Modern elite football is getting more and more demanding in terms of the numbers of matches played during the season that may add extra physical and mental load to the players. A top level European team used to play around 50 matches in the 2008/2009 season, and this number has increased to around 60 in the 2018/2019 season. In addition, for the most outstanding players, we also have to add the friendly matches as well as the international fixtures to the total. This may result in more than 70 matches played per season.1 The UEFA Elite Club injury study with 36 top European clubs reported a 2.5-fold increase in training and match time between the 2001/2002 and 2013/2014 season,2 and this constitutes an elevated workload for the players. Tactical changes in match play and the new organizational initiatives launched by FIFA are expected to have a massive impact on players` physiological and psychological demands. The number of matches played will probably rise substantially in the near future as a consequence of the following: (a) From 2021 or later, as the final decision of FIFA on fixtures reshuffling due to COVID-19 pandemic is pending, the expanded edition of the FIFA Club World Cup will be launched with 24 teams participating; (b) the FIFA World Cup Qatar 2022 will be held in November and December, right in the middle of most European league competitions; and (c) from 2026, the FIFA World Cup will be played with 48 teams instead of 32 that participate now. These changes collectively with the increasing number of knockout matches in the FIFA tournaments will increase the occurrence of extra-time imposing additional challenge to players and to team preparation.3 The aim of this editorial was to explore the evolution of the game and speculate on the potential impact the organizational and tactical changes may have on players` performance, mental, and physical health. The ultimate aim was to prepare the medical, sports science, and coaching staff on better handling the challenges ahead.
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