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New PhD-thesis on Norway's best female footballer players


Physiotherapist Agnethe Nilstad from the Oslo Sports Trauma Research Center has through her PhD-work investigated risk factors for lower extremity injuries in female football players and how sports physiotherapists can utilize screening as a step to prevent injuries.


Friday, June 27, Agnethe Nilstad will defend her PhD-thesis "Injuries and risk factors in elite female football - Implications for screening and prevention."

In her PhD-defense, Agnethe will start out going through her main findings through 5 years of hard work. The aims of her PhD-work were to validate a novel method for injury registration in sports and to investigate risk factors for lower extremity injuries, as well as to further assess screening tools used to identify athletes at risk.

Could these injuries been avoided?

For Agnethe Nilstad (picture), this question has been the driving force for her PhD-work through 5 years, work that has resulted in 4 scientific publications in high-ranked international sports medicine journals and a lot of media coverage (see example on forskning.no – in Norwegian).


 - Injury surveillance is important to understand the extent of the problem, the injury itself or a specific injury type.


- In my research, we recorded all players´ training and match activities (playing time), as well as all injuries resulting in absence from play, by using text messaging (SMS-tracking) with weekly reports throughout the season. 


- Based on our findings, we recommend future investigations to conduct injury registrations in team sports using individual weekly reports rather than monthly medical staff registrations.


- It appears that the team medical staff missed more than half of all injuries. When athletes report directly to us, we registered a much higher proportion, Agnethe adds.

Unfortunately, an ACL injury, an injury to the anterior cruciate ligament, is a common knee injury among female elite athletes, and by far the most severe knee injury.

Another research question that came up through Agnethe´s work was “what can be done to avoid another and unnecessary new injury? 

Screening - how to identify athletes at risk for injury?


Before the 2009 football season, approximately 200 female football players in the Norwegian top division for females participated in screening tests at the Norwegian School of Sport Sciences (NIH) to be part of a huge long-term project aiming at identifying potential risk factors for ACL injuries.


(link to ACL risk factor project)


Better players - higher risk?
Several findings from Agnethe´s work indicated somewhat surprising that players who performed well on both strength and stability tests had an increased likelihood of an injury.


- A potential explanation might be that these players are among the best players who are more involved in the game and therefore exposed to potential risk situations that again may lead to injury, Agnethe discusses in her thesis.

Another finding revealed that elite female football players with a previous knee injury has 9 times higher risk of new knee injury on the same side as compared with those without such an injury before.

Valuable knowledge for further work on injury prevention

Agnethe Nilstad PhD-thesis provides valuable knowledge about how injury risk in female elite football can be reduced and how we as sports clinicians and scientists better can follow up footballers who already have sustained an injury.

Furthermore, athlete screenings are essential to identify players at risk of injury, and we have shown that a real-time observations by a physiotherapist can be used to identify athletes with high knee valgus angles during drop jumps.

Thor Einar Andersen, Tron Krosshaug and Roald Bahr served as supervisors for Agnethe.

Read more about Agnethe´s projects.

Trial lecture and PhD-defense on June 27, 2014

10:15 - 11:00: Trial lecture "Forebygging og fysikalsk behandling av skulderinstabilitet hos utøvere i kastidrett."

13:00 - 16:00: PhD-defense

Dissertation committee

Head of dissertation committee: Professor Jorunn Sundgot-Borgen, Norwegian School of Sport Sciences, Norway

1. Opponent: Professor Mette Kreutzfeldt Zebis, Copenhagen University Hospital Hvidovre, Denmark

2. Opponent: Dr Arne Kristian Aune, Teres Drammen, Drammen, Norway.

The trial lecture and public defense will take place in Norwegian and is open to the public.

Location: NIH, Auditorium D