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Hematology, Hormones, Inflammation, and Muscle Damage in Elite and Professional Soccer Players: A Systematic Review with Implications for Exercise

Abstract

Background

Knowledge of the long-term effects of soccer training on hematological, hormonal, inflammatory, and muscle damage markers and physical performance may help to better design strength and conditioning programs for performance development and injury prevention for the individual player and the team.

Objectives

The aim of this systematic review was to summarize and discuss evidence on the long-term effects of soccer training on selected hematological, hormonal, inflammatory, and muscle damage markers and physical performance in elite and professional soccer players. A second goal was to investigate associations between selected physiological markers and measures of performance.

Methods

Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, a systematic literature search was conducted in four electronic databases (PubMed, ISI Web of Knowledge, Web of Science, and SPORTDiscus) from inception until August 2020 to identify articles related to soccer training effects. To be included in this systematic review, studies had to examine male elite (national level) and/or professional (international level) soccer players aged > 17 years and a soccer training period > 4 weeks, and report outcomes related to hematological, hormonal, inflammatory, muscle damage, and performance markers.

Results

The search syntax initially identified 2420 records. After screening titles, abstracts, and full texts, 20 eligible studies were included in this systematic review, with training durations lasting between 4 and 18 weeks in 15 studies, around 6 months in four studies, and around 1 year in one study. Effects of long-term soccer training revealed parameter-specific increases or decreases in hematological, hormonal, inflammatory, and muscle damage markers and physical performance. Two studies showed a moderate increase in hematological markers such as hemoglobin (effect size [ES] = 0.67–0.93). Parameter-specific changes were noted for hormonal markers in the form of increases for total testosterone (ES = 0.20–0.67) and free testosterone (FT) (ES = 0.20–0.65) and decreases for cortisol (ES =  − 0.28 to − 1.31). Finally, moderate to very large increases were found for muscle damage markers such as creatine kinase (ES = 0.94–6.80) and physical performance such as countermovement jump (CMJ) height (ES = 0.50–1.11) and squat jump (SJ) height (ES = 0.65–1.28). After long-term periods of soccer training, significant positive correlations were found between percentage change (Δ%) in FT and Δ% in CMJ height (r = 0.94; p = 0.04) and between Δ% in total testosterone/cortisol (TT/C) ratio and Δ% in SJ (r = 0.89; p = 0.03).

Conclusions

Findings suggest that long-term soccer training induces increases/decreases in hematological, hormonal, inflammatory, and muscle damage markers and physical performance in male elite and professional soccer players. These fluctuations can be explained by different contextual factors (e.g., training load, duration of training, psychological factors, mood state). Interestingly, the observed changes in hormonal parameters (FT and TT/C) were related to vertical jump performance changes (e.g., CMJ and SJ). Anabolic hormones and TT/C can possibly be used as a tool to identify physical performance alteration after long-term soccer training.

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Data Availability

All data supporting the findings of this study are available in this published article.

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Correspondence to Urs Granacher or Hassane Zouhal.

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Funding

This study was supported by the Deutsche Forschungsgemeinschaft (DFG) and Open Access Publishing Fund of the University of Potsdam, Germany.

Conflict of interest

Karim Saidi, Abderraouf Ben Abderrahman, Anthony C. Hackney, Benoit Bideau, Sghaeir Zouita, Urs Granacher, and Hassane Zouhal declare that they have no conflicts of interest relevant to the content of this review.

Author contributions

KS, ABA, and HZ were involved in the conceptualization of the study, the data analysis, and the writing of the manuscript. UG, SZ, and BB were involved in the data assessment, data analysis, and writing of the manuscript. ACH and UG were involved in the writing of the manuscript. All authors approved the final version of the manuscript.

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Saidi, K., Abderrahman, A.B., Hackney, A.C. et al. Hematology, Hormones, Inflammation, and Muscle Damage in Elite and Professional Soccer Players: A Systematic Review with Implications for Exercise. Sports Med 51, 2607–2627 (2021). https://doi.org/10.1007/s40279-021-01522-w

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