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The relationship between physical match performance and 48-h post-game

creatine kinase concentrations in English Premier League soccer players

Article in International Journal of Sports Science & Coaching · December 2016

DOI: 10.1177/1747954116676111

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Original research
International Journal of Sports Science
& Coaching
2016, Vol. 11(6) 846–852
The relationship between physical ! The Author(s) 2016
Reprints and permissions:
match performance and 48-h post-game sagepub.co.uk/journalsPermissions.nav
DOI: 10.1177/1747954116676111
creatine kinase concentrations in spo.sagepub.com

English Premier League soccer players

A Scott1,2, JJ Malone1,2, R Morgans2, D Burgess3,

W Gregson4, JP Morton1,2 and B Drust1,2

Abstract
The aim of the investigation was to determine the relationship between blood creatine kinase and physical match
performance in 15 elite male soccer players competing in the English Premier League. Blood samples were collected
48 h following a competitive match and analysed for creatine kinase concentration immediately after collection. Physical
match performance data were collected using a computerised tracking system (ProzoneÕ ) from >6 matches for each
player. Mean  S.D creatine kinase concentration 48 h post-match was 520  224 m.mol.l1. Large individual variation
in creatine kinase response at this time point was observed (184 m.mol.l1 to 1573 m.mol.l1). No significant correlation
coefficients were observed between the chosen indicators of physical match performance and creatine kinase con-
centration 48 h post-match. These data suggest that creatine kinase concentrations are elevated as a consequence
of playing a soccer match. Creatine kinase may also be of limited value in supporting important decisions in the
coaching process.

Keywords
Association football, performance analysis, sport physiology, muscle damage

Introduction the likelihood of a successful performance outcome

Soccer is a sport that involves stochastic exercise. The but also increase the risk of injury.2 The development
activities completed during matches involve frequent and implementation of strategies that monitor an indi-
unpredictable changes in intensity that range from vidual’s recovery from intense training or competitive
static pauses to maximal sprints.1 Lazarim et al.2 have match play is therefore of interest to both practitioners
suggested that the muscular overload associated with and coaches as such data may support important
the demands of matches and training can lead to decisions on player involvement in both preparation
micro-trauma in both the muscle and connective periods and games.
tissue. Such changes have been linked to the reductions
in performance that are observed following training Reviewers: Holden MacRae (Pepperdine University, USA)
Mehis Viru (University of Tartu, Estonia)
sessions and matches.3–5 The demands of the competi-
1
tive schedule at the elite level require players to fre- Research Institute for Sport and Exercise Sciences, Liverpool John
Moores University, Liverpool, UK
quently play matches and train with relatively short 2
Liverpool Football Club, Liverpool, UK
recovery durations. The time periods between matches 3
Port Adelaide Australian Rules Football Club, Port Adelaide, Australia
and training may be insufficient to restore and recover 4
Research Institute for Sport and Exercise Sciences, Liverpool John
important processes (e.g. glycogen repletion, muscle Moores University, Liverpool, UK
damage and mental fatigue) and can lead to match-
related fatigue (a decline in physical performance Corresponding author:
B Drust, Research Institute for Sport and Exercise Sciences, Liverpool
during the hours and days following the match that John Moores University, 70 Great Crosshall Street, Liverpool L3 2AB,
leads players to perform at sub-optimal levels of UK.
physiological function6,7). This may not only reduce Email: [email protected]
Scott et al. 847

Effective monitoring strategies in soccer require the Method

tracking of variables that are sensitive to the physio-
logical changes that accompany the stress of soccer-
Experimental approach to the problem
specific exercise. Various hormones and muscle This investigation was completed as part of the
enzymes have the potential to assist in the assessment on-going scientific support strategy implemented at a
of the status of players both immediately and in the professional soccer club. As a consequence of this
longer term (3–7 days) following intense exercise.6 approach, a traditional scientific experimental design
Creatine kinase is an enzyme that is found in both the was not employed for the investigation. The research
cytosol and the mitochondria of the muscle that can be aim was fulfilled by collecting data on the match activ-
used as an indirect biomarker that may indicate muscle ity profiles and post-match CK concentrations of a
damage.8,9 Previous research has suggested that CK group of elite soccer players across a competitive
can be used as a marker for the early detection of English Premier League (EPL) season. Following this
player fatigue or muscle overload in soccer players2,10 data collection, the available information was analysed
as it is only released into the circulation following aug- using statistical techniques that examined the relation-
mented cell permeability following the muscle protein ships between important physical match performance
degradation that can accompany intense muscular con- variables and CK measured 48 h post-match. The col-
tractions. This makes it a potentially useful tool to lection of CK was part of the on-going monitoring
monitor player recovery status within soccer. This processes employed within the club to evaluate the
information could be useful in supporting the planning performance and the recovery status of the players
and developing of individualised coaching programmes (other assessments included heart rate monitoring,
for players and squads. GPS tracking and subjective evaluations of training
Few scientific studies have been completed to evalu- load).
ate the role that CK may have on the coaching pro-
gramme in an elite athletic population, especially
soccer players. Creatine kinase appears related to
Subjects
high-intensity activities11,12 and the subjective ratings Data were collected from a total of 15 elite soccer
of player performance provided by coaches13 in team players (mean  S.D.; age, 26  4 years; height,
sports. Only one study has, so far, examined the rela- 1.8  0.6 m; body mass, 84  6 kg). All participants
tionship between the activities completed within a soccer played for an elite professional soccer team competing
match and CK concentrations post-match.14 The data in the English Premier League (EPL). Data were
reported by Thorpe and Sunderland14 also indicate a collected during the 2011–2012 domestic season.
relationship between post-match salivary CK concen- Goalkeepers were excluded from the sample due to
tration and the number of sprints and the distance their specialised role within the team. Only outfield
covered by semi-professional soccer players. The rela- players were therefore included in the sample. The pos-
tionships between CK and indicators of physical itional breakdown for the sample of players included
match performance in this study may, however, be a was: three fullbacks, three central defenders, two wide-
consequence of the research methodology that was midfielders, four central midfielders and three forwards.
used in the study. These issues include the limited sam- In an attempt to control the potential influence of
pling frequency of the technology that was used to differences in the number of observations on each
evaluate the activities of players within the match, the player impacting the data, a threshold of >6 completed
standard of player included in the sample and most matches per player was used for subject inclusion in this
importantly the small sample size (a single match) on investigation. The study conformed to the ethical
which the relationships were developed. This may standards of the local university ethics committee
mean that the CK data produced from these studies though was not locally approved. This was a direct
cannot provide comprehensive guidelines as to the rela- consequence of the data collection being a condition
tionship between CK and physical match performance of the player’s employment at the soccer club in ques-
and therefore how CK may be used to support coaching tion. Such situations have been recognised by Winter
decisions in professional sport. The aim of this investiga- and Maughan15 as influencing the normal conditions
tion is therefore to examine the relationships between for ethical approval. Every effort was made for the
blood CK measured 48 h post-match and the physical data collection to adhere to recommendations of best
match performance of an elite soccer playing population practice so as to protect the interests and welfare of
across a regular season period. Such data have the both the participants and the researchers. This included
potential to provide information on the effectiveness the Informed consent of both the Head of Sport Science
of biochemical markers to support the decision- and Medical Department at the club in question and
making process associated with coaching in elite soccer. the players.
848 International Journal of Sports Science & Coaching 11(6)

Procedures during data collection due to the nature of this investi-

Match performance data was collected across the entire gation. Such factors are, however, unlikely to impact
39 weeks of the competitive season. Match performance upon the data to any large extent as a consequence of
data were produced using a semi-automated multi- the similarity in individual player’s routines following
camera recognition system (ProzoneÕ , Leeds, each match. Creatine kinase samples were analysed
England) installed at the home stadium of the study immediately after collection via spectrophotom-
team. This system enabled data to be collected on all etry using a commercially available reagent kit
players in the 18 home league matches played in the (ReflotronÕ Systems, Roche, Mannheim, Germany).
EPL season. Kick-off times were between 12:45 and Capillary blood analysed using this method displays
20:00 depending on the fixture schedule and/or the an intra-assay reliability of <3% coefficient of
requirements of the live television provider. All matches variation.19
were preceded by a training session completed on the
day before the match and was followed by a recovery
Statistical analyses
day in which all players were not required to report to
the club’s training facilities. The generation of physical Statistical analysis for the investigation followed two
match performance data using ProzoneÕ is based upon stages. Stage one calculated mean data values for
the development of a continuous movement trajectory each subject’s CK score and each of the ProzoneÕ phys-
for each individual player during match-play.16 Recent ical match performance variables across the available
studies have evaluated the validity and reliability of sample of matches for each individual. The second
ProzoneÕ and found the system to be reliable for mea- stage involved statistical analysis to determine within-
suring match activity in soccer.16–18 subjects correlation coefficients between each player’s
To develop the players’ activity profiles, movements CK values at 48 h post-match and the individual’s phys-
were coded into the following categories and speed ical match performance output collected during the
thresholds: standing (0–0.2 m.s1), walking (0.2– match. These correlation coefficients were calculated
2 m.s1), jogging (2–4 m.s1), running (4–5.5 m.s1), from outputs from the general linear models20 accord-
high-speed running (5.5–7 m.s1), and sprinting ing to the approach of Bland and Altman21,22 using
(>7 m.s1) as in previous investigations.17,18 The fol- SPSS version 17 (SPSS Inc., Chicago, IL, USA). The
lowing physical variables were selected for the analysis data reported in the manuscript are represented as
of the relationship between match performance and mean  SD. For all statistical analysis, p < 0.05 was
post-match CK: (1) total distance covered (TD); considered significant.
(2) total high-intensity running distance (THIRD) (run-
ning speed >5.5 m.s1 over a 0.5 s time interval);
(3) total high-intensity running number (THIRN);
Results
(4) total sprint distance (TSD) (average running speed Table 1 shows the physical match performance data
>7 m.s1 over a 0.5 s interval) and (5) total sprint relating to distance covered for the sample of players
number (TSN); (6) average speed (AVE) (average from the matches that were associated with the data
speed is the mean value (metres per second) of the collection for blood CK concentrations used in this
speeds that have been completed by a specific player investigation. These values are similar to those
for specific time periods; and (7) recovery time (REC)
(average time in seconds between high intensity activity
bouts >5.5 m.s1).
Blood samples were taken from each participant’s Table 1. Physical match performance data by position for the
distance covered in the games selected for analysis (mean  SD).
fingertip at a time point approximately 48 h post-
match. All samples were taken between the hours of Position Total distance (m) THIRD (m) TSD (m)
09:00 and 10:00 prior to the start of training. The sam-
ples were collected in a standing position using a sterile CD 9672  389 534  122 133  51
lancet (Roche, Mannheim, Germany) in combination WD 10507  428 1035  189 339  102
with a spring-loaded Accu-Chek lancet device (Roche, CM 11454  763 1161  279 326  123
Mannheim, Germany). Every effort was made to con- WM 10663  975 1331  254 451  150
trol a range of factors that have the potential to impact ST 10476  647 1180  275 338  136
CK concentration. These included the time of day and Overall 10574  854 1030  358 312  154
the immediate nutritional intake prior to the sample
Total distance: total distance covered; THIRD: total high-intensity running
collection. Other potentially important variables such distance; TSD: total sprint distance (average  SD); CD: central defender;
as post-match nutrition and activity not associated with WD: wide defender; CM: centre midfielder; WM: wide midfielder,
official training sessions could not be rigidly controlled ST: striker.
Scott et al. 849

Table 2. Creatine kinase values by position in the games Table 3. Table showing the relationship between creatine
selected for analysis (mean  SD, minimum, maximum values). kinase and physical match performance variables.

Average 95% Confidence

Position CK value Min. value Max. value Intervals

CD 437  200 203 1250 Sig. Lower Upper

WD 511  110 296 758 Variables R-value (p < 0.05) bound bound
CM 566  310 184 1573 Total distance (m) 0.076 0.34 0.072 0.221
WM 612  169 365 1110 HSRD (m) 0.045 0.57 0.103 0.191
ST 513  220 210 1360 HSRN (No.) 0.051 0.52 0.097 0.097
Overall 520  224 184 1573 THIRD (m) 0.083 0.30 0.065 0.228
CD: central defender; WD: wide defender; CM: centre midfielder; THIRN (no.) 0.018 0.82 0.13 0.165
WM: wide midfielder, ST: striker. HIRP (m) 0.058 0.47 0.09 0.204
HIRWP (m) 0.002 0.98 0.145 0.149
previously reported for elite players in the litera- TSD (m) 0.108 0.71 0.04 0.251
ture.17,18 The THIRN and TSN (140  43 and TSN (m) 0.084 0.29 0.064 0.229
46  19, respectively) also seem representative of this Ave. Speed (m/s) 0.146 0.64 0.001 0.287
type of data.17,23 The REC and the AVE are broadly Rec Time (s) 0.057 0.47 0.091 0.203
representative of the overall intensity of effort of indi-
vidual players across the match. The REC was 44  18 s Total distance: total distance covered; HSRD: high-speed running dis-
tance; HSRN: high-speed running number; THIRD: total high-intensity
with the AVE calculated as 1.9  0.1 m.s1. running distance; THIRN: total high-intensity running number; HIRP:
Average CK concentration for the sample of players high-intensity running with possession; HIRWP: high-intensity running
48 h post-match was 520  224 m.mol.l1 (see Table 2). distance without possession; TSD: total sprint distance; TSN: total
Individual player values showed great variation in the sprint number; Ave. Speed: average speed; rec time: recovery time.
CK response to matches. This variation ranged from
184 m.mol.l1 to 1573 m.mol.l1. The R-values obtained
from the correlation coefficients signify the strength of The application of the data in this manuscript is
the relationship between CK and the selected ProzoneÕ partly dependent on the extent that the information
variables (see Table 3). No significant relationships can be generalised to other populations of soccer
were observed between any indicator of physical players. The physical match performance metrics
match performance and CK concentration measured included in our study are similar to those reported in
48 h post-match (see Figure 1). a range of previously published literature.17,23–25 This
would seem to indicate that our sample is reflective of
the physical demands that are associated with profes-
Discussion
sional soccer at this competitive standard. The concen-
The aim of this investigation was to examine the rela- trations of CK that were observed 48 h post-match
tionships between blood CK obtained at 48 h post exer- (520  224 m.mol.l1) are comparable to those in similar
cise and the physical match performance of a group of athlete populations (Coelho et al.,10 þ102%; Nedelec
elite soccer players using information from a compu- et al.,7 þ105%). This would support the data within the
terised semi-automatic tracking system (ProzoneÕ ). literature that the completion of a professional soccer
Our findings suggest that the activity completed match leads to significant increases in CK.
within a match is not related to the CK concentrations The physiological understanding of the reasons for
that are observed 48 h post-match. This would suggest increases in CK following exercise is not well under-
that CK at this time point may not be of value for stood.2,3 It has been suggested that high CK levels are
practitioners to track subtle changes in the physical a function of the damage to muscle cell membranes
match performance potential of players during the during exercise.26 Such damage may be related to the
competitive season. As such, measuring CK may not amount of eccentric activation of the muscle as such
be of great use in supporting important decisions for actions result in a higher tension per cross sectional
coaches related to the physical status of players. Based area.14 These actions are common during intense
on our data, practitioners who are involved in the sci- bouts of activity within a soccer match2 and therefore
entific support of players in elite soccer environments are a potential explanation for the findings in this inves-
may therefore be advised to consider alternative tigation. Our sample also displayed a large variation in
physiological/biochemical markers within their moni- the CK concentrations observed as noted previ-
toring programmes during time periods between games. ously within research on team sports players.2,10,13,26
850 International Journal of Sports Science & Coaching 11(6)

Figure 1. Elite soccer player’s creatine kinase relationships compared to selected physical performance measures. (a) Total distance
covered; (b) average speed (m/s); (c) recovery time (s); (d) high-speed running distance (m); (e) total sprint distance (m); (f) total
high-intensity running distance (m); (g) high-speed running number (n); (h) total sprint number (n); (i) total high-intensity running
number (n); (j) total high-intensity runnig distance in possession (m); (k) total high-intensity running distance out of possession (m).

Such variations are highly likely to be a result of the The current investigation is the first that has examined
individual characteristics of players (e.g. age, fitness the relationship between post-match CK and physical
level, etc.) that can affect CK concentration2,27 and/or indicators of match performance in this elite population
if the individual in question can be classified as either a across multiple matches using highly accurate move-
responder or non-responder with respect to CK ment analysis techniques. Our data failed to demon-
response.28 strate any significant relationships between any
The marked differences observed in CK concentra- indicators of physical match performance and 48 h
tion from pre to post-match may be partly due to the post-match CK values. This is in contrast to the find-
different amounts of specific match activities/actions ings of Lazarim et al.2 who were able to use the data
completed by soccer players.2 They may also be a they collected to link to performance by the application
direct result of any match-related injuries that were an upper CK threshold to determine whether a player
experienced by the participants during the game.28 required a reduced training load for the following week.
Scott et al. 851

Data from other team sports do, however, support our with a group of elite soccer players competing in a
findings by illustrating that physical variables, such as high-level team in a competitive season in the EPL.
tackles and impacts, are more clearly associated with This approach influenced potentially important aspects
CK than the movement patterns that are common in of the research design of this investigation, more spe-
team sports such as soccer.29,30 This would support the cifically the collection of additional CK samples in and
idea that CK is influenced by the damage associated around the competitive fixture (e.g. more pre-match
with injuries linked to competition.28 This evidence and post-match samples). These restrictions clearly
would suggest that CK values obtained 48 h post exer- limit the potential to determine a detailed CK response
cise might not accurately reflect changes in the activity to the preparation for and recovery from match-play
profiles completed by soccer players during EPL or examine the relationships between CK and phys-
matches. Such monitoring approaches may not there- ical match performance at other time points post-
fore be useful in tracking the physiological stresses exercise.
associated with elite competitive match-play at this
time point and as a consequence may limit the infor-
mation that can be provided to support the team selec-
Conclusion
tion process based on an individual player’s response to Understanding the relationships between match per-
specific match demands. formance and indicators of the status of the muscular
The failure to observe a link between the movement system in the elite soccer player who will compete in a
profile of EPL players and CK in our data may be a large number of matches (>60) during a domestic
function of the experimental design that was employed season would seem to be an important practical con-
within this investigation. Such methodological issues sideration. This type of data may give coaches an
may be related to either the variables chosen for ana- insight into the ‘‘readiness’’ of individual players and
lysis and/or a consequence of the ‘‘real world’’ therefore provide input into decisions such as team
approach to this research investigation. The variables selection or individual player preparation strategies.
chosen to explore the links between CK and movement While it has been suggested that CK provides a poten-
profiles were based upon previously identified import- tial biochemical marker for use in elite team sports, our
ant match performance indicators.17,25,31 As such, our data indicate that changes in CK concentrations at 48 h
approach reflects an evidence-based evaluation of an post-match do not seem to be linked to the locomotor
individual’s physical match performance. The semi- activity completed by soccer players during EPL
automatic computerised tracking system used to gener- matches. This would indicate that CK may not be
ate the data in this investigation has the potential to used within elite soccer clubs to provide an indication
provide additional movement-related and technical of the specific match activities completed by during
variables. While the importance of these variables has games. CK concentrations do, however, seem to be sen-
not been systematically evaluated with respect to their sitive to the overall demands of match-play (e.g. the
importance to elite professional match-play, they have physical stress, injury) that may be associated with
the potential to influence the CK response 48 h post- the game. As such it may be useful on a more general
match. For example, accelerations and decelerations level of athlete monitoring. The ‘‘real world’’ approach
(that involve substantial eccentric components) are fre- to this study is, however, associated with limitations
quently completed during matches.32,33 Future research that do not permit a comprehensive recommendation
should attempt to investigate the links between such on the application of CK analysis to athlete tracking to
variables and 48 h post-match CK concentrations to be made. As such, this area requires further consider-
see if these are more strongly related than more trad- ation especially with respect to an understanding of
itional indicators thought to be representative of individual player characteristics and the time course
players’ activity profiles. Our investigation also failed of CK responses to acute and chronic exercise. Other
to examine the potential relationships between the areas of future research should include the examination
observed CK concentration and indicators of neuro- of the relationship between other biochemical (e.g. IgA,
muscular function such as assessments of range of hormone concentrations), neuromuscular (e.g. jump
motion, jump performance, and/or sensitivity to performance), physiological (heart rate responses) and
direct muscular palpation. The inclusion of such data subjective responses (RPE, wellness, sleep) and match
in future research would facilitate the interpretation of activity.
CK data and its link to player status.
‘‘Real world’’ approaches to research provide data Declaration of Conflicting Interests
that is high in ecologically validity yet which may be The author(s) declared no potential conflicts of interest with
limited in terms of its degree of traditional experimental respect to the research, authorship, and/or publication of this
control. The data in this investigation were collected article.
852 International Journal of Sports Science & Coaching 11(6)

Funding 17. Di Salvo V, Gregson W, Atkinson G, et al. Analysis of

high intensity activity in premier league soccer. Int J
The author(s) received no financial support for the research,
Sport Med 2009; 30: 205–212.
authorship, and/or publication of this article.
18. Gregson W, Drust B, Atkinson G, et al. Match-to-match
variability of high-speed activities in premier league
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