Anatomy of human knee joint.

With nine Premier league stars presently sidelined with anterior cruciate ligament damage the Cutter speaks to Kitman Labs on what is being done to prevent this modern-day plight that is depriving us of our finest talents.

For generations of footballers a cruciate injury often meant a premature end to their career or a stalling so severe and drawn out they never returned the same player.

On Boxing Day 1962 a collision with a Bury keeper left a 27 year old Brian Clough in agony in the Roker Park mud, his cruciate ligaments torn, his prolific goalscoring days over. A wild challenge by Paul Gascoigne in the 1991 FA Cup Final resulted in the most extravagant British talent of the modern era on crutches throughout his mid-twenties while my own childhood hero, Manchester City’s Paul Lake, was cruelly robbed of countless England caps and becoming a household name when an ACL injury struck at just 21.

These days the advancement of medical science means that in most cases an ACL injury equates to a season on the sidelines, an admittedly horrific setback to any player’s development but usually followed by a full recuperation after a period of intense rehab. In 2008 Chelsea’s Michael Essien sustained ACL damage yet was back in action just five months later.

Which is wonderful news except…there is an awful flip-side. While medical science has improved to such an extent that this sporting affliction is no longer – or rarely at least – career threatening every other aspect of the game has also progressed. Pitches have hardened, boots are bladed, the player themselves are now highly tuned athletes taut to their limits. This has seen a proliferation of ACL injuries like never before with presently nine and counting Premier League stars out of action due to serious anterior cruciate ligament damage. It has become a plight of football and sport in general and it is costing us our finest talents.

Which is where Kitman Labs CEO and founder Stephen Smith comes in. Smith’s research focuses on identifying combined risk factors as predictors of athlete injury. Or in more simplistic terms he believes he has found a way of helping preventing injuries by identifying when a player is at heightened risk of sustaining such an injury and can inform coaches and medics so the chances of a player succumbing to an ACL is reduced.Their Athlete Optimisation System has already been embraced by Norwich City and Everton and could yet prove to put an end to the all-too-common sight of a player collapsing in the turf, his season all but over.

We spoke to Stephen about why ACLs are becoming more commonplace and what fantastic work is being done behind the scenes to help prevent further unwelcome instances.

 DC: Nine Premier league stars are currently side-lined with serious anterior cruciate ligament problems. Why are we seeing such an increase in this specific type of injury?

Soccer requires many explosive movement patterns, like sudden changes of direction, hard accelerations, decelerations and landings, along with a high degree of body contact, all factors which places significant pressure and stress on the ACL. With the improvements in training methods and nutritional programmes bigger, stronger, more powerful athletes are being created which in combination with inadequate recovery due to the volume of games being played, can lead to a tear, or worse, a complete rupture. This makes ACL injuries a frequent occurrence in the Premier League.

ACL injuries are not confined to the Premier league however with on average 4 players a year experiencing this type of injury in the NBA every year and a staggering 119 players suffering this injury in the NFL over the last number of seasons.

DC: Are bladed boots  a concern?

As mentioned above numerous factors can contribute to a player incurring an ACL injury. Research does indicate however that non-contact ACL injuries account for 70-84 percent of all ACL tears in both females and males. ACL injuries tend to occur during the landing phase of a jump or during a cutting movement, precisely when the ACL is working against the translation and rotation of the lower leg. These non-contact ACL injuries frequently occur when the player plants their foot but the force of the movement places too much pressure on the ACL leading to an ACL strain or rupture. The potentially greater traction offered by blades and other boots with multiple stud configurations may place the player at increased risk of ACL injury due to the increased likelihood of the players boots sticking in the turf however very little research exists on this subject.

DC: Bournemouth’s Glenn Murray tweeted recently that the firm modern pitches are to blame saying ‘If the turf doesn’t give our bodies do! Killing us!’ Are the authorities listening and will anything be done?

Early findings indicate that players achieve higher top speeds at a greater frequency and can accelerate faster on firmer pitches particularly artificial pitches e.g 4G pitches. This can potentially put greater stress on players, particularly those with existing or historical tendon and ligament issues, potentially increasing their risk of incurring some sort of soft tissue injury. Players who are used to the day to day stressor of using an artificial pitch for training and matches tend not to have higher rates than players who train on softer grass surfaces however. This seems to suggest that the change in stimulus may be one of the contributing factors for increased perception of exertion for players i.e going from one surface to an unfamiliar surface and also a contributing factor to soft tissue injury.

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DC: Your software provides markerless motion capture and real-time alerts. As someone who struggles to follow the science bits in The Big Bang Theory could you break all this done in layman’s terms as to what the software offers.

We collect data that is relevant for soccer players and then use our system to convert this data into real-time actionable alerts for coaches. In really simple terms, we tell coaches and medics when a player is at heightened risk. Our system is made up of three components that work seamlessly together:

Profiler is the analytics engine or heart of the system that all data collected if funneled through and which the coaching team uses to gain powerful insights to make informed decisions

Capture is the first markerless biomechanical assessment tool that uses motion capture to record player movements; all athlete data is updated in Profiler real-time

Athlete is the easy-to-use application players use to enter health and wellness responses; all data is automatically updated to Profiler

Research suggests that the angle of both knees during the landing phase of a jump is a useful indicator of future ACL injury. As a result, clients use our Capture system to collect, amongst other variables, knee position during the landing phase of a counter movement jump (CMJ) – all within 30 seconds! This forms one portion of the daily “stress” and “response” screening process which includes tracking players wellbeing (using our Athlete app) e.g Sleep, Mood, Stress, reviewing a players training load with both objective data from objective data sources such as GPS e.g Total distance, number of accelerations as well as the players perception of how difficult a training session was. This data is then analysed using a machine learning formula to assess if the player is at an elevated risk of injury or performance decrement which will translate into alerts in Profiler.


DC: You’ve recently announced deals with Norwich and Everton. What does that entail?

Norwich and Everton are using the Kitman Labs Athlete Optimisation System with a view to reducing injury and optimising the performance of their players. This entails daily monitoring in order to obtain valuable data from the players which our system then turns into actionable insights that enable their practitioners to make better decisions surrounding the players. We also help with the storing and sharing of important player medical data within the organisation.

DC: Can you tell us about the origins of Kitman labs. Your beginnings and where you are now. 

Kitman Labs was founded based upon the research of its CEO and founder, Stephen Smith in 2012.  Smith’s research focused on identifying combined risk factors as predictors of athlete injury. The Athlete Optimisation System was developed by Kitman Labs’ sport scientists and practitioners to provide professional and elite sport teams with a better way to evaluate athlete performance and reduce the risk of injury. The software system uses machine learning algorithms to determine each player’s individual stress response and provides coaches with real-time actionable insights to enable them to make more informed decisions. We are now working across more than 30 teams in 14 leagues worldwide and our system is taking the professional sporting world by storm as there is now a realisation that injuries cost teams success.

DC: Your work aside what can be done to reduce the plight of ACLs?

Despite the huge investment in sport science and the explosion in popularity of wearable devices in recent years, injuries including ACL injuries have continued to rise in the Premier League bringing with them a huge monetary cost for the clubs involved not to mention the discomfort and distress caused to the player themselves. In 2014-15 the Premier League spent £198 million on injured players which was an increase of 2.2% from the prior season.

The Premier League has acknowledged this growing problem and the role sport science has to play in reversing this negative trend by launching the Elite Player Performance Plan three years ago with injury prevention a key component in the development of domestic players. However much of the research had focused on assessing the causes of injury rather than measures that can be taken to prevent them such as predictive analysis of data and identification of key risk factors for injury.

The Premier league could use the Australian Football League (AFL) as a good example of successful implementation of injury prevention strategies. The injury rate in the AFL has been consistent over the last number of seasons and saw a reduction in both the number of injuries and severity of injury between the 2012/13 season and the 2013/14 season. The AFL compiles a detailed injury report at the end of each season which allows for comprehensive injury reporting throughout the season. The AFL has also used the injury and player data available to them to inform rule changes within the game e.g Interchange & substitution that has impacted injury rates in the league since their introduction.

Find out more on Kitman Labs here.