EPL 2030: Active Skin, Graphene Sensors and Future of Football Injury Prevention

Ed HawkinsSpecial to Bleacher ReportJune 13, 2017

B/R

Imagine a world where a team could keep track of their star player 24 hours day. You could see what they had for breakfast, when they last went to the toilet, which muscles were in danger of tearing—even whether they had engaged in sexual intercourse the night before a big match.

To take things further, what if you could send electric signals pumping through a player's body to ensure they performed a pass correctly or struck the ball with perfect technique? It might sound like fantasy, but it could be here sooner than you think.

The idea of an "active skin," of membranes printed onto the human body, has been discussed and explored in laboratories, meeting rooms and coffee shops across the world. The technology may only be five to 10 years away. That's according to Dr. Ian Pearson, one of the world's leading futurologists. He believes professional football clubs will eventually move away from wearable technology, such as GPS monitors, and begin printing directly onto the skin of their players.

"The technology for printing membranes is already here; people are sticking membranes on their bodies," Dr. Pearson told Bleacher Report. "There is smart and electric skin to pick up bio signs like skin conductivity, moisture in the skin to see if the player is sweating heavily, while shining light beams into the skin and picking up reflections can tell you all about blood oxygen level.

"It might give you clues to players' fitness, and you can use that to monitor them over months. That kind of technology is already here, but if you wanted to print straight onto the skin, you might have to wait for five to 10 years. A lot of these technologies would help with training and player performance."

Pearson expects the miniaturisation of such membranes will allow printing to take place electronically directly onto the skin, which will enable players to be tracked every minute of the day both on and off the training field.

No cost is being spared when it comes to injury prevention in football
No cost is being spared when it comes to injury prevention in footballDave Thompson/Getty Images

"For someone valuable like a footballer, it would be worth doing," Pearson said. "It would cost a lot to have your body covered and monitored, but it's very economical for footballers. The manager and medics would then have a constant readout of every single player on the field. They could analyse all of that. They could have a simple alert system, where it alerts them that a player has a leg injury and would recommend pulling them off or they'd be no use for the next couple of matches."

Electronic capsules on the skin could aid player development in the future, Pearson said. By blasting these tiny devices, it would be possible to make contact with nerve endings and blood capillaries, leading to better data readings and feedback.

While that technology may be some way off in terms of miniaturisation, he believes performance can be accelerated by giving direct neurofeedback while a player is training. This is the line where the player and robotics clash—not to mention an ethical conundrum for those within the game.

"If you have a new signing, showing lots of promise, you can accelerate that progress by giving them direct neurofeedback while they're doing something," Pearson explained.

"If you are trying to kick a ball in a particular direction, the computer knows the correct arc your foot should be going through, and obviously with some natural talent, you'll be doing it almost right anyway, but perhaps not perfectly. What you want is for that person to get their muscle memory really toned so the perfect kick feels much more comfortable than the imperfect kick and so you remember to do it more comfortably.

"The more you do it, the better you get, and you can do that by putting signals into the nervous system in the active skin. You can create direct links from the skin to the nervous system. You could get the player to do what felt right and the computer would make sure it felt right. The computer could accelerate your learning because you would be learning the correct way to do something from the start."

While to some the idea of a player being hit with electric pulses to ensure they can correctly curl home a free-kick from 30 yards may sound rather outlandish, the idea of an active skin is closer than expected.

One of the materials being considered for such a project is graphene. The thinnest material on earth, one million times thinner than a human hair and the world's first two-dimensional material, it is atom thick. Discovered in 2004 by Nobel Prize-winning pair Professor Andre Geim and Professor Kostya Novoselov at the University of Manchester, graphene could prove revolutionary in how players are monitored and analysed.

Professor Andre Geim, left, and Dr. Konstantin Novoselov are seen outside Manchester University
Professor Andre Geim, left, and Dr. Konstantin Novoselov are seen outside Manchester UniversityJON SUPER/Associated Press/Associated Press/Associated Press

Dr Mohammad Nazmul Karim, of the National Graphene Institute in Manchester, believes the day when graphene will be used in football could come within the next couple of decades. While the material is already used in the production of tennis rackets and Formula One cars, it is yet to be tested on skin. He predicts graphene-based inks could be printed onto textile materials such as football shirts in the coming years.

"We're still not quite sure about the toxicity of graphene, and people are working to find out whether there are any problems with it or not," he said. "I am hoping something will happen before 20 years, and maybe in the next two or three. The one we are missing is producing high-quality graphene ink in high quantity. Once we get to that point, maybe we'll be able to do big productions. We have printed graphene onto textiles, and it is highly conductive—you could make a device from it.

"You can paint sensors, print a battery and use solar cells to power it. In an ideal garment like a football shirt, you could print a sensor and connect that to a battery and connect it with solar panels. That's an idea we are working on."

The wait for such devices to hit the market will likely be long. In the meantime, clubs have already placed their faith in wearable technology and systems devised by market leaders such as U.S.-based company Kitman Labs. CEO Steve Smith, who learned his trade in Ireland with Leinster Rugby, now leads a brand that works with Championship side Norwich City and Everton in the Premier League, as well as numerous other sports brands.

Kitman Labs worked with Norwich and Everton
Kitman Labs worked with Norwich and EvertonMatthew Lewis/Getty Images

Smith says clubs want information instantly—how players sleep, what their body is doing and how they deal with stress on a daily basis. What Kitman Labs does is use a system comprising of three components that has helped reduce client injuries by roughly 30 per cent.

The Capture tool—a 3D-video-based athlete assessment system—enables coaches to perform individual biomechanical examinations on players in less than a minute. The mobile app that accompanies this, Athlete, allows the player to register how they are feeling and their wellbeing. The profiler takes this information, collates it and adds other layers to generate individual alerts for each player. It's cloud-based, so it can be accessed easily from any device connected to the internet.

Capture takes into account whether an athlete is leaning on one leg more than the other, whether there are any weaknesses in certain muscles or forming patterns that could give employers clues as to how an injury may be sustained. It's about giving coaches warning signs that an injury may be imminent—proactive rather than reactive.

The system can track whether a player is struggling with a less flexible hamstring, or a calf muscle that is beginning to strain, hence alerting the coach to a potential problem. That alert could help prevent the team losing one of its star players during a crucial period of the season.

Smith is conscious to point out that while many systems can track sleep or movement, they are not conducive to the individual. What may apply to one player may not to another. In essence, what is needed is a tool that treats each athlete on a case-by-case basis.

"It's pretty ridiculous to think every athlete is going to respond the same," Smith told Bleacher Report. "To think that whatever causes a hamstring injury in one athlete is going to cause the same in another athlete is a pretty naive view. As humans, we are very unique and very complex. The future is having individual threads of proactive healthcare."

Smith believes football has a strong appetite for such tools, but he is cautious and wary of the challenges such technology could face.

"The most dangerous thing about dealing with data is the people who misinterpret it," he said.

"Utilising data we don't understand is quite dangerous because if we use that to change an athlete's training problem or limit what they do, then effectively we're limiting their athletic potential. If we are doing that in the dark, then we're actually affecting careers."

Leading clubs—including Atletico Madrid, AC Milan, Borussia Dortmund and Leicester City—have placed their faith in a different company, Catapult. Like the methods used by Kitman Labs, it charts the progress of players and can spot patterns in players' routines that may be useful in preventing further injury. Using inertial sensor data by employing accelerometers, magnetometers and gyroscopes, it's able to keep track of even the smallest movements each player is making.

Atletico Madrid are one of the clubs looking to gain an edge in injury prevention
Atletico Madrid are one of the clubs looking to gain an edge in injury preventionDenis Doyle/Getty Images

For those working in the sports science industry, such as Dr. Carl Wells, who works at Perform at St. George's Park, which is one of the leading sports-science centres in the world, wearable technology plays a crucial part in monitoring players. Wells said those in the wearable technology sector are still in search of the perfect product.

"There are one or two products out there which are striving to get there, but aren't quite there yet from the experience we've had," he said.

"A football player spends three or four hours out there on the training field; the rest of the time they're away from the club, and you want to know what they're up to. So can the technology then feed back into the club what they're getting up to?

"We want to know what kind of rest they're getting, what their quality of sleep is like, looking at heart rate variability, what their breathing rate is like, what physical status they're in when they're not at the club itself. I think that's the holy grail. I think that's what a number of companies are working towards, but nobody seems to have the perfect model yet."

While technology is advancing rapidly, the human body is also going through changes of its own. For Wells, who regularly presents his research at international meetings, the past 20 years have seen a huge improvement in the fitness and general wellbeing of players. He cites Jamie Vardy as one of the game's most ideal specimens in terms of shape, physique and athletic ability, as well as Everton's Yannick Bolasie and Crystal Palace's Wilfried Zaha, both of whom he has worked with in the past.

Vardy, who has a body fat percentage of less than eight per cent—reduced to six when using calculations from a seven-site skin-fold test—helped Leicester to the Premier League title and is now a fixture in the England squad. His sprinting ability, which has been a feature of Leicester's counter-attacking, is an example of the new breed of player, according to Wells—and perhaps provides the prototype for what players may look like in the future.

"There's a mix of both evidence-based research and also anecdotal-based evidence on how a footballer's body has changed over the past 20 years," Wells said.

"Players are leaner, their body composition has improved. They have less body fat, have a higher level of lean body mass, and typically they tend to be taller. Though it's always important to remember in football, because it's predominantly a skill-based sport, you're always going to get that variety of body type within the team.

"We're seeing research over the past seven years in the Premier League that the amount of high-intensity running and number of sprints performed has increased massively. High-intensity distance has gone up by 35 per cent. The number of high-intensity activities has increased by 80 to 85 per cent, and that research is published. It really is evident that the game is quicker and quicker.

"Moving forward, the game will have players who have the physical capabilities and resilience to play the game quicker week in, week out. Players will have to be quick, even more athletic in terms of body composition and fibre-type composition to perform repeated high-intensity bouts."

Jamie Vardy has a body fat percentage of less than eight per cent
Jamie Vardy has a body fat percentage of less than eight per centTony Marshall/Getty Images

If Wells' prediction rings true, the load on players will have to be carefully managed, or injuries could become more prevalent. According to a UEFA report published in 2014, which examined injuries to players at some of Europe's top teams, it was noted the average team sustained 3.4 injuries per 1,000 hours in training, but that number increased markedly within games, climbing to 23.2 injuries per 1,000 hours.

If the tempo of the game increases, will players be able to endure the extra physical demands placed on them, or might they eventually burn out? "It's about what approach sports scientists take in managing the load the player experiences," Wells explained.

"Research now suggests if you do that (play high-intensity games) too often, the body doesn't build its natural resilience to the ever-increasing demand of the quicker game. The best way to deal with this is not to train less but to train more."

While technology has helped solve a number of problems, there are still areas that remain a source of frustration for those working within football's medical departments. The slow recovery and rehabilitation from anterior cruciate ligament (ACL) injuries remains a major area of concern, as does the treatment of concussions.

For Dr. Charlotte Cowie, head of performance medicine at the English Football Association, the quest to find a way to regenerate cartilage and muscle is one of the most important issues facing those in the business. While there has been some encouragement in terms of stem cell use, she believes there could still be a 20-year wait for an ideal method.

"I think in terms of sporting injuries, there are two areas of tissue that don't heal very well by themselves, and those are tendons and cartilage," she told Bleacher Report. "Quite often the career-ending injuries that people suffer, unless they get a catastrophic trauma where they suffer a really bad tackle, are the wear-and-tear injuries, which tend to occur in tendons such as the patellar and Achilles, and within cartilage, particularly within the knee in footballers."

At the moment, knee cartilage is often replaced with cartilage taken from elsewhere in the body in order to help it regrow, but this has mixed results. The way cartilage regrows in the body, where it becomes known as fibrocartilage, means it's not as strong or durable as the natural version humans are born with. The failure to find a worthy replacement has left hundreds of players in pain after their careers have ended, while others have been forced to retire prematurely.

St. George's Park is one of the leading sports-science centres
St. George's Park is one of the leading sports-science centresHandout/Getty Images

"We don't have a way of getting an area of damaged cartilage to regenerate in the same way it started off as," Cowie said. "There's always a little bit of a compromise one way or the other. Some people do get good results, but sometimes they're not really long-lasting. Others have an operation. Some operations players have, you can guarantee that 90 per cent of the time it will have a positive effect, but some of the ones that are put in place to deal with large areas of damaged cartilage have a lower success rate."

While it remains uncertain what the next 10 to 15 years may bring in terms of medical advancement and invention, all those interviewed believe the game will get faster and more intense and will place more emphasis on analytics. This all adds up to more reliance on those within the world of sports science. As the competition between clubs on the field becomes ever greater, the battle to ensure players are as fit and as powerful will only intensify. The investment in injury prevention is expected to increase heavily even if caution still remains.

"All of these things are only as good as the person who is inputting the information," Cowie said with caution. "There was a point 10 years ago when I thought we were heading towards everyone being big and super muscular, but there are always people proving us wrong—Jamie Vardy being one.

"I think if you’ve got the skills and physical attributes as well as the technical and tactical awareness, those things are always going to be as important, if not more important than your physical prowess in this game. That’s what makes football different to a lot of other sports—it’s what makes it exciting as well."

All quotes and information obtained firsthand unless otherwise indicated.