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Elevated heat, humidity and solar load combined with low air movement independently and additively impair performance, increase the perception of effort and the risk of heat-related illnesses. For the specific context of professional football, the Fédération Internationale de Football Association (FIFA) heat guidelines are often used as the default policy. Still, these seem less protective than guidelines in other sports or from countries traditionally exposed to extreme hot conditions. Following several high-profile international and continental competitions played in hot conditions (eg, 2014 FIFA World Cup Brazil), a series of cross-sectional studies showed that national team players and their managers unanimously mentioned that the hot and humid conditions during these matches made it difficult as a team to perform. Such a concern is likely to be relevant for the upcoming 2026 FIFA World Cup that will be held in the traditional June-July window across 16 host cities in Canada, Mexico and USA. Therefore, to better protect players\' health and performance during training and match play in hot conditions, we present our starting 11 Hot Tips that should be considered and facilitated by governing bodies, competition organisers, clubs, staff members and players.

Given the scientific and public concern regarding the short-, medium- and long-term consequences of heading on brain health, being proactive about developing and implementing guidelines that help reduce the burden (volume, impact magnitude and injury risk) of heading in young and beginner players appears justified. This narrative review explores the evidence underpinning strategies that could be incorporated into future heading guidelines to reduce heading burden in players across all levels of football. A four-step search strategy was utilised to identify all data-based papers related to heading in football. Eligibility criteria for inclusion were: (1) original data, (2) study population included football players, (3) outcome measures included one or more of the following: number of headers, measurement of head acceleration during heading, or head/brain injury incidence, and (4) published in English or English translation available. In total, 58 papers were included that outlined strategies based on (1) game or team development, (2) player skill development and (3) equipment. In particular, greater emphasis existed for small-sided games (particularly in young players) where fewer headers are observed when compared with the conventional 11 versus 11 game, as well as reducing headers from goal kicks and corners. Evidence also existed for developing a heading coaching framework that focusses on technical proficiency as well as neuromuscular neck exercises integrated into general injury reduction exercise programs, enforcement of rules related to deliberate head contact and using lower-pressure match and training balls. To mitigate potential risks of heading on brain health, a number of pragmatic strategies have been examined in scientific studies and may be considered as part of future heading guidelines.

Several sports have published consensus statements on methods and reporting of epidemiological studies concerning injuries and illnesses with football (soccer) producing one of the first guidelines. This football-specific consensus statement was published in 2006 and required an update to align with scientific developments in the field. The International Olympic Committee (IOC) recently released a sports-generic consensus statement outlining methods for recording and reporting epidemiological data on injury and illness in sport and encouraged the development of sport-specific extensions.The Fédération Internationale de Football Association Medical Scientific Advisory Board established a panel of 16 football medicine and/or science experts, two players and one coach. With a foundation in the IOC consensus statement, the panel performed literature reviews on each included subtopic and performed two rounds of voting prior to and during a 2-day consensus meeting. The panel agreed on 40 of 75 pre-meeting and 21 of 44 meeting voting statements, respectively. The methodology and definitions presented in this comprehensive football-specific extension should ensure more consistent study designs, data collection procedures and use of nomenclature in future epidemiological studies of football injuries and illnesses regardless of setting. It should facilitate comparisons across studies and pooling of data.

Recent findings of neurodegenerative pathology in former professional football players have once again called into question the role that \"heading\", a fundamental aspect of the game, plays in the onset of neurological disease. By introducing guidelines aimed at limiting heading among youth players, the United Kingdom recently joined the United States as the only two nations yet to implement heading regulation in response to growing concerns surrounding football\'s head injury burden.
Evaluating the efficacy of risk mitigation strategies requires the continual reviewal of available evidence, however, youth heading guidelines have yet to undergo such an empirical evaluation. This review aims to address this absence by first discussing the literature informing heading-related health risk, followed by an assessment of the decision to limit youth heading in response to this research.
The risk of injury due to heading remains highly uncertain, especially as it pertains to youth players for whom epidemiological data is severely lacking. However, consideration of policy making under conditions of scientific uncertainty, as well as intrinsic risk factors of acute head injury in children and adolescents, currently warrants a precautionary approach to youth heading regulation.
Further research must be pursued to ensure that future risk management strategies remain grounded in evidence and enhance the safety of football for vulnerable individuals. While our understanding of the neurological outcomes of heading remains limited, the adoption of heading guidelines reflects an appropriate response to uncertain risk.

OBJECTIVE: To review the prevalence, short- and long-term impact of exercise on blood pressure, and the evaluation and treatment of hypertension in competitive athletes.
RESULTS: Due, in part, to inconsistencies in measurement and the definitions used, the true prevalence of hypertension is unknown as reports range from 0 to 83%. With recent changes in the blood pressure guidelines, the proportion of athletes that meet criteria for elevated blood pressure or stage 1 hypertension has increased dramatically with over one-third of collegiate and professional athletes meeting criteria for hypertension. Data consistently show that American-style football players, particularly linemen, display the highest rates of hypertension. These athletes typically have a larger body mass index, higher body fat percentage, and weight gain in serial follow-up. Many athletes with hypertension have traditional risk factors, and, to date, there is no evidence of a causal relationship between long-term sport participation and increased risk of developing hypertension. Many more athletes now meet criteria for hypertension, given the updated blood pressure guidelines. This should be taken as an opportunity for early intervention, as athletes are not immune to the development of cardiovascular risk factors and disease.

Despite more than four decades of research examining the physical demands of match-play, quantification of the customary training loads of adult male professional soccer players is comparatively recent. The training loads experienced by players during weekly micro-cycles are influenced by phase of season, player position, frequency of games, player starting status, player-specific training goals and club coaching philosophy. From a macronutrient perspective, the periodization of physical loading within (i.e., match versus training days) and between contrasting micro-cycles (e.g., 1, 2 or 3 games per week schedules) has implications for daily carbohydrate (CHO) requirements. Indeed, aside from the well-recognised role of muscle glycogen as the predominant energy source during match-play, it is now recognised that the glycogen granule may exert regulatory roles in activating or attenuating the molecular machinery that modulate skeletal muscle adaptations to training. With this in mind, the concept of CHO periodization is gaining in popularity, whereby CHO intake is adjusted day-by-day and meal-by-meal according to the fuelling demands and specific goals of the upcoming session. On this basis, the present paper provides a contemporary overview and theoretical framework for which to periodize CHO availability for the professional soccer player according to the \"fuel for the work\" paradigm.

Strength testing is a key part of rehabilitation and return to sport (RTS) decision making for football players after anterior cruciate ligament reconstruction (ACLR). Isokinetic testing has been the gold standard for strength measurement for decades, but a uniform protocol and clinical implications of test results are lacking. Therefore, this study aimed to 1) develop a uniform protocol for football players based on knowledge and experience from experts in the field of ACL rehabilitation and 2) clarify the clinical interpretation of different isokinetic test outcomes. In a structured Delphi consensus procedure 42 experts (98% full response rate) fulfilled three rounds that involved a survey, content analysis and anonymised feedback report for each round. Surveys addressed the isokinetic protocol, evaluation report and torque-angle curve of the isokinetic test for strength evaluation in football players after ACLR. The final protocol consisted of concentric knee flexion and extension isokinetic testing with 5 repetitions at 60°/sec, 20 repetitions at 180°/sec and 15 repetitions at 300°/sec and 60 seconds rest between sets. All parameters were deemed valuable, with Peak Torque, Max Rep Total Work, Total Work, Range of Motion and Agonist to Antagonist ratio being considered key for clinical interpretation. For qualitative assessment, it was advised to assess the shape, course, volume, potential dips, peak, and build-up to the peak of the parabola. This Delphi consensus study provided a guideline for data collection and clinical interpretation of isokinetic strength testing in football players after ACLR.

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