Mid-season World Cup should mean less, not more injuries for international stars

The decision to stage the 2022 FIFA World Cup in the middle of the domestic football season, and in the heat of Qatar, has led to fears of players picking up injuries while on prolonged international duty.

However, the controversial men’s tournament might actually throw up less fitness problems for UK-based players than a traditional summer competition, as University of Leicester’s Director of Research in the School of Health and Physiotherapy Lecturer, Dr Seth O’Neill, explains in this blog…

Ever since the 2022 World Cup was announced for Qatar there has been concern about the potential issues with heat. Obviously in the summer, this is a real problem with temperatures reaching up to 45 degrees Celsius – and that is without the addition of the sun trap effects possible in stadiums. However, with this edition of the tournament taking place in Qatar’s winter, the temperatures are set to be around 27 degrees Celsius for the evening games and possibly up to the low 30s with the addition of humidity in the earlier games. These temperatures are not really different to what players competed in for the 2020 Euros. The main difference may really be the lack of acclimatisation due to Premiership games having run so close to the start of the World Cup. Equally, the record temperatures experienced in the UK during this year’s pre-season should have given players some exposure to exceptionally high temperatures. Obviously the FA’s medical team will have used experiences during this period and previous campaigns to come up with an action plan to attempt to reduce the impact of heat on performance. But I expect we are unlikely to see issues related to it. 

The other key aspect that players, coaches and pundits have been discussing is the risk of injury related to the tournament being sandwiched in a normal season. This is something that medical and conditioning personal and teams the world over have been considering. The assumption is that the lack of recovery time will see a significant increase in injuries. However it’s possible we will see the reverse. 

Normally one considers injuries to relate to players’ training and game time. The assumption being the more hours they play, the greater the risk of injury due to over training and accumulative fatigue. This concept has been the status quo mantra in football for decades. However, the data does not support this. Most injuries in football (and other sports) occur during pre-season. This is simply due to players resting during the off season and deconditioning somewhat. 

We all know that if we go on holiday for a week, and eat and drink what we want, trying to return to sports can be a challenge. This is because we lose muscle mass a lot quicker than people think, fitness drops and when we return we push a little harder to lose that weight we gained whilst away. 

Imagine that in football, an off-season of four weeks, not total rest but little running and training for the players, they return to training and now the coach puts them through their paces in order to ‘get them fit’. This period of intense training on mild de-conditioning of tissue (reduction in resilience of connective tissue) and also strength loss, appears to give the perfect scenario for increased injuries. Once we have passed pre-season and early season, players are now fit and their bodies have adapted to the demands of training and match-play. This coincides with a reduction in injuries. It of course does not mean injuries do not happen, but on balance we see less of them.  This is the situation for this World Cup. 

Contact injuries related to bad tackles or getting shoved in the back are difficult to prevent/reduce, however, non-contact injuries are generally accepted as something we can reduce via various exercise programmes that improve resilience/robustness of connective tissues like ligaments, muscles and tendons. Many injury reduction programmes have been developed, for example the FIFA 11+, Hamstring training via Nordics and groin muscle training using the Copenhagen programme. All have shown good effects at preventing non-contact injuries. 

Due to the World Cup sitting within the playing season we have passed the ‘high risk’ pre-season and early season stage and players should be conditioned well. It’s now up to the medical teams to consider what each individual player’s background of training and match play has been, and tailor the training during the competition. 

However if we forget about injuries and concentrate on performance the lack of training and playing regularly together for the various squads could cause some serious issues with team cohesion and playing style. This had been suggested as potentially leading to some shock results in the opening games. Iran defeating Wales, Belgium being humbled by Morocco and Argentina losing to Saudi Arabia might just be cases in point.