England has recently secured its place at the FIFA Men’s Football World Cup and will be facing Senegal on Sunday. As knockout stage momentum builds up, Consultant Cardiologist Dr Manav Sohal discusses the effects of elite-level football training on the heart and the benefits of a more recreational approach.

The intermittent high-intensity activity is the real challenge

Elite-level footballers typically partake in 12-14 hours of intensive training per week and will have spent countless hours honing their craft from an early age.  The result of these many hours of effort is usually a finely-tuned athlete capable of bringing joy to millions of fans with a burst of pace, a graceful turn and a powerful strike into the top corner of the net. 

Where athletes differ

The physiological demands of elite-level football are related to the nature of the exercise patterns.  Players usually perform activity that includes both a dynamic and a static component.  The need for frequent changes in both speed of movement and direction makes the activity profile intermittent and is characterised by both aerobic and anaerobic energy expenditure. 

Elite football players almost invariably have low resting heart rates but will be able to reach peak heart rates in excess of 190 beats per minute when reaching maximum intensity, and it is this wide range that distinguishes them from non-elite athletes who are ‘recreationally’ fit.  Put more simply, elite-level footballers will have a number of ‘gears’ through which they can shift according to the ebbs and flows of a match.

The long-term intensive training programme leads to several changes to the structure and function of the heart as well as to the cardiovascular system as a whole. At a basic level, the heart is effectively a muscle pump, and it has four chambers, two receiving chambers at the top and two pumping chambers at the bottom.  Much like your arm muscles when you go to the gym, the heart muscle will get bigger as it works harder. 

Elite footballers typically have larger chambers with thicker walls and excellent pumping function.  These changes typically persist whilst training continues at a high level but will regress once activity tapers off. 

The electrical changes accompanying high-level training, such as a slow heart rate, may persist and athletes training in such volumes are up to five times more likely to develop abnormalities of their heart rhythm, including atrial fibrillation.

What about the cardiac effects of football for the rest of us?

Recreational football conducted as small-sided games such as 4v4 to 6v6 has broad-ranging physiological effects with more pronounced changes achieved than through recreational running, interval running and fitness training. 

Its marked effect on the cardiovascular system may, in part, be a result of average heart rates being around 80% of maximal heart rate during training, with a substantial amount of time spent at 80-90% irrespective of age, fitness status and previous experience of football training.

Importantly, 65–75-year-old men with no prior experience of football, overweight men with type 2 diabetes, and men with prostate cancer have been shown to be able to perform football training with a significant amount of time spent with a heart rate above 80% of predicted maximum. 

In one study, over one hour, participants typically completed over 100 runs, dribbles, shots, tackles, turns and jumps per session.  Crucially, despite the high heart rates during training, recreational football had the lowest score in perceived exertion in comparison with other activities such as jogging, interval running and fitness training. 

This might explain why participants found the game enjoyable and maintained interest even after the study period was over.  This tells us that recreational football can be something picked up by a wide spectrum of people with little or no experience.

So, we have seen that recreational football training conducted in small-sided games promotes health.  It results in favourable changes and the changes typically occur within the first three months. 

Football is by far the most popular sport in the world, with more than 400 million active players.  As well as the physical benefits, recreational football is associated with positive psychosocial interactions and is more likely to be sustained in the long term when compared to other activities, such as running.

8 reasons why you should take up recreational football this world cup season

As attention turns to the Men’s Football World Cup, it might inspire many of you to give it a go.  Football does not have to be played at 100mph and most folk will be able to participate. 

The potential benefits to your cardiovascular system could be significant and you are in serious danger of enjoying it hugely!

Studies have shown that the benefits specific to the recreational participant training for an hour once or twice a week are:

1. Blood pressure lowering - This effect can be significant and the reduction seen is often more pronounced than that seen with other types of exercise.
2. Lower resting heart rate- an indicator of better underlying cardiovascular fitness.
3. Better heart pump function.
4. Reduced LDL or ‘bad’ cholesterol.
5. Reduced weight and body fat.
6. Stronger bones including higher bone mineral density.
7. More efficient utilisation of oxygen by muscles.
8. Better balance.

How to practice recreational football safely

Like all high energy cardio activities, it is important to gradually increase speed , intensity and effort. If you have any family history of heart conditions or experience symptoms whilst playing or at rest, a Cardiac Screening can help give you peace of mind and play football safely.

If you have any concerns regarding your heart and suitability for participation in recreational football or exercise in general, our  team of Consultant Cardiologists are very happy to provide guidance at our Cardiac Health clinisc at New Victoria Hospital.

For more information, please call us on 020 8949 9030 or email us at [email protected]