflammation and localized pain. [22]
Although levels of depression and pain in retired football players are on par with the societal average, [23] some players suffer from post-retirement chronic injuries. Head injuries are a particular concern.
Studies have long shown former American football NFL players have a longer life expectancy than the general public or males with a similar age and race distribution, but a higher rate of cardiovascular issues. [24] A study comparing the deaths of former Major League Baseball players found baseball players lived longer still, perhaps suggesting a "healthy worker" bias where NFL athletes lived less long than they would otherwise have, despite their longer than average life expectancy. [25] A 2009 review of the evidence in the American Journal of Medicine concluded the existing evidence "did not suggest an increased mortality" but does "suggest increased cardiovascular risk..., particularly the heavier linemen." [26]
In association football, a 2011 German study found that German national team players lived 1.9 years less than the general male population. [27]
Football players participating in international matches for Germany have reduced longevity compared to the general population. This disadvantage was the larger, the earlier the international football player started his international career. This finding is in line with the current knowledge of life expectancy in major athletes, especially those from other team sports
A 1983 study of rugby players found that the life expectancy of All Blacks was the same as for the general population. [28]
Australian rules footballers have lower death rates than the general population. [29]
American football players are prone to head injuries such as concussions. In later life, this increases the risk of dementia [30] and Alzheimer's. [31] Professional American football players self-reporting concussions are at greater risk for having depressive episodes later in life compared with those retired players self-reporting no concussions. [32] [33]
Probably due to the repeated trauma associated with heading balls, professional association football has been suggested to increase the incidence of amyotrophic lateral sclerosis. [34] In a 1987 study of former Norwegian association football national team players, one third of the players were found to have central cerebral atrophy, i.e. brain damage. [35] A 1999 study connected soccer to chronic traumatic head injury (CTHI): [36]
[P]articipation in amateur association football in general and concussion specifically is associated with impaired performance in memory and planning functions. Due to the worldwide popularity of soccer, these observations may have important public health implications
Anterior cruciate ligaments are particularly vulnerable in most types of football due to injuries that can be sustained during tackles.
An increased incidence of osteoarthritis in the hip joint has been found in retired football players. [37]
A 2012 study of association football injuries found that 19% of all injuries were muscle injuries, of which 54% affected the thigh muscles. [38]
In a 2009 study, association football was found to be associated with favourable sleep patterns and psychological functioning in adolescent male football players. [39]
The rate of suicide among NFL vets has been found to be 59% lower than in the general population. [40]
In 2012, FIFA released a paper intended to identify key risk factors for association football players. [41]
In 2015, a systematic review of a sample of fifty-four peer-reviewed publications and three articles on elite athletes’ mortality and longevity, resulted in major longevity outcomes for the elite athletes (baseball, football, soccer, basketball, and cycling) "compared to age and sex-matched controls from the general population and other athletes." The span longevities were influenced by factors like the type of sport, the playing position, the race, and the energy system. [42]
An observational study held from professional footballers -active (during their career) and recently retired (post-career, aged more than 45 years)- in 70 countries between 2007 and 2013, elaborated on data from the World Footballers' Union (FIFPro), recorded 214 deaths of which 25% was caused by accidents, 11% by suicides and 33% by a suspected cardiac pathology (on an overall 55% of deaths caused by some sort of disease). [43]
Clinical evaluation, ECG, and echocardiography are required for the athletes as pre-participation tools in order to prevent sudden cardiac deaths in people aged less than 35. To evaluate the risk of myocardial fibrosis, may use and recommend the additional use of late gadolinium enhancement (LGE) with pre- and post-contrast and extracellular volume fraction (ECV) images. [44] Even encouraged, it wasn't yet made mandatory.
In 2015, 205 deaths among North American professional athletes who were registered as active at the time of their decease were analysed. Data were collected for the four major sports: National Basketball Association (NBA), National Football League (NFL), National Hockey League (NHL), and Major League Baseball (MLB). The NFL and NBA active players had "a higher likelihood of dying in a car accident" and a significantly higher likelihood of dying from a cardiac-related illness compared to the NHL and MLB active populations. [45]
In 2013, a study on 3,439 retired athletes of the National Football Leagues with at least five credited playing seasons between 1959 and 1988 did not show a statistical correlation between suicide mortality and professional activity, particularly football-related compared with the general control sample. No stratification was reported between speed and non-speed position players. [46]
Until the 2000s a very limited number of formal studies has been published on mortality from all causes in soccer players, despite the high interest of the public to the matter. An extended study held in Italy between 1975 and 2003 on a total of 5.389 players, aged 14–35 years, highlighted that, while the mortality for cancer and cardiovascular diseases among the football players cohort was significantly lower than the general Italian population, the "mortality rates for amyotrophic lateral sclerosis and car accidents were significantly higher than expected, and for ALS the risk is 18 times than expected." [47]
Sports injuries are injuries that occur during sports, or exercising in general. In the United States, there are approximately 30 million people who participate in some form of organized sports. Of those 30 million, about 3 million athletes aged 14 and under suffered a sports injury annually. According to a study performed at Stanford University, 21% of the injuries observed in elite college athletes caused them to miss at least one day of sports activity, and approximately 77% of these injuries involved the knee, leg, ankle, or foot. The leading death-causing sports injury is traumatic head or neck injuries.
The participation of women and girls in sports, physical fitness, and exercise has existed throughout history. However, participation rates and activities vary in accordance with nation, era, geography, and stage of economic development. The modern era of organized sports did not begin to emerge either for women or men until the late industrial age.
Ulnar collateral ligament reconstruction, colloquially known as Tommy John surgery, is a surgical graft procedure where the ulnar collateral ligament in the medial elbow is replaced with either a tendon from elsewhere in the patient's body, or with one from a deceased donor. The procedure is common among collegiate and professional athletes in several sports, particularly in baseball. The surgery is performed to restore optimal function for repetitive elbow movements or specifically throwing ability, often extending the careers of professional athletes. In many athletes, the surgery is done more than once during their careers.
A concussion, also known as a mild traumatic brain injury (mTBI), is a head injury that temporarily affects brain functioning. Symptoms may include loss of consciousness; memory loss; headaches; difficulty with thinking, concentration, or balance; nausea; blurred vision; dizziness; sleep disturbances, and mood changes. Any of these symptoms may begin immediately, or appear days after the injury. Concussion should be suspected if a person indirectly or directly hits their head and experiences any of the symptoms of concussion. Symptoms of a concussion may be delayed by 1–2 days after the accident. It is not unusual for symptoms to last 2 weeks in adults and 4 weeks in children. Fewer than 10% of sports-related concussions among children are associated with loss of consciousness.
Health issues in American football comprise a large number of health risks associated with participating in the sport. Injuries are relatively common in American football, due to its nature as a full-contact game. Injuries occur during both practice and games. Several factors can affect the frequency of injuries: epidemiological studies have shown older players can be at a greater risk, while equipment and experienced coaches can reduce the risk of injury. Common injuries include strains, sprains, fractures, dislocations, and concussions. Concussions have become a concern, as they increase the risk of mental illnesses like dementia and chronic traumatic encephalopathy (CTE). In individual leagues like the National Football League (NFL) and National Collegiate Athletic Association (NCAA), a public injury report is published containing all injured players on a team, their injury and the game-day status of each player.
A contact sport is any sport where physical contact between competitors, or their environment, is an integral part of the game. For example, gridiron football. Contact may come about as the result of intentional or incidental actions by the players in the course of play. This is in contrast to noncontact sports where players often have no opportunity to make contact with each other and the laws of the game may expressly forbid contact. In contact sports some forms of contact are encouraged as a critical aspect of the game such as tackling, while others are incidental such as when shielding the ball or contesting an aerial challenge. As the types of contact between players is not equal between all sports they define the types of contact that is deemed acceptable and fall within the laws of the game, while outlawing other types of physical contact that might be considered expressly dangerous or risky such as a high tackle or spear tackle, or against the spirit of the game such as striking below the belt or other unsportsmanlike conduct. Where there is a limit as to how much contact is acceptable most sports have a mechanism to call a foul by the referee, umpire or similar official when an offence is deemed to have occurred.
Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease linked to repeated trauma to the head. The encephalopathy symptoms can include behavioral problems, mood problems, and problems with thinking. The disease often gets worse over time and can result in dementia.
Second-impact syndrome (SIS) occurs when the brain swells rapidly, and catastrophically, after a person has a second concussion before symptoms from an earlier one have subsided. This second blow may occur minutes, days, or weeks after an initial concussion, and even the mildest grade of concussion can lead to second impact syndrome. The condition is often fatal, and almost everyone who is not killed is severely disabled. The cause of SIS is uncertain, but it is thought that the brain's arterioles lose their ability to regulate their diameter, and therefore lose control over cerebral blood flow, causing massive cerebral edema.
The fencing response is an unnatural position of the arms following a concussion. Immediately after moderate forces have been applied to the brainstem, the forearms are held flexed or extended for a period lasting up to several seconds after the impact. The fencing response is often observed during athletic competition involving contact, such as combat sports, American football, ice hockey, rugby union, rugby league and Australian rules football. It is used as an overt indicator of injury force magnitude and midbrain localization to aid in injury identification and classification for events including on-field and/or bystander observations of sports-related head injuries.
The health issues of youth sports are concerns regarding the health and wellbeing of young people between the ages of 6 and 18 who participate in an organized sport. Given that these athletes are physically and mentally underdeveloped, they are particularly susceptible to heat illness, eating disorders and injury; sufficiently severe conditions can result in death. Awareness and prevention are key factors in preventing many health issues in youth sports.
The health issues of athletics concern their physical and mental well-being in organized sport. If athletes are physically and mentally underdeveloped, they are susceptible to mental or physical problems. Efforts to improve performance can lead to harm from overtraining, adopting eating habits that damage them physically or psychologically, like using steroids or supplements.
Prevention of mild traumatic brain injury involves taking general measures to prevent traumatic brain injury, such as wearing seat belts, using airbags in cars, securing heavy furnitures and objects before earthquake or covering and holding under the table during an earthquake. Older people are encouraged to try to prevent falls, for example by keeping floors free of clutter and wearing thin, flat, shoes with hard soles that do not interfere with balance.
Dr. Bennet Ifeakandu Omalu is a Nigerian-American physician, forensic pathologist, and neuropathologist who was the first to discover and publish findings on chronic traumatic encephalopathy (CTE) in American football players while working at the Allegheny County coroner's office in Pittsburgh. He later became the chief medical examiner for San Joaquin County, California, and is a professor at the University of California, Davis, department of medical pathology and laboratory medicine. He is currently the president and medical director of Bennet Omalu Pathology.
Concussions and play-related head blows in American football have been shown to be the cause of chronic traumatic encephalopathy (CTE), which has led to player deaths and other debilitating symptoms after retirement, including memory loss, depression, anxiety, headaches, stress, and sleep disturbances.
Concussion, a type of mild traumatic brain injury that is caused by a direct or indirect hit to the head, body, or face is a common injury associated with sports and can affect people of all ages. A concussion is defined as a "complex pathophysiological process affecting the brain, induced by biomechanical forces". A concussion should be suspected in any person who falls or has a hit to their face or their body and has a visible sign/clue that they may have a concussion or experiences any symptoms of concussion. The Concussion Recognition Tool 6 (CRT6) can be used to help non-medically trained people manage sport related concussion on the sideline to ensure that they are directed to the appropriate care. Symptoms of concussion can be felt right away or appear over the first 1-2 days after an accident. If an athlete has a suspected sport-related concussion they should not return to play that day, not be left alone for the first three hours after their injury, not drive until cleared by a medical professional, and not return to any activity that has a risk of hitting their head or falling until they have a medical assessment. If the person has worsening symptoms or any 'red flag symptoms', they need immediate medical attention. Concussions cannot be seen on X-rays or CT scans.
A catastrophic injury is a severe injury to the spine, spinal cord, or brain. It may also include skull or spinal fractures. This is a subset of the definition for the legal term catastrophic injury, which is based on the definition used by the American Medical Association.
A sports-related traumatic brain injury is a serious accident which may lead to significant morbidity or mortality. Traumatic brain injury (TBI) in sports are usually a result of physical contact with another person or stationary object, These sports may include boxing, gridiron football, field/ice hockey, lacrosse, martial arts, rugby, soccer, wrestling, auto racing, cycling, equestrian, rollerblading, skateboarding, skiing or snowboarding.
A traumatic brain injury (TBI) is a blow, jolt or penetration to the head that disrupts the function of the brain. Most TBIs are caused by falls, jumps, motor vehicle traffic crashes, being struck by a person or a blunt object, and assault. Student-athletes may be put at risk in school sports, creating concern about concussions and brain injury. A concussion can be caused by a direct blow to the head, or an indirect blow to the body that causes reactions in the brain. The result of a concussion is neurological impairment that may resolve spontaneously but may also have long-term consequences.
Concussions in professional rugby union are the most common injury received. Concussion can occur where an individual experiences an impact to the head, and are also notable in high-contact sports, including American football, boxing, MMA and Hockey. Concussions can occur in recreational activities like horse riding, jumping, cycling, and skiing as a result of forceful rotational moment, resulting in injuries to the brain due to the contact with the skull, giving the skull not enough time to move with the body, causing the brain to press against the skull. With the development of equipment and training methods, further education on identifying concussion symptoms, as well as adjustments to the terms of contact may allow players to make more informed decisions on their conduct on the pitch.
James David Forbes Calder is a British orthopaedic surgeon specialising in sporting injuries. He has built a reputation for treating foot and ankle injuries in top international athletes - soccer players from the English Premier League and European clubs including Paris St Germain, AC Milan, Barcelona FC, Real Madrid, Olympique de Marseille FC in addition to rugby players from England, Ireland, Scotland and Wales, GB Olympic teams, England and Indian cricket teams and UK Athletics.
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