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Ayala F, Robles-Palazón FJ, Blázquez-Rincón D, López-Valenciano A, López-López JA, De Ste Croix M. A systematic review and network meta-analysis on the effectiveness of exercise-based interventions for reducing the injury incidence in youth team-sport players. Part 2: an analysis by movement patterns. Ann Med 2024; 56:2337724. [PMID: 38614120 PMCID: PMC11018023 DOI: 10.1080/07853890.2024.2337724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 02/29/2024] [Indexed: 04/15/2024] Open
Abstract
The objectives of this network meta-analysis were: (a) to estimate and compare the pooled effects of some injury prevention programs (IPPs) whose exercise-based components were categorized using a movement pattern-specific taxonomy on reducing overall and some specific body regions (lower extremity, thigh, knee, and ankle) injury incidences in youth team sport athletes and (b) to explore the individual effects of these components on the injury incidence rates (IIRs) previously mentioned. Searches were performed in PubMed, Web of Science, SPORTDiscus, and Cochrane Library. Eligible criteria were: exercise-based interventions comprised of exercises involving athletic motor skill competencies and evaluated against a control group, overall IIRs were reported, and youth (≤19 years old) team sport players. For the current analysis, a taxonomy based on movement patterns was employed for exercise component identification (upper body pushing and pulling; lower body concentric and eccentric; core; mechanics; acceleration; and lower body stability). Pooled effects were calculated by frequentist random effects pairwise and network meta-analyses. Nineteen studies were included. Most of the IPPs exhibit risk reduction when compared to their control groups on overall, lower extremity, and ankle injuries. Interventions comprised of lower body concentric and eccentric, core, mechanics, and lower body stability exercises were the most effective measures for reducing these injuries. None of the IPPs demonstrated to be effective for reducing thigh injuries, and contradictory results were found for knee injuries. Individual analysis at component level revealed that the lower body (bilateral and unilateral, concentric, and eccentric) component was the only one associated with a significant reduction on overall injuries. Indirect evidence suggests that interventions incorporating lower body concentric and eccentric, core, mechanics, and lower body stability exercises might be the most effective for reducing overall, lower extremity, and ankle injuries in youth team sports.
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Affiliation(s)
- Francisco Ayala
- Department of Physical Activity and Sport, Faculty of Sport Sciences, Campus of Excellence Mare Nostrum, University of Murcia, Murcia, Spain
- School of Education, Sport and Applied Sciences, University of Gloucestershire, Gloucester, UK
| | - Francisco Javier Robles-Palazón
- Department of Physical Activity and Sport, Faculty of Sport Sciences, Campus of Excellence Mare Nostrum, University of Murcia, Murcia, Spain
- Centre for Human Movement and Rehabilitation, University of Salford, Salford, UK
| | - Desirée Blázquez-Rincón
- Department of Psychology and Education, Faculty of Health Sciences and Education, Madrid Open University (UDIMA), Madrid, Spain
| | - Alejandro López-Valenciano
- Department of Education Science, School of Humanities and Communication Sciences, CEU-Cardenal Herrera University, Castellón de la Plana, Spain
| | - José Antonio López-López
- Department of Basic Psychology and Methodology, Faculty of Psychology and Speech Therapy, University of Murcia, Murcia, Spain
| | - Mark De Ste Croix
- School of Education, Sport and Applied Sciences, University of Gloucestershire, Gloucester, UK
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Vermeulen R, van Dyk N, Whiteley R, Chamari K, Gregson W, Lolli L, Bahr R, Tol JL, Serner A. Injury-inciting circumstances of sudden-onset hamstring injuries: video analyses of 63 match injuries in male professional football players in the Qatar Stars League (2013-2020). Br J Sports Med 2024:bjsports-2023-106722. [PMID: 39242176 DOI: 10.1136/bjsports-2023-106722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2024] [Indexed: 09/09/2024]
Abstract
OBJECTIVE To describe and categorise the injury-inciting circumstances of sudden-onset hamstring match injuries in professional football players using systematic video analysis. METHODS Using a prospective injury surveillance database, all sudden-onset hamstring match injuries in male football players (18 years and older) from the Qatar Stars League between September 2013 and August 2020 were reviewed and cross-referenced with broadcasted match footage. Videos with a clear observable painful event (ie, a player grabbing their posterior thigh) were included. Nine investigators independently analysed all videos to describe and categorise injury-inciting circumstances. We used three main categories: playing situation (eg, time of injury), player action(s) (eg, running) and other considerations (eg, contact). Player action(s) and other considerations were not mutually exclusive. RESULTS We included 63 sudden-onset hamstring match injuries out of 295 registered injuries between 2013 and 2020. Running was involved in 86% of injuries. Hamstring injuries occurred primarily during acceleration of 0-10 m (24% of all injuries) and in general at different running distances (0-50 m) and speeds (slow to fast). At 0-10 m distance, indirect player-to-player contact and inadequate balance were involved in 53% and 67% of the cases, respectively. Pressing occurred in 46% of all injuries (injured player pressing opponent: 25%; being pressed by opponent: 21%) and frequently involved player-to-player contact (69% of the cases when the injured player was pressing vs 15% of the cases when the opponent was pressing) and inadequate balance (82% vs 50%, respectively). Other player actions that did not involve running (n=9, 14% of all injuries) were kicking (n=6) and jumping (n=3). CONCLUSION The injury-inciting circumstances of sudden-onset hamstring match injuries in football varied. The most common single-player action (24%) was acceleration over a distance of <10 m. Pressing, inadequate balance and indirect contact were frequently seen player actions. Injury prevention research in football should look beyond high-speed running as the leading risk factor for sudden-onset hamstring injuries.
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Affiliation(s)
- Robin Vermeulen
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
- Amsterdam University Medical Centers, Academic Medical Center, Amsterdam Movement Sciences, Academic Center for Evidence Based Sports Medicine, Amsterdam IOC Center, ACHSS, Amsterdam, The Netherlands
| | - Nicol van Dyk
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
- School of Public Health, Physiotherapy and Sport Science, University College Dublin, Dublin, Ireland
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Rod Whiteley
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Karim Chamari
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
- Naufar, Wellness and Recovery Center, Doha, Qatar
| | - Warren Gregson
- Football Performance and Science Department, Aspire Academy, Doha, Qatar
- Department of Sport and Exercise Sciences, Manchester Metropolitan University Institute of Sport, Manchester, UK
| | - Lorenzo Lolli
- Football Performance and Science Department, Aspire Academy, Doha, Qatar
- Department of Sport and Exercise Sciences, Manchester Metropolitan University Institute of Sport, Manchester, UK
| | - Roald Bahr
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
- Department of Sports Medicine, Oslo Sports Trauma Research Center, Norwegian School of Sports Sciences, Oslo, Norway
| | - Johannes L Tol
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
- Amsterdam University Medical Centers, Academic Medical Center, Amsterdam Movement Sciences, Academic Center for Evidence Based Sports Medicine, Amsterdam IOC Center, ACHSS, Amsterdam, The Netherlands
| | - Andreas Serner
- Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
- FIFA Medical, Fédération Internationale de Football Association, Zurich, Switzerland
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Ohtsubo R, Saito H, Hirose N. Characterizing Muscle Activity in Soccer Players with a History of Hamstring Strain Injuries during Accelerated Sprinting. J Sports Sci Med 2024; 23:656-662. [PMID: 39228776 PMCID: PMC11366853 DOI: 10.52082/jssm.2024.656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 07/31/2024] [Indexed: 09/05/2024]
Abstract
This study aimed to characterize muscle activity in male soccer players with a history of hamstring strain injuries (HSI) during accelerated sprinting. Thirteen patients each in the HSI group (history of HSI) and in the healthy group (with no history of HSI) were included. 26 male soccer players of which 13 with and 13 without HSI history were included in this study. Ten muscles were evaluated on electromyography activity during overground sprinting. The testing protocol consisted of a maximal sprint over a distance of 30 meters. One running stride was divided into the early stance phase, late stance phase, early swing phase, mid-swing phase, and late swing phase, and the average muscle activity per phase and the timing of the peak root-mean-square value appearance during each stride were calculated. Statistical analysis was performed using repeated-measures two-way ANOVA (group × phase), and multiple comparison tests were performed using the Bonferroni method when the interaction or main effect was significant. The statistical significance level was set at p < 0.05. Gluteus maximus (Gmax), gluteus medius (Gmed), and external oblique (EO) showed activity differences based on HSI history. Gmax was 30% lower, EO was 20% lower, and Gmed was 40% higher in HSI group. This study suggests that, despite previous findings that HSI is most likely during the late swing phase, the HSI group shows a higher injury risk in the early stance phase. This is due to differences in trunk and gluteal muscle activity between the late swing and early stance phases compared to the healthy group. In summary, HSI group had lower activity in the muscles contributing to trunk instability, especially EO and Gmax, before and after ground impact during accelerated sprinting, compared to Healthy.
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Affiliation(s)
- Ryo Ohtsubo
- Graduate School of Sport Sciences, Waseda University, Tokyo, Japan
| | - Hiromi Saito
- Graduate School of Sport Sciences, Waseda University, Tokyo, Japan
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Achenbach L, Bloch H, Klein C, Damm T, Obinger M, Rudert M, Krutsch W, Szymski D. Four distinct patterns of anterior cruciate ligament injury in women's professional football (soccer): a systematic video analysis of 37 match injuries. Br J Sports Med 2024; 58:709-716. [PMID: 38684328 PMCID: PMC11228206 DOI: 10.1136/bjsports-2023-107113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND To identify mechanisms and patterns of anterior cruciate ligament (ACL) injury in adult women's professional football by means of video match analysis. METHODS ACL match injuries sustained in Germany's first women's league during the 2016-2017 to 2022-2023 seasons were prospectively analysed by three expert raters using a standardised observation form. Epidemiological and injury data, as well as the medical history of ACL tears, were obtained from media reports and the statutory accident insurance for professional athletes. RESULTS Thirty-seven ACL injuries sustained in official football matches were included in the video analysis, of which 24 (65%) had associated knee injuries, mainly meniscus and collateral ligament injuries. According to the categorised contact mechanisms, 17 (46%) were non-contact injuries, 14 indirect contact injuries (38%) and six direct contact injuries (16%). Of the 17 non-contact injuries, seven (41%) occurred during the first 15 min of the match. Contact mechanisms did not differ between primary and secondary ACL injuries to the same or the contralateral side. Most injuries (80%) of field players occurred during horizontal movements such as sprinting (n=9, 26%), change-of-direction manoeuvres (n=7, 19%), stopping (n=5, 14%) and lunging (n=5, 14%). Four distinct repetitive patterns of ACL match injuries were identified: (1) non-contact 'pressing ACL injury' (n=9), (2) indirect contact 'parallel sprinting and tackling ACL injury' (n=7), (3) direct contact 'knee-to-knee ACL injury' (n=6) and (4) non-contact 'landing ACL injury' (n=4). CONCLUSION Most of the identified patterns of ACL injuries in women's professional football have great potential for prevention.
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Affiliation(s)
- Leonard Achenbach
- Department of Orthopedics, Julius Maximilians University Würzburg, Wurzburg, Germany
| | - Hendrik Bloch
- Department of Sports Injury Prevention, VBG, German Statutory Accident Insurance for the Administrative Sector, Bielefeld, Germany
| | - Christian Klein
- Department of Sports Injury Prevention, VBG, German Statutory Accident Insurance for the Administrative Sector, Bielefeld, Germany
| | - Theresa Damm
- Faculty of Medicine, University Würzburg, Würzburg, Germany
| | - Matthias Obinger
- University of Cooperative Education for Sports and Health, Baunatal, Germany
| | - Maximilian Rudert
- Department of Orthopedics, Julius Maximilians University Würzburg, Wurzburg, Germany
| | - Werner Krutsch
- Department of Traumatology, University Clinic Regensburg, Regensburg, Germany
- SportDocsFranken, Nuremberg, Germany
| | - Dominik Szymski
- Department of Traumatology, University Clinic Regensburg, Regensburg, Germany
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Della Villa F, Buckthorpe M, Pellegrini A, Ranzini A, Esposito F, Crescenzo C, Nanni G, Zago M. A comparative video analysis of hamstring injuries mechanism and situational pattern in men's and women's football (soccer). Knee Surg Sports Traumatol Arthrosc 2024. [PMID: 38881374 DOI: 10.1002/ksa.12313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 04/03/2024] [Accepted: 05/29/2024] [Indexed: 06/18/2024]
Abstract
PURPOSE To describe the injury mechanism and situational patterns of severe (absence >28 days) hamstring muscle injuries in professional male and female football (soccer) players. METHODS The data for males were sourced from Serie A clubs participating in both national and international competitions from 2018 to 2021. For the female cohort, hamstring injuries were identified during matches of the top national/international competitions from 2017 to 2023. Video footage was obtained, and three raters categorised injury mechanisms and situational patterns. Injuries were also examined according to the month, minute and location. RESULTS A total of 129 severe hamstring injuries were identified, with 64 occurring in females and 65 in males. Video analysis was possible for 29 (45%) female cases and 61 (94%) male cases. Female injuries had longer lay-off times (97.8 ± 77.1 days) than males (39.6 ± 20.9 days). Females had a higher proportion of indirect contact injuries (34%) than males (13%) and a lower proportion of non-contact injuries (66% vs. 87%). Four situational patterns were identified: running was the most common for both sexes, representing 59% of female injuries and 41% of male injuries. Over-stretching injuries were split across open and CKC scenarios but collectively explained nearly half (48%) of male injuries but only one in five (21%) female injuries. Kicking injuries had a higher proportion in females (17%) than males (10%). Injuries were more common in the second half for females and the first half for males. CONCLUSION Females had a higher proportion of indirect contact, running and kicking injuries and a lower proportion of non-contact and stretch-type injuries than males. Understanding injury patterns can inform tailored prevention programs, considering sex-specific differences. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
| | - Matthew Buckthorpe
- Education and Research Department, Isokinetic Medical Group, Bologna, Italy
- Faculty of Sport, Technology and Health Sciences, St Mary's University, Twickenham, London, UK
| | - Alessandro Pellegrini
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy
| | - Alice Ranzini
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy
| | - Fabio Esposito
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy
| | | | - Gianni Nanni
- Medical Area, Bologna Football Club 1909, Bologna, Italy
| | - Matteo Zago
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy
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6
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Nieto Torrejón L, Martínez-Serrano A, Villalón JM, Alcaraz PE. Economic impact of muscle injury rate and hamstring strain injuries in professional football clubs. Evidence from LaLiga. PLoS One 2024; 19:e0301498. [PMID: 38870170 PMCID: PMC11175487 DOI: 10.1371/journal.pone.0301498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 03/18/2024] [Indexed: 06/15/2024] Open
Abstract
The aims of this study were: 1) to describe the total muscular injuries, and specifically HSIs, and their corresponding missed matches; 2) to analyse their economic impact; and 3) to estimate the loss of incomes due to TV rights, in first division clubs from LaLigaTM depending on the expected and actual ranking position during the 2018/2019 season. To do that, a cross-sectional study for season 18/19 and for all players of the 20 Spanish professional football clubs was performed. The economic impact of injuries was estimated considering the missed matches and salary cost of all players and the audio-visual income loss was estimated considering the Spanish Royal Decree of Law (RDL 5/2015). The high number of muscular (270) and hamstring injuries (57) implies a high cost for professional first division football clubs, specifically € 365,811 per month for the former and € 47,388 per month for the latter. In addition, reaching a worse than expected position in LaLigaTM ranking involved a loss of 45,2 million € in TV rights incomes. The high cost of muscle injuries in first division teams justifies the need for multidisciplinary teams that are capable of reducing the number of injuries as well as recovery times.
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Affiliation(s)
- Laura Nieto Torrejón
- Faculty of Economics and Business, Universidad Católica de Murcia (UCAM), Murcia, Spain
| | - Antonio Martínez-Serrano
- UCAM Research Center for High Performance Sport, Universidad Católica de Murcia (UCAM), Murcia, Spain
- Faculty of Sport Sciences, Universidad Católica de Murcia (UCAM), Murcia, Spain
- Strength and Conditioning Society (SCS), Murcia, Spain
| | | | - Pedro E. Alcaraz
- UCAM Research Center for High Performance Sport, Universidad Católica de Murcia (UCAM), Murcia, Spain
- Faculty of Sport Sciences, Universidad Católica de Murcia (UCAM), Murcia, Spain
- Strength and Conditioning Society (SCS), Murcia, Spain
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Serner A, Chamari K, Hassanmirzaei B, Moreira F, Bahr R, Massey A, Grimm K, Clarsen B, Tabben M. Time-loss injuries and illnesses at the FIFA world cup Qatar 2022. SCI MED FOOTBALL 2024:1-8. [PMID: 38860817 DOI: 10.1080/24733938.2024.2357568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 05/12/2024] [Indexed: 06/12/2024]
Abstract
The study aimed to analyse incidence and characteristics of time-loss injuries and illnesses during the FIFA World Cup Qatar 2022. Of 838 male football players, 705 consented to participate. Team medical staff reported 82 time-loss injuries, corresponding to an injury event incidence of 5.6 injuries/1000 h of total exposure (95%CI 4.5 to 7.0 injuries/1000 h), with a median of 2 time-loss injury events per team (IQR, 1 to 4.5, range 0-7). The total injury burden was 103 (95% CI 61 to 152) days per 1000 h. Muscle/tendon injuries had the highest incidence of tissue types (48 cases, 3.3/1000 h (95% CI 2.5 to 4.4), and hamstring muscle injuries were the most frequent diagnosis (16 cases, incidence 1.1/1000 h, 95% CI 0.6 to 1.8). Match injury event incidence was 20.6/1000 h (15.0 to 27.7) and training injury event incidence was 2.1/1000 h (1.4 to 3.1). The majority (52%) of sudden-onset injuries were non-contact injuries, 40% direct contact and 8% indirect contact. We recorded 15 time-loss illnesses, corresponding to an illness event incidence of 1.1 per 1000 competition days, (95% CI: 0.6 to 1.8), and illness burden of 2.1 (1.0 to 3.4) days lost per 1000 competition days. The most common illness was respiratory infection (12 cases, 80%). Match injury event incidence was the lowest in any FIFA World Cup since injuries have been monitored.
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Affiliation(s)
- Andreas Serner
- FIFA Medical, Fédération Internationale de Football Association, Zurich, Switzerland
| | - Karim Chamari
- Aspetar Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar
- Higher institute of Sport and Physical Education, ISSEP Ksar Saïd, Manouba University, Manouba, Tunisia
| | - Bahar Hassanmirzaei
- Aspetar Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Francisco Moreira
- Aspetar Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar
| | - Roald Bahr
- Aspetar Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar
- Oslo Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Andrew Massey
- FIFA Medical, Fédération Internationale de Football Association, Zurich, Switzerland
| | - Katharina Grimm
- FIFA Medical, Fédération Internationale de Football Association, Zurich, Switzerland
| | - Ben Clarsen
- FIFA Medical, Fédération Internationale de Football Association, Zurich, Switzerland
| | - Montassar Tabben
- Aspetar Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar
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Carmona G, Moreno-Simonet L, Cosio PL, Astrella A, Fernández D, Cadefau JA, Rodas G, Jou C, Milisenda JC, Cano MD, Arànega R, Marotta M, Grau JM, Padullés JM, Mendiguchia J. Hamstrings on focus: Are 72 hours sufficient for recovery after a football (soccer) match? A multidisciplinary approach based on hamstring injury risk factors and histology. J Sports Sci 2024; 42:1130-1146. [PMID: 39087576 DOI: 10.1080/02640414.2024.2386209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 07/23/2024] [Indexed: 08/02/2024]
Abstract
This study aimed to assess acute and residual changes in sprint-related hamstring injury (HSI) risk factors after a football (soccer) match, focusing on recovery within the commonly observed 72-h timeframe between elite football matches. We used a multifactorial approach within a football context, incorporating optical and ultrastructural microscopic analysis of BFlh (biceps femoris long head) muscle fibres, along with an examination of BFlh fibre composition. Changes in sprint performance-related factors and HSI modifiable risk factors were examined until 3 days after the match (MD +3) in 20 football players. BFlh biopsy specimens were obtained before and at MD +3 in 10 players. The findings indicated that at MD +3, sprint-related performance and HSI risk factors had not fully recovered, with notable increases in localized BFlh fibre disruptions. Interestingly, match load (both external and internal) did not correlate with changes in sprint performance or HSI risk factors nor with BFlh fibre disruption. Furthermore, our study revealed a balanced distribution of ATPase-based fibre types in BFlh, with type-II fibres associated with sprint performance. Overall, the results suggest that a 72-h recovery period may not be adequate for hamstring muscles in terms of both HSI risk factors and BFlh fibre structure following a football match.
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Affiliation(s)
- Gerard Carmona
- TecnoCampus, Departament de Ciències de la Salut, Grup de Recerca Tecnologia Aplicada a l'Alt Rendiment i la Salut (TAARS), Universitat Pompeu Fabra, Mataró, Spain
| | - Lia Moreno-Simonet
- Institut Nacional d'Educació Física de Catalunya (INEFC), Universitat de Barcelona (UB), Barcelona, Spain
| | - Pedro Luís Cosio
- Institut Nacional d'Educació Física de Catalunya (INEFC), Universitat de Barcelona (UB), Barcelona, Spain
| | - Andrea Astrella
- International Doctoral School, Rey Juan Carlos University, Madrid, Spain
- Physiotherapy Department, RX2 Sports & Health, Madrid, Spain
| | - Daniel Fernández
- Sports performance Department, Futbol Club Barcelona, Rink Hockey, Barcelona, Spain
| | - Joan Aureli Cadefau
- Institut Nacional d'Educació Física de Catalunya (INEFC), Universitat de Barcelona (UB), Barcelona, Spain
| | - Gil Rodas
- Sports Medicine Unit, Hospital Clinic and Sant Joan de Déu, Barcelona, Spain
- Medical Department, Medical Department of Futbol Club Barcelona (FIFA Medical Center of Excellence) and Barça Innovation, Barcelona, Spain
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Cristina Jou
- Pathology Department and Biobank, Hospital Sant Joan de Déu Barcelona, Barcelona, Spain
- Applied Research in Neuromuscular Diseases, Sant Joan de Déu Research Institut (IRSJD), Barcelona, Spain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - José César Milisenda
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Muscle Research and Mitochondrial Function Lab, Centre de Recerca Biomèdica CELLEX - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - María Dolores Cano
- Muscle Research and Mitochondrial Function Lab, Centre de Recerca Biomèdica CELLEX - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Raquel Arànega
- Muscle Research and Mitochondrial Function Lab, Centre de Recerca Biomèdica CELLEX - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Mario Marotta
- Leitat Foundation, Leitat Technological Center, Carrer de la Innovació 2, Terrassa, Barcelona, Spain
- Department of Internal Medicine, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Josep Maria Grau
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Muscle Research and Mitochondrial Function Lab, Centre de Recerca Biomèdica CELLEX - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Internal Medicine, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Josep Maria Padullés
- Institut Nacional d'Educació Física de Catalunya (INEFC), Universitat de Barcelona (UB), Barcelona, Spain
| | - Jurdan Mendiguchia
- Department of Physical Therapy, ZENTRUM Rehab and Performance Center, Barañain, Spain
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9
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Bloch H, Klein C. [Injury prevention in football : A challenge for team doctors and coaching team]. ORTHOPADIE (HEIDELBERG, GERMANY) 2024; 53:420-426. [PMID: 38662137 DOI: 10.1007/s00132-024-04503-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/05/2024] [Indexed: 04/26/2024]
Abstract
High injury rates and long injury-related downtimes demonstrate the need for effective and differentiated injury prevention strategies in football. Preventive measures should take place in various fields and should not be reduced to training programmes or medical approaches. The so-called "Big 6 of injury prevention" provide an overview of the key areas that should be addressed. In modern sports medicine, it should be a matter of course that the team doctor already participates in the primary prevention strategies and does not only get involved in the post-traumatic treatment. Similarly, a decision on a player's return to play after an injury should not be based solely on the medical assessment of the team doctor. Good communication and interdisciplinary cooperation, therefore, form the basis for successful prevention.
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Affiliation(s)
- Hendrik Bloch
- Bezirksverwaltung Bielefeld, Verwaltungs-Berufsgenossenschaft (VBG), Nikolaus-Dürkopp-Straße 8, 33602, Bielefeld, Deutschland.
| | - Christian Klein
- Bezirksverwaltung Bergisch Gladbach, Verwaltungs-Berufsgenossenschaft (VBG), Bergisch Gladbach, Deutschland
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Della Villa F, Massa B, Bortolami A, Nanni G, Olmo J, Virgile A, Buckthorpe M. Infographic. Injury mechanisms and situational patterns of severe lower limb muscle injuries in male professional football (soccer) players: a systematic video analysis study on 103 cases. Br J Sports Med 2024; 58:689-690. [PMID: 38527769 DOI: 10.1136/bjsports-2023-107908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2024] [Indexed: 03/27/2024]
Affiliation(s)
| | - Bruno Massa
- Education and Research Department, Isokinetic Medical Group, Bologna, Italy
| | - Antonio Bortolami
- Education and Research Department, Isokinetic Medical Group, Bologna, Italy
| | - Gianni Nanni
- Education and Research Department, Isokinetic Medical Group, Bologna, Italy
| | - Jesus Olmo
- Education and Research Department, Isokinetic Medical Group, Bologna, Italy
| | - Adam Virgile
- College of Nursing and Health Sciences, University of Vermont, Burlington, Vermont, USA
| | - Matthew Buckthorpe
- Education and Research Department, Isokinetic Medical Group, Bologna, Italy
- Faculty of Sport, Technology and Health Sciences, St Mary's University Twickenham, London, UK
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11
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Astrella A, Iordanov D, De Caro D, Jiménez-Reyes P, Mendiguchia J. Biceps femoris muscle-tendon strain during an entire overground sprint acceleration: a biomechanical explanation for hamstring injuries in the acceleration phase. Sports Biomech 2024:1-14. [PMID: 38739086 DOI: 10.1080/14763141.2024.2353233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 05/02/2024] [Indexed: 05/14/2024]
Abstract
The objectives of this study were to analyse the peak muscle-tendon (MT) strain of the hamstring during an entire acceleration sprint overground and examine their relationship with relative joint angles and segment orientation in the sagittal plane, which are the direct causes of MT strain. Kinematic data were recorded using a 3D inertial motion capture system in 21 male semi-professional soccer players during 40-metre overground sprint. Scaled musculoskeletal models were used to estimate peak MT strain in the hamstring over 16 steps. Biceps femoris long head (BFLH) exhibited the largest peaks in MT strain compared to semitendinosus (ST) and semimembranosus (SM) muscles across all the steps, with its overall strain decreased as the number of steps and maximum speed increased. Hip flexion angle was found to be a strong predictor (p < 0.001) of joint angles, being the orientation of the pelvis in the sagittal plane of the segment with the greatest influence (p < 0.001) on the peak MT strain of BFLH during sprinting. The current study provides a biomechanical explanation for the high proportion of hamstring injuries in the acceleration phase of sprinting.
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Affiliation(s)
- Andrea Astrella
- International Doctoral School, Rey Juan Carlos University, Madrid, Spain
- Department of Muscle Science, RX2 Sports & Health, Madrid, Spain
| | - Daniel Iordanov
- Sports Department, Universidad Politecnica de Madrid, Madrid, Spain
| | - Dario De Caro
- Department of Muscle Science, RX2 Sports & Health, Madrid, Spain
| | | | - Jurdan Mendiguchia
- Department of Muscle Science, RX2 Sports & Health, Madrid, Spain
- Department of Physical Therapy, ZENTRUM Rehab and Performance Center, Barañain, Spain
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12
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Soler A, Agulló F, Hernández-Davó J, Raya-González J, Del Coso J, González-Ródenas J, Moreno-Pérez V. Influence of the External Workload on Calf Muscle Strain Injuries in Professional Football Players: A Pilot Study. Sports Health 2024:19417381241247754. [PMID: 38708680 DOI: 10.1177/19417381241247754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024] Open
Abstract
BACKGROUND The influence of external workload variables on the development of calf muscle strainsin football players has not been previously explored. HYPOTHESIS Overloaded players would have an increased risk of calf muscle strain injury. STUDY DESIGN Prospective observational study. LEVEL OF EVIDENCE Level 4. METHODS A total of 41 professional football players from 1 team were monitored for 2 consecutive seasons. Total distance covered (TD), and distances covered at high-intensity running, high sprint running, low (LACC) and high (HACC) acceleration, low (LDEC) and high (HDEC) deceleration, and at high metabolic load distance (HMLD) were monitored with GPS units. Accumulated players' external workload in the week before injury was compared with the weekly mean value of the 6 weeks before injury occurred for each player. RESULTS Ten players (24.3%) suffered 16 calf muscle strain injuries (3.1 injuries per 1000 hours of match play; 0.5 injuries per 1000 hours of training exposure). Players with a calf muscle injury were older (p = 0.03), with higher body weight (p = 0.01) and height (p = 0.03). Injured players displayed substantially higher total training volume (p < 0.01), TD (p < 0.01), LACC (p < 0.01), LDEC (p < 0.01), HACC (p < 0.01), HDEC (p < 0.01), and HMLD (p = 0.03) in the week before injury, in comparison with the mean values of these variables in the 6 weeks before injury. CONCLUSION A week with a higher-than-habitual external workload might increase the risk of calf muscle strain injury in professional football players. Calf muscle injuries were preceded by a week with unusually high workloads associated with accelerating and decelerating distances and higher training volumes. CLINICAL RELEVANCE Monitoring external workload indicators may be helpful in determine players with a higher risk of calf muscle strain injury due to excessive workload during training/competition.
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Affiliation(s)
| | | | | | | | - Juan Del Coso
- Sport Sciences Research Centre, Rey Juan Carlos University, Spain
| | | | - Víctor Moreno-Pérez
- Sports Research Center, Miguel Hernandez University of Elche, Alicante, Spain
- Center for Translational Research in Physiotherapy, Department of Pathology and Surgery, Miguel Hernandez University of Elche, San Joan, Spain
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13
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Bramah C, Tawiah-Dodoo J, Rhodes S, Elliott JD, Dos’Santos T. The Sprint Mechanics Assessment Score: A Qualitative Screening Tool for the In-field Assessment of Sprint Running Mechanics. Am J Sports Med 2024; 52:1608-1616. [PMID: 38544464 PMCID: PMC11064464 DOI: 10.1177/03635465241235525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 01/03/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Qualitative movement screening tools provide a practical method of assessing mechanical patterns associated with potential injury development. Biomechanics play a role in hamstring strain injury and are recommended as a consideration within injury screening and rehabilitation programs. However, no methods are available for the in-field assessment of sprint running mechanics associated with hamstring strain injuries. PURPOSE To investigate the intra- and interrater reliability of a novel screening tool assessing in-field sprint running mechanics titled the Sprint Mechanics Assessment Score (S-MAS) and present normative S-MAS data to facilitate the interpretation of performance standards for future assessment uses. STUDY DESIGN Cohort study (diagnosis); Level of evidence, 3. METHODS Maximal sprint running trials (35 m) were recorded from 136 elite soccer players using a slow-motion camera. All videos were scored using the S-MAS by a single assessor. Videos from 36 players (18 men and 18 women) were rated by 2 independent assessors blinded to each other's results to establish interrater reliability. One assessor scored all videos in a randomized order 1 week later to establish intrarater reliability. Intraclass correlation coefficients (ICCs) based on single measures using a 2-way mixed-effects model, with absolute agreement with 95% CI and kappa coefficients with percentage agreements, were used to assess the reliability of the overall score and individual score items, respectively. T-scores were calculated from the means and standard deviations of the male and female groups to present normative data values. The Mann-Whitney U test and the Wilcoxon signed-rank test were used to assess between-sex differences and between-limb differences, respectively. RESULTS The S-MAS showed good intrarater (ICC, 0.828 [95% CI, 0.688-0.908]) and interrater (ICC, 0.799 [95% CI, 0.642-0.892]) reliability, with a standard error of measurement of 1 point. Kappa coefficients for individual score items demonstrated moderate to substantial intra- and interrater agreement for most parameters, with percentage agreements ranging from 75% to 88.8% for intrarater and 66.6% to 88.8% for interrater reliability. No significant sex differences were observed for overall scores, with mean values of 4.2 and 3.8 for men and women, respectively (P = .27). CONCLUSION The S-MAS is a new tool developed for assessing sprint running mechanics associated with lower limb injuries in male and female soccer players. The reliable and easy-to-use nature of the S-MAS means that this method can be integrated into practice, potentially aiding future injury screening and research looking to identify athletes who may demonstrate mechanical patterns potentially associated with hamstring strain injuries.
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Affiliation(s)
- Christopher Bramah
- School of Health & Society, University of Salford, Salford, Manchester, UK
- Manchester Institute of Health & Performance, Manchester, UK
| | | | - Samantha Rhodes
- School of Health & Society, University of Salford, Salford, Manchester, UK
- Manchester Institute of Health & Performance, Manchester, UK
- Nuffield Health, Manchester Institute of Health & Performance, UK
| | - Joshua D. Elliott
- Manchester Institute of Health & Performance, Manchester, UK
- Nuffield Health, Manchester Institute of Health & Performance, UK
- Research Institute for Sport and Exercise, University of Canberra, Canberra, Australia
| | - Thomas Dos’Santos
- Department of Sport & Exercise Sciences, Manchester Metropolitan University, Manchester, UK
- Manchester Institute of Sport, Metropolitan University, Manchester, UK
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14
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Bramah C, Mendiguchia J, Dos'Santos T, Morin JB. Exploring the Role of Sprint Biomechanics in Hamstring Strain Injuries: A Current Opinion on Existing Concepts and Evidence. Sports Med 2024; 54:783-793. [PMID: 37725240 PMCID: PMC11052868 DOI: 10.1007/s40279-023-01925-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2023] [Indexed: 09/21/2023]
Abstract
Hamstring strain injuries are one of the most common injuries in sprint-based sports with the mechanism of injury considered the result of an interaction between applied mechanical strain and the capacity of the muscle to tolerate strain. To date, injury prevention and rehabilitation strategies have frequently focused on enhancing the capacity of the hamstrings to tolerate strain, with little consideration of factors directly influencing mechanical strain. Sprint running biomechanics are one factor proposed to influence the mechanical strain applied to the hamstrings that may be modified (towards reduced strain) within rehabilitation and injury prevention programs. This article aims to explore the theoretical mechanistic link between sprint running mechanics and hamstring strain injury, along with the available supporting evidence. In doing so, it hopes to provide practitioners with an understanding of mechanical parameters that may influence hamstring strain injury whilst also identifying areas for further research exploration.
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Affiliation(s)
- Christopher Bramah
- School of Health and Society, University of Salford, Allerton Building, Frederick Road Campus, Salford, M6 6PU, UK.
- Manchester Institute of Health and Performance, Manchester, UK.
| | - Jurdan Mendiguchia
- Department of Physical Therapy, ZENTRUM Rehab and Performance Centre, Barañain, Spain
| | - Thomas Dos'Santos
- Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, UK
- Manchester Institute of Sport, Metropolitan University, Manchester, UK
| | - Jean-Benoȋt Morin
- University Jean Monnet Saint-Etienne, Lyon 1, University Savoie Mont-Blanc, Inter-University Laboratory of Human Movement Biology, EA 7424, Saint-Etienne, France
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15
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Cross J, Kung SM, Welch N. Assessing the reliability of biomechanical variables during a horizontal deceleration task in healthy adults. J Sports Sci 2024; 42:263-269. [PMID: 38484285 DOI: 10.1080/02640414.2024.2327874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 03/01/2024] [Indexed: 04/23/2024]
Abstract
Horizontal deceleration technique is an underpinning factor to musculoskeletal injury risk and performance in multidirectional sport. This study primarily assessed within- and between-session reliability of biomechanical and performance-based aspects of a horizontal deceleration technique and secondarily investigated the effects of limb dominance on reliability. Fifteen participants completed four horizontal decelerations on each leg during test and retest sessions. A three-dimensional motion analysis system was used to collect kinetic and kinematic data. Completion time, ground contact time, rate of horizontal deceleration, minimum centre of mass height, peak eccentric force, impulse ratio, touchdown distance, sagittal plane foot and knee angles at initial contact, maximum sagittal plane thorax angle, and maximum knee flexion moment were assessed. Coefficients of variation (COV) and intraclass correlation coefficients (ICC) were used to assess within- and between-session reliability, respectively. Seven variables showed "great" within-session reliability bilaterally (COV ≤9.13%). ICC scores were 'excellent' (≥0.91; n = 4), or 'good' (0.76-0.89; n = 7), bilaterally. Limb dominance affected five variables; three were more reliable for the dominant leg. This horizontal deceleration task was reliable for most variables, with little effect of limb dominance on reliability. This deceleration task may be reliably used to assess and track changes in deceleration technique in healthy adults.
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Affiliation(s)
- Joshua Cross
- Sports Medicine Department, UPMC Sports Surgery Clinic, Dublin, Ireland
| | - Stacey M Kung
- Sports Medicine Department, UPMC Sports Surgery Clinic, Dublin, Ireland
| | - Neil Welch
- Sports Medicine Department, UPMC Sports Surgery Clinic, Dublin, Ireland
- School of Health and Human Performance, Dublin City University, Dublin, Ireland
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16
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Amundsen R, Thorarinsdottir S, Larmo A, Pedersen R, Andersen TE, Møller M, Bahr R. #ReadyToplay: hamstring injuries in women's football - a two-season prospective cohort study in the Norwegian women's premier league. SCI MED FOOTBALL 2024:1-9. [PMID: 38243669 DOI: 10.1080/24733938.2024.2305389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/07/2024] [Indexed: 01/21/2024]
Abstract
In this two-season prospective cohort study (2020-2021), we aimed to describe the characteristics, clinical findings and magnetic resonance imaging (MRI) findings of hamstring injuries in the Norwegian women's premier league. Hamstring injuries were examined by team physiotherapists using a standardised clinical examination and injury form. Injury location and severity (modified Peetrons classification) were graded based on MRI by two independent radiologists. Fifty-three hamstring injuries were clinically examined, 31 of these with MRI. Hamstring injuries caused 8 days (median) lost from football (interquartile range: 3-15 days, range: 0-188 days), most were non-contact and occurred during sprinting. Gradual-onset (53%) and sudden-onset injuries (47%) were evenly distributed. The injuries examined with MRI were classified as grade 0 (52%), grade 1 (16%) or grade 2 (29%). One proximal tendinopathy case was not graded. Grade 2 injuries caused more time loss than grade 0 (19 ± 8 vs. 7 ± 7 days, p = 0.002). Of injuries with MRI changes, 60% were in the m. biceps femoris, mainly the muscle-tendon junction, and 40% in the m. semimembranosus, most in the proximal tendon. Compared to previous findings from men's football, a higher proportion of hamstring injuries in women's football had a gradual onset and involved the m. semimembranosus, particularly its proximal tendon.
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Affiliation(s)
- R Amundsen
- Oslo Sports Trauma Research Center, Institute of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - S Thorarinsdottir
- Oslo Sports Trauma Research Center, Institute of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - A Larmo
- Radiology Department, Evidia Norge AS, Oslo, Norway
| | - R Pedersen
- Radiology Department, Unilabs Norge AS, Oslo, Norway
| | - T E Andersen
- Oslo Sports Trauma Research Center, Institute of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
- The Norwegian Football Association Medical Centre (Idrettens helsesenter), The Norwegian Football Association, Oslo, Norway
| | - M Møller
- Oslo Sports Trauma Research Center, Institute of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - R Bahr
- Oslo Sports Trauma Research Center, Institute of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
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17
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Hoenig T, Rahlf L, Wilke J, Krauß I, Dalos D, Willwacher S, Mai P, Hollander K, Fohrmann D, Krosshaug T, Gronwald T. Appraising the Methodological Quality of Sports Injury Video Analysis Studies: The QA-SIVAS Scale. Sports Med 2024; 54:203-211. [PMID: 37632664 PMCID: PMC10799118 DOI: 10.1007/s40279-023-01907-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2023] [Indexed: 08/28/2023]
Abstract
BACKGROUND Video analysis (VA) is commonly used in the assessment of sports injuries and has received considerable research interest. Until now, no tool has been available for the assessment of study quality. Therefore, the objective of this study was to develop and evaluate a valid instrument that reliably assesses the methodological quality of VA studies. METHODS The Quality Appraisal for Sports Injury Video Analysis Studies (QA-SIVAS) scale was developed using a modified Delphi approach including expert consensus and pilot testing. Reliability was examined through intraclass correlation coefficient (ICC3,1) and free-marginal kappa statistics by three independent raters. Construct validity was investigated by comparing QA-SIVAS with expert ratings by using Kendall's tau analysis. Rating time was studied by applying the scale to 21 studies and computing the mean time for rating per study article. RESULTS The QA-SIVAS scale consists of an 18-item checklist addressing the study design, data source, conduct, report, and discussion of VA studies in sports injury research. Inter- and intra-rater reliability were excellent with ICCs > 0.97. Expert ratings revealed a high construct validity (0.71; p < 0.001). Mean rating time was 10 ± 2 min per article. CONCLUSION QA-SIVAS is a reliable and valid instrument that can be easily applied to sports injury research. Future studies in the field of VA should adhere to standardized methodological criteria and strict quality guidelines.
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Affiliation(s)
- Tim Hoenig
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lina Rahlf
- Department of Exercise Physiology, Institute of Sports Science, Europa-Universität Flensburg, Flensburg, Germany
| | - Jan Wilke
- Department of Movement Sciences, University of Klagenfurt, Klagenfurt am Wörthersee, Austria
| | - Inga Krauß
- Department of Sports Medicine, University Hospital Tuebingen, Tuebingen, Germany
| | - Dimitris Dalos
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- UKE Athleticum, Center for Sports Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
| | - Steffen Willwacher
- Institute for Advanced Biomechanics and Motion Studies, Offenburg University of Applied Sciences, Offenburg, Germany
| | - Patrick Mai
- Institute for Advanced Biomechanics and Motion Studies, Offenburg University of Applied Sciences, Offenburg, Germany
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Cologne, Germany
| | - Karsten Hollander
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
| | - Dominik Fohrmann
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
| | - Tron Krosshaug
- Department of Sports Medicine, Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway
| | - Thomas Gronwald
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany.
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18
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Della Villa F, Massa B, Bortolami A, Nanni G, Olmo J, Buckthorpe M. Injury mechanisms and situational patterns of severe lower limb muscle injuries in male professional football (soccer) players: a systematic video analysis study on 103 cases. Br J Sports Med 2023; 57:1550-1558. [PMID: 37898508 DOI: 10.1136/bjsports-2023-106850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2023] [Indexed: 10/30/2023]
Abstract
OBJECTIVE The objective of this study is to describe the mechanism of injury and situational patterns (based on ball possession and playing action leading to injury) of severe (lay-off time >28 days) lower limb muscle injuries in professional male football (soccer) players during match play. METHODS Players experiencing a severe muscle injury of the lower limb during Italian first (Serie A) division male football matches over three consecutive seasons (2018-2021) were identified. Video footage was obtained and three raters independently categorised injury mechanism and situational patterns using a standardised checklist. Injury epidemiology (month), timing of injuries within the match and location of injuries on the pitch were also examined. RESULTS We identified 121 lower limb severe muscle injuries. Videos of sufficient quality were available for 103 (85%) cases, including 61 (60%) hamstring, 17 (16%) calf, 16 (15%) adductor and 9 (9%) quadricep muscle injuries. Nearly two-thirds of injuries involved the dominant/kicking leg (n=65, 63%). Eighty-five (83%) injuries were non-contact and 18 (17%) indirect contact. Four main situational patterns were identified and accounted for 88% of injuries: (1) running/acceleration (n=35, 34%); (2) closed kinetic chain stretching (n=21, 20%); (3) open kinetic chain stretching (n=19, 18%) and (4) kicking (n=16, 16%), with differences between muscle groups. 71% of injuries occurred in the first half of the match (p<0.01), with a gradual increase through the first half. CONCLUSION Most severe muscle injuries during football matches were non-contact and occurred in the first half during running/acceleration, open and closed kinetic chain stretching, or kicking.
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Affiliation(s)
- Francesco Della Villa
- Education and Research Department, Isokinetic Medical Group, FIFA Medical Centre of Excellence, Bologna, Italy
| | - Bruno Massa
- Education and Research Department, Isokinetic Medical Group, FIFA Medical Centre of Excellence, Bologna, Italy
| | - Antonio Bortolami
- Education and Research Department, Isokinetic Medical Group, FIFA Medical Centre of Excellence, Bologna, Italy
| | - Gianni Nanni
- Education and Research Department, Isokinetic Medical Group, FIFA Medical Centre of Excellence, Bologna, Italy
| | - Jesus Olmo
- Education and Research Department, Isokinetic Medical Group, FIFA Medical Centre of Excellence, Bologna, Italy
| | - Matthew Buckthorpe
- Education and Research Department, Isokinetic Medical Group, FIFA Medical Centre of Excellence, Bologna, Italy
- Faculty of Sport, Technology and Health Sciences, St Mary's University, Twickenham, London, UK
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19
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Edouard P, Reurink G, Mackey AL, Lieber RL, Pizzari T, Järvinen TAH, Gronwald T, Hollander K. Traumatic muscle injury. Nat Rev Dis Primers 2023; 9:56. [PMID: 37857686 DOI: 10.1038/s41572-023-00469-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/22/2023] [Indexed: 10/21/2023]
Abstract
Traumatic muscle injury represents a collection of skeletal muscle pathologies caused by trauma to the muscle tissue and is defined as damage to the muscle tissue that can result in a functional deficit. Traumatic muscle injury can affect people across the lifespan and can result from high stresses and strains to skeletal muscle tissue, often due to muscle activation while the muscle is lengthening, resulting in indirect and non-contact muscle injuries (strains or ruptures), or from external impact, resulting in direct muscle injuries (contusion or laceration). At a microscopic level, muscle fibres can repair focal damage but must be completely regenerated after full myofibre necrosis. The diagnosis of muscle injury is based on patient history and physical examination. Imaging may be indicated to eliminate differential diagnoses. The management of muscle injury has changed within the past 5 years from initial rest, immobilization and (over)protection to early activation and progressive loading using an active approach. One challenge of muscle injury management is that numerous medical treatment options, such as medications and injections, are often used or proposed to try to accelerate muscle recovery despite very limited efficacy evidence. Another challenge is the prevention of muscle injury owing to the multifactorial and complex nature of this injury.
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Affiliation(s)
- Pascal Edouard
- Université Jean Monnet, Lyon 1, Université Savoie Mont-Blanc, Inter-university Laboratory of Human Movement Biology, Saint-Etienne, France.
- Department of Clinical and Exercise Physiology, Sports Medicine Unit, University Hospital of Saint-Etienne, Faculty of Medicine, Saint-Etienne, France.
| | - Gustaaf Reurink
- Department of Orthopedic Surgery and Sports Medicine, Academic Medical Center, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
- Academic Center for Evidence-based Sports Medicine (ACES), Academic Medical Center, Amsterdam, Netherlands
- The Sports Physicians Group, Onze Lieve Vrouwe Gasthuis, Amsterdam, Netherlands
| | - Abigail L Mackey
- Institute of Sports Medicine Copenhagen, Department of Orthopaedic Surgery M, Bispebjerg Hospital, Copenhagen, Denmark
- Center for Healthy Aging, Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Richard L Lieber
- Shirley Ryan AbilityLab, Chicago, IL, USA
- Departments of Physical Medicine and Rehabilitation and Biomedical Engineering, Northwestern University, Chicago, IL, USA
- Hines VA Medical Center, Maywood, IL, USA
| | - Tania Pizzari
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Tero A H Järvinen
- Tampere University and Tampere University Hospital, Tampere, Finland
| | - Thomas Gronwald
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
| | - Karsten Hollander
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
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20
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Markovic G, Karuc I. Backheel Pass During Forward Running as a Mechanism of Severe Acute Hamstring Injury in Football: A Case Report. Clin J Sport Med 2023; 33:569-570. [PMID: 37358314 DOI: 10.1097/jsm.0000000000001168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 05/22/2023] [Indexed: 06/27/2023]
Abstract
ABSTRACT Proximal hamstring tendon avulsions represent the most severe hamstring injury in sports and are typically sustained during stretch-related movements in closed kinetic chain: forced hip hyperflexion combined with knee extension. Here, we present the case study of the right-foot dominant professional football player with a severe proximal hamstring tendon avulsion injury and concomitant lower-grade injuries of hamstring muscle-tendon complex caused by a potentially new football-specific injury mechanism: right-foot backheel pass during forward running (ie, a kick directly backward). This mechanism involves a specific stretch-shortening cycle action of hamstring muscles in open-kinetic chain movement that has not yet been described in the scientific literature. Although further studies related to this football-specific hamstring injury mechanism are needed, clinicians and coaches working in football should be aware of it and potentially introduce additional injury mechanism-specific exercises and strategies for prevention of severe hamstring injuries which often require surgical intervention.
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Affiliation(s)
- Goran Markovic
- Motus Melior, Sports & Rehabilitation Clinic, Zagreb, Croatia
- Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia; and
- Faculty of Health Sciences, Primorska University, Izola, Slovenia
| | - Ivan Karuc
- Motus Melior, Sports & Rehabilitation Clinic, Zagreb, Croatia
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21
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Kamandulis S, Cadefau JA, Snieckus A, Mickevicius M, Lukonaitiene I, Muanjai P, Satkunskiene D, Molina V, de Blas Foix X, Conte D. The effects of high-velocity hamstring muscle training on injury prevention in football players. Front Physiol 2023; 14:1219087. [PMID: 37670769 PMCID: PMC10475598 DOI: 10.3389/fphys.2023.1219087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 08/10/2023] [Indexed: 09/07/2023] Open
Abstract
Background: Explosive and fast body movements, sprints, jumps and quick changes of direction, which are characteristic of the football training, place considerable strain on the hamstring muscles. Due to the high occurrence of hamstring injuries, new preventive strategies are required that focus on high-velocity training. The purpose was to assess the effectiveness of high-velocity elastic-band training in reducing the occurrence of hamstring injuries in football players. Methods: Male football players from 15 teams (n = 319) playing in national competitions participated in this study. The players were involved in a 5-week exercise period in either the intervention group (INT) or the control group (CON), with a follow-up period of ∼4 months where hamstring injuries and exposure time were recorded. The INT group had two to three sessions per week of elastic-band training with low-load, high-velocity leg curls while lying prone; the CON group performed self-paced football-specific drills. Results: The incidence rate of hamstring injuries was 6.5% in the INT group (8 out of 123 players) and 9.2% in the CON group (18 out of 196 players). Although the INT group showed almost 1/3 reduction in hamstring injury incidence compared to the CON group, the difference was not statistically significant (p > 0.05). Moreover, no differences (p > 0.05, odds ratio [OR] = trivial-to-small) in distribution between the groups were found in hamstring injury characteristics (leg dominance and mechanism) except for the distribution of injuries that occurred during matches or training (p = 0.036; OR = 6.14, moderate). Conclusion: The program of high-velocity elastic-band training did not prove to be effective in preventing hamstring muscle injuries in football players despite displaying some positive indications that could be considering when creating injury prevention programs.
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Affiliation(s)
- Sigitas Kamandulis
- Institute of Sports Science and Innovation, Lithuanian Sports University, Kaunas, Lithuania
| | - Joan Aureli Cadefau
- National Institute of Physical Education (INEFC), Barcelona University, Barcelona, Spain
| | - Audrius Snieckus
- Institute of Sports Science and Innovation, Lithuanian Sports University, Kaunas, Lithuania
| | - Mantas Mickevicius
- Institute of Sports Science and Innovation, Lithuanian Sports University, Kaunas, Lithuania
| | - Inga Lukonaitiene
- Institute of Sports Science and Innovation, Lithuanian Sports University, Kaunas, Lithuania
| | - Pornpimol Muanjai
- Department of Physical Therapy, Faculty of Allied Health Sciences, Burapha University, Chon Buri, Thailand
| | - Danguole Satkunskiene
- Institute of Sports Science and Innovation, Lithuanian Sports University, Kaunas, Lithuania
| | - Victor Molina
- National Institute of Physical Education (INEFC), Barcelona University, Barcelona, Spain
| | - Xavier de Blas Foix
- Faculty of Psychology Education Sciences and Sport Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - Daniele Conte
- Institute of Sports Science and Innovation, Lithuanian Sports University, Kaunas, Lithuania
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22
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Kerin F, O'Flanagan S, Coyle J, Farrell G, Curley D, McCarthy Persson U, De Vito G, Delahunt E. Intramuscular Tendon Injuries of the Hamstring Muscles: A More Severe Variant? A Narrative Review. SPORTS MEDICINE - OPEN 2023; 9:75. [PMID: 37578668 PMCID: PMC10425319 DOI: 10.1186/s40798-023-00621-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 07/20/2023] [Indexed: 08/15/2023]
Abstract
Hamstring strain injuries (HSI) are one of the most common sport-related injuries. They have a high injury burden and a high recurrence rate. The development of novel muscle injury grading systems has provided new insights into the possible impact of injury location on the time to return to play (TTRTP) and re-injury following HSI. In particular, injuries to the intramuscular tendon (IMT) may be present in up to 41% of all HSI and have been described as a 'serious thigh muscle strain'. Re-injury rates as high as 60% have been described in elite track and field athletes, as well as prolonged TTRTP. A systematic search was carried out using appropriate keywords to identify articles reporting on HSI involving the IMT in athletes. The primary aim was to determine whether IMT injuries warrant being classified as a distinct clinical entity with different expected outcomes to other hamstring muscle injuries. This narrative review summarises the existing evidence on: (1) the anatomy of the IMT and its response to injury; (2) the role of MRI and novel grading scales in IMT injury management (3) clinical assessment of IMT injuries, (4) TTRTP and re-injury rates across sports following IMT, (5) conservative rehabilitation and the role of specific 'IMT-oriented' strategies, and (6) indications for and approaches to surgery. The review found that important clinical outcomes such as re-injury rates and TTRTP vary across populations, cohorts and sports which suggest that outcomes are specific to the sporting context. Bespoke rehabilitation, tailored to IMT injury, has been shown to significantly reduce re-injuries in elite track and field athletes, without compromising TTRTP. Continued prospective studies across other sports and cohorts, are warranted to further establish relevant clinical findings, indications for surgical intervention and outcomes across other sporting cohorts.
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Affiliation(s)
- Fearghal Kerin
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.
| | - Stuart O'Flanagan
- Leinster Rugby, Dublin, Ireland
- Radiology Department, Sports Surgery Clinic, Dublin, Ireland
| | - Joe Coyle
- Radiology Department, Sports Surgery Clinic, Dublin, Ireland
| | | | | | - Ulrik McCarthy Persson
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | | | - Eamonn Delahunt
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
- Institute for Sport and Health, University College Dublin, Dublin, Ireland
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23
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Martínez-Silván D, Wik EH, Arnáiz J, Farooq A, Mónaco M. Association Between Magnetic Resonance Imaging Findings and Time to Return to Sport After Muscle Injuries in High-Level Youth Athletes. Clin J Sport Med 2023; 33:225-232. [PMID: 37042815 DOI: 10.1097/jsm.0000000000001112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 11/04/2022] [Indexed: 04/13/2023]
Abstract
OBJECTIVE To describe the relationship between magnetic resonance imaging (MRI) findings and time to return to sport (RTS) from muscle injuries in youth athletes. DESIGN Prospective collection of injury surveillance data over 6 seasons (2014-2015 to 2019-2020) and reanalysis of MRIs by a radiologist blinded to RTS time after the data collection period. SETTING National sports academy and sports medicine hospital. PARTICIPANTS Male youth (11-19 years) athletes participating in the football (soccer) or athletics (track and field) programs with a muscle injury. INDEPENDENT VARIABLES Magnetic resonance imaging findings (eg, grade and location) in time-loss muscle injuries. MAIN OUTCOME VARIABLES Injury incidence, distributions, and RTS time. RESULTS In total, 353 time-loss muscle injuries were recorded for 1089 athlete-seasons, of which 85 satisfied our inclusion criteria (MRI within 14 days). Return to sport time was significantly longer for reinjuries compared with index injuries. Associations between MRI findings and RTS time were specific to the muscle group, with significant differences in RTS time observed between categories of structure, location, and grade. The largest number of injuries was to the hamstrings (n = 46), where injuries involving the tendon were more severe than those involving the myotendinous junction and muscle, proximal injuries were more severe than mid-portion and distal, and longer RTS time was observed for higher injury grade ( P < 0.05). CONCLUSIONS Muscle injuries in youth are diverse and cannot be treated as a single injury type. Specific injury durations can be expected depending on injury characteristics such as reinjury, location, structure, and grade.
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Affiliation(s)
- Daniel Martínez-Silván
- NSMP - Aspire Academy Sports Medicine Center, Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar
| | - Eirik Halvorsen Wik
- NSMP - Aspire Academy Sports Medicine Center, Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar
- Institute of Sport and Exercise Medicine, Department of Sport Science, Faculty of Medicine and Health Sciences, Stellenbosch University, Rylaan, Tygerberg, South Africa
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Rylaan, Tygerberg, South Africa; and
| | - Javier Arnáiz
- NSMP - Aspire Academy Sports Medicine Center, Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar
- School of Medicine-Qatar, Weill Cornell University, Doha, Qatar
| | - Abdulaziz Farooq
- NSMP - Aspire Academy Sports Medicine Center, Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar
| | - Mauricio Mónaco
- NSMP - Aspire Academy Sports Medicine Center, Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar
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24
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Jokela A, Valle X, Kosola J, Rodas G, Til L, Burova M, Pleshkov P, Andersson H, Pasta G, Manetti P, Lupón G, Pruna R, García-Romero-Pérez A, Lempainen L. Mechanisms of Hamstring Injury in Professional Soccer Players: Video Analysis and Magnetic Resonance Imaging Findings. Clin J Sport Med 2023; 33:217-224. [PMID: 36730099 PMCID: PMC10128906 DOI: 10.1097/jsm.0000000000001109] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 10/21/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To describe the injury mechanisms and magnetic resonance imaging (MRI) findings in acute hamstring injuries of male soccer players using a systematic video analysis. DESIGN Descriptive case series study of consecutive acute hamstring injuries from September 2017 to January 2022. SETTING Two specialized sports medicine hospitals. PARTICIPANTS Professional male soccer players aged between 18 and 40 years, referred for injury assessment within 7 days after an acute hamstring injury, with an available video footage of the injury and positive finding on MRI. INDEPENDENT VARIABLES Hamstring injury mechanisms (specific scoring based on standardized models) in relation to hamstring muscle injury MRI findings. MAIN OUTCOME MEASURES Hamstring injury mechanism (playing situation, player/opponent behavior, movement, and biomechanical body positions) and MRI injury location. RESULTS Fourteen videos of acute hamstring injuries in 13 professional male soccer players were analyzed. Three different injury mechanisms were seen: mixed-type (both sprint-related and stretch-related, 43%), stretch-type (36%), and sprint-type (21%). Most common actions during injury moments were change of direction (29%), kicking (29%), and running (21%). Most injuries occurred at high or very high horizontal speed (71%) and affected isolated proximal biceps femoris (BF) (36%). Most frequent body positions at defined injury moments were neutral trunk (43%), hip flexion 45-90 degrees (57%), and knee flexion <45 degrees (93%). Magnetic resonance imaging findings showed that 79% were isolated single-tendon injuries. CONCLUSIONS According to a video analysis, most hamstring injuries in soccer occur during high-speed movements. Physicians should suspect proximal and isolated single-tendon-most often BF-hamstring injury, if represented injury mechanisms are seen during game play. In addition to sprinting and stretching, also mixed-type injury mechanisms occur.
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Affiliation(s)
- Aleksi Jokela
- Faculty of Medicine, University of Turku, Turku, Finland
- Department of Orthopaedics and Traumatology, Turku University Hospital, Turku, Finland
| | - Xavier Valle
- FC Barcelona, Medical Department, Barcelona, Spain
- Department de Cirurgia de la Facultat de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jussi Kosola
- Department of Physical Activity and Health, Paavo Nurmi Centre, University of Turku, Turku, Finland;
| | - Gil Rodas
- FC Barcelona, Medical Department, Barcelona, Spain
| | - Lluís Til
- Human Performance Department SL Benfica, Lisbon, Portugal
| | | | | | | | | | | | | | - Ricard Pruna
- Department of Orthopaedics and Traumatology, Turku University Hospital, Turku, Finland
| | - Alvaro García-Romero-Pérez
- Watford FC, Injury Prevention and Rehabilitation Department, Watford, United Kingdom
- Physiotherapy Department, Universidad Camilo José Cela, Madrid, Spain; and
| | - Lasse Lempainen
- Department of Physical Activity and Health, Paavo Nurmi Centre, University of Turku, Turku, Finland;
- FinnOrthopaedics/Hospital Pihlajalinna, Turku, Finland and Department of Physical Activity and Health, Paavo Nurmi Centre, University of Turku, Turku, Finland.
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25
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Ekstrand J, Hallén A, Marin V, Gauffin H. Most modifiable risk factors for hamstring muscle injury in women's elite football are extrinsic and associated with the club, the team, and the coaching staff and not the players themselves: the UEFA Women's Elite Club Injury Study. Knee Surg Sports Traumatol Arthrosc 2023:10.1007/s00167-023-07429-5. [PMID: 37121935 DOI: 10.1007/s00167-023-07429-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 04/19/2023] [Indexed: 05/02/2023]
Abstract
PURPOSE To describe the perceived importance of suggested hamstring injury risk factors according to chief medical officers (CMOs) of European women's professional football clubs. A secondary objective was to compare if these perceptions differed between teams with a lower-than-average and higher-than-average hamstring injury burden. METHODS The CMOs of eleven European professional women's football clubs were initially asked to suggest modifiable risk factors for hamstring injury. These risk factors were rated in according with their perceived importance on a 5-graded Likert scale. Participating teams were divided in two groups depending on their hamstring injury burden during the 2020/21 season. The LOW group consisted of six teams that had a lower-than-average hamstring injury burden. The HIGH group consisted of five teams that had a higher-than-average hamstring injury burden. RESULTS Twenty-one risk factors were suggested, most of which were extrinsic in nature, hence associated with the coaching staff, the team or the club organization rather than with the players themselves. The risk factors with the highest average importance were: "lack of communication between medical staff and coaching staff" and "load on players" (each with a weighted average of 3.9), followed by "lack of regular exposure to high-speed football actions during training" and "playing matches 2-3 times a week" (weighted average of 3.8 and 3.7). Differently from the LOW group, the HIGH group perceived the coaching factors (style of coach leadership, training/exercise surveillance by coaching staff) as more important. CONCLUSION In accordance to the eleven CMOs recruited in this study, most risk factors for hamstring injuries are extrinsic in nature and associated with the club, the team, and the coaching staff, and not the players themselves. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Jan Ekstrand
- Unit of Community Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Platensgatan 19, S-582 20, Linköping, Sweden.
- Football Research Group, Linköping, Sweden.
| | - Anna Hallén
- Unit of Community Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Platensgatan 19, S-582 20, Linköping, Sweden
- Football Research Group, Linköping, Sweden
| | - Vittoria Marin
- Isokinetic Medical Group, FIFA Medical Centre of Excellence, London, UK
| | - Håkan Gauffin
- Department of Orthopedics and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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26
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Hoenig T, Gronwald T, Hollander K, Klein C, Frosch KH, Ueblacker P, Rolvien T. Video analysis of Achilles tendon ruptures in professional male football (soccer) reveals underlying injury patterns and provides strategies for injury prevention. Knee Surg Sports Traumatol Arthrosc 2023; 31:2236-2245. [PMID: 36977780 PMCID: PMC10183418 DOI: 10.1007/s00167-023-07384-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 01/30/2023] [Indexed: 03/30/2023]
Abstract
PURPOSE In professional football (soccer), Achilles tendon ruptures are severe injuries. Video analysis promotes a better understanding of the underlying situational and biomechanical patterns, and provides a roadmap for future research to improve the management and prevention of Achilles tendon ruptures. The purpose of this study was to identify injury patterns contributing to acute Achilles tendon ruptures in professional male football players. METHODS Professional male football players with an acute Achilles tendon rupture were identified using an online database. For every in-competition injury, the corresponding football match was detected. Video footage of the injury was accessed using Wyscout.com or publicly available video databases. Situational patterns and injury biomechanics of the injury frame were independently analysed by two reviewers using a standardised checklist and a motion analysis software. Finally, consensus was reached to describe the main injury patterns of Achilles tendon ruptures in professional male football players. RESULTS The search identified video footage of 80 Achilles tendon ruptures in 78 players. Most injuries (94%) occurred through indirect or non-contact mechanisms. The kinematic analysis revealed characteristic joint positions at the time of injury consisting of hip extension, knee extension, ankle dorsiflexion, foot abduction, and foot pronation in most cases. The underlying direction of movement was from flexion to extension (knee) and from plantarflexion to dorsiflexion (ankle). Player actions identified as main injury patterns were stepping back (26%), landing (20%), running/sprinting (18%), jumping (13%), and starting (10%). CONCLUSION Most Achilles tendon ruptures in professional male football players are closed-chain indirect or non-contact injuries. Sudden loading to the plantarflexor musculotendinous unit remains to be the main component for most cases. By achieving a better understanding of underlying injury mechanisms, this study provides new strategies for the prevention of Achilles tendon ruptures. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Tim Hoenig
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20251, Hamburg, Germany.
| | - Thomas Gronwald
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
| | - Karsten Hollander
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
| | - Christian Klein
- Department of Sports Injury Prevention, VBG, German Statutory Accident Insurance for the Administrative Sector, Hamburg, Germany
| | - Karl-Heinz Frosch
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20251, Hamburg, Germany
| | - Peter Ueblacker
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20251, Hamburg, Germany
- FC Bayern München Football Club, Munich, Germany
- Orthopaedics and Sports Medicine Practice, Munich, Germany
| | - Tim Rolvien
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20251, Hamburg, Germany
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27
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Suskens JJM, Tol JL, Kerkhoffs GMMJ, Maas H, van Dieën JH, Reurink G. Activity distribution among the hamstring muscles during high-speed running: A descriptive multichannel surface EMG study. Scand J Med Sci Sports 2023; 33:954-965. [PMID: 36752650 DOI: 10.1111/sms.14326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 01/27/2023] [Accepted: 02/02/2023] [Indexed: 02/09/2023]
Abstract
PURPOSE This study assessed activity distribution among the hamstring muscles during high-speed running. The objective was to compare within and between muscle activity, relative contribution and hip and knee joint angles at peak muscle activity during high-speed running. METHODS Through multichannel electromyography, we measured muscle activity in male basketball players during high-speed running on a treadmill at 15 locations: five for biceps femoris long head, four for semitendinosus, and six for semimembranosus. Muscle activity was calculated for each location within each hamstring muscle individually for each percent of a stride cycle. RESULTS Twenty-nine non-injured basketball players were included (mean age: 17 ± 1 years; mass, 85 ± 9 kg; height, 193 ± 9 cm). Heterogeneous activity was found for all individual hamstring muscles across multiple events of the stride cycle. In the late-swing phase, muscle activity and relative contribution of the semimembranosus was significantly higher than of the semitendinosus. There was no significant difference in hip and knee joint angles at instant of peak muscle activity, assessed locally within individual hamstring muscles, as well as in general over the whole hamstring muscle. CONCLUSION Hamstring muscles were most active in the late-swing phase during high-speed running. In this phase, the semimembranosus was most active and the semitendinosus was least active. Within the biceps femoris long head, the most proximal region was significantly more active in the late-swing phase, compared to other muscle regions. For each muscle and location, peak muscle activity occurred at similar hip and knee joint angles.
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Affiliation(s)
- Jozef J M Suskens
- Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Amsterdam Collaboration on Health and Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam, The Netherlands
| | - Johannes L Tol
- Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Amsterdam Collaboration on Health and Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam, The Netherlands.,Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Gino M M J Kerkhoffs
- Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Amsterdam Collaboration on Health and Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam, The Netherlands
| | - Huub Maas
- Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands
| | - Jaap H van Dieën
- Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands
| | - Gustaaf Reurink
- Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Amsterdam Collaboration on Health and Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam, The Netherlands
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28
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Relationship between maximal strength and hamstring-to-quadriceps ratios in balanced and unbalanced legs in futsal athletes. SPORT SCIENCES FOR HEALTH 2023. [DOI: 10.1007/s11332-023-01046-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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29
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Aiello F, Impellizzeri FM, Brown SJ, Serner A, McCall A. Injury-Inciting Activities in Male and Female Football Players: A Systematic Review. Sports Med 2023; 53:151-176. [PMID: 36315396 PMCID: PMC9807506 DOI: 10.1007/s40279-022-01753-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND A comprehensive examination of the sport-specific activities performed around the time of injury is important to hypothesise injury mechanisms, develop prevention strategies, improve management, and inform future investigations. The aim of this systematic review is to summarise the current literature describing the activities performed around the time of injury in football (soccer). METHODS A systematic search was carried out in PubMed, Web of Science, SPORTDiscus, and OpenGrey. Studies were included if participants were football players aged > 13 years old and the activities performed at the time of injury were reported together with the total number of injuries. Risk of bias was assessed using an adapted version of checklists developed for prevalence studies. The activities reported by the studies were grouped to account for inconsistent reporting, and the proportion of each injury activity was calculated. Data were not meta-analysed due to high heterogeneity of methods and classification criteria. RESULTS We included 64 studies reporting on 56,740 injuries in total. ACL injures were analysed by 12 studies, ankle/foot and knee injuries were analysed by five studies, thigh injuries were analysed by four studies, hip/groin injuries were analysed by three studies, and hamstring injuries were analysed by two studies. Five studies analysed more than one type of injury and 38 studies did not specify the type of injuries analysed. Running and kicking were the predominant activities leading to thigh and hamstring injuries. Changing direction and kicking were the predominant activities leading to hip and groin injuries and duels were the predominant activities leading to ankle injuries. Duels and pressing seem the predominant activities leading to ACL injuries, while results for other knee and general injuries were inconsistent. CONCLUSIONS A qualitative summary of the activities performed at the time of injury has been reported. The results need to be interpreted carefully due to the risk of bias observed in the included studies. If we are to meaningfully progress our knowledge in this area, it is paramount that future research uses consistent methods to record and classify injuries and activities leading up to and performed at the time of injury. REGISTRATION The protocol of this systematic review was registered at the Open Science Framework ( https://doi.org/10.17605/OSF.IO/U96KV ).
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Affiliation(s)
- Francesco Aiello
- Arsenal Performance and Research Team, Arsenal Football Club, London, UK
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK
| | - Franco M Impellizzeri
- Faculty of Health, Sport and Exercise Discipline Group, University of Technology Sydney, Sydney, Australia
| | - Susan J Brown
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK
| | - Andreas Serner
- FIFA Medical, Fédération Internationale de Football Association, Zurich, Switzerland
| | - Alan McCall
- Arsenal Performance and Research Team, Arsenal Football Club, London, UK.
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK.
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30
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Nuñez FJ, Ritzmann R, Hernandez-Abad F, Martinez JC, Suarez-Arrones L. Muscle Architecture, Morphology, and Mechanical and Functional Properties of Biceps Femoris Long Head in Professional Soccer Players with a Prior Healed Injured Hamstring. J Clin Med 2022; 11:7222. [PMID: 36498796 PMCID: PMC9738030 DOI: 10.3390/jcm11237222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 11/28/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE The aim of the present study was to compare the fascicle length, pennation angle, muscle thickness and stiffness of the biceps femoris long head, and eccentric hamstring strength between injured dominant limbs, injured non-dominant limbs, uninjured dominant limbs and uninjured non-dominant legs in previously injured players, and between dominant and non-dominant legs in uninjured elite soccer players. MATERIALS AND METHODS Twenty elite soccer players participated in this study. Ultrasound imaging and MyotonPRO were used to determine the morphological and mechanical properties of the biceps femoris long head. Isokinetic and Nordic hamstring exercises were used to assess eccentric hamstring strength. RESULTS Previously injured players showed substantially lower fascicle length and muscle thickness, and significantly higher biceps femoris long head stiffness than uninjured players, without differences between limbs. CONCLUSION The morphological and mechanical properties of elite soccer players with hamstring injury history were different from those in uninjured players. The lack of differences between limbs showed that these values are characteristics of individual players that must be considered in the design of programs to prevent BFlh injury.
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Affiliation(s)
| | - Ramona Ritzmann
- Department of Sports and Sport Science, University of Freiburg, 79106 Freiburg, Germany
| | - Fernando Hernandez-Abad
- Department of Sport Sciences, European University of the Canary Islands, 38300 Tenerife, Spain
| | | | - Luis Suarez-Arrones
- Department of Sport Sciences, Universidad Pablo de Olavide, 41013 Sevilla, Spain
- Performance Departament, FC Lugano, 6900 Lugano, Switzerland
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31
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Gronwald T, Klein C, Hoenig T, Pietzonka M, Bloch H, Edouard P, Hollander K. Infographic. Video analysis of match hamstring injury patterns in professional male football (soccer) teaches us about the need for demand-specific multicomponent exercise-based risk reduction programmes. Br J Sports Med 2022; 56:bjsports-2022-105600. [PMID: 35649706 DOI: 10.1136/bjsports-2022-105600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2022] [Indexed: 11/03/2022]
Affiliation(s)
- Thomas Gronwald
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
| | - Christian Klein
- Department of Sports Injury Prevention, VBG, German Statutory Accident Insurance for the Administrative Sector, Hamburg, Germany
| | - Tim Hoenig
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Micha Pietzonka
- Department of Sports Injury Prevention, VBG, German Statutory Accident Insurance for the Administrative Sector, Hamburg, Germany
| | - Hendrik Bloch
- Department of Sports Injury Prevention, VBG, German Statutory Accident Insurance for the Administrative Sector, Hamburg, Germany
| | - Pascal Edouard
- Inter-university Laboratory of Human Movement Biology, EA 7424, Univ Lyon, UJM-Saint-Etienne, Saint-Etienne, France
- Department of Clinical and Exercise Physiology, Sports Medicine Unit, University Hospital of Saint-Etienne, Faculty of Medicine, Saint-Etienne, France
| | - Karsten Hollander
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
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32
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Widodo AF, Tien CW, Chen CW, Lai SC. Isotonic and Isometric Exercise Interventions Improve the Hamstring Muscles’ Strength and Flexibility: A Narrative Review. Healthcare (Basel) 2022; 10:healthcare10050811. [PMID: 35627948 PMCID: PMC9140507 DOI: 10.3390/healthcare10050811] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/23/2022] [Accepted: 04/24/2022] [Indexed: 02/01/2023] Open
Abstract
Background: Hamstring weakness has been associated with an increased risk of hamstring strain, a common sports injury that occurs when athletes perform actions such as quick sprints. The hamstring complex comprises three distinct muscles: the long and short heads of the bicep femoris, the semimembranosus, and the semitendinosus. Methods: The researchers collected the data from different electronic databases: PubMed, Google Scholar, and the Web of Science. Results: Many studies have been conducted on the numerous benefits of hamstring strength, in terms of athletic performance and injury prevention. Isotonic and isometric exercises are commonly used to improve hamstring strength, with each exercise type having a unique effect on the hamstring muscles. Isotonic exercise improves the muscles’ strength, increasing their ability to resist any force, while isometric training increases strength and the muscles’ ability to produce power by changing the muscle length. Conclusions: These exercises, when performed at low intensity, but with high repetition, can be used by the healthy general population to prepare for training and daily exercise. This can improve hamstring muscle strength and flexibility, leading to enhanced performance and reduced injury risk.
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Affiliation(s)
- Akhmad Fajri Widodo
- International Sport Science Master’s Program, College of Human Development and Health, National Taipei University of Nursing and Health Sciences, Taipei 112303, Taiwan;
| | - Cheng-Wen Tien
- Physical Education Office, General Education Centre, National Taipei University of Nursing and Health Sciences, Taipei 112303, Taiwan;
| | - Chien-Wei Chen
- International Sport Science Master’s Program, College of Human Development and Health, National Taipei University of Nursing and Health Sciences, Taipei 112303, Taiwan;
- Department of Exercise and Health Science, College of Human Development and Health, National Taipei University of Nursing and Health Sciences, Taipei 112303, Taiwan;
- Correspondence:
| | - Shih-Chiung Lai
- Department of Exercise and Health Science, College of Human Development and Health, National Taipei University of Nursing and Health Sciences, Taipei 112303, Taiwan;
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Garcia AG, Andrade R, Afonso J, Runco JL, Maestro A, Espregueira-Mendes J. Hamstrings injuries in football. J Orthop 2022; 31:72-77. [PMID: 35464813 PMCID: PMC9026901 DOI: 10.1016/j.jor.2022.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/08/2022] [Accepted: 04/09/2022] [Indexed: 11/15/2022] Open
Abstract
Background Hamstrings injuries are a major concern in football (soccer), affecting both recreational players and professional athletes. Although being a recognized issue within the football community, its incidence has been increasing over the last years and still poses a challenge to all practitioners involved. Study objectives and rationale The goal of this narrative review is to outline hamstrings injuries epidemiology and mechanisms of injury, identify and discuss its risk factors, provide an approach to a proper early diagnosis, evaluate the efficacy of current treatment options and return to sports, and present the best strategies for hamstrings injury prevention. These guidelines will help the sports medicine staff team on how to better manage their players with or at risk of hamstrings injuries. Conclusion Despite several breakthroughs in research of hamstrings injuries, there is still heterogeneity across studies and lack of consensus in regards to classification, diagnosis, treatment and prevention. Hamstrings injuries compromise the athlete's performance with time loss due to injury, shortens their highest-level career longevity with higher risk of reinjury rates, and is a defying problem for clubs to balance financial losses due to having their players off the pitch. Further research is warranted to keep moving forward with evidence on treating and preventing hamstrings injuries to mitigate its high incidence and keep the players safe.
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Affiliation(s)
- André Gismonti Garcia
- Casa de Saúde São José, Rio de Janeiro, Brazil
- Clínica Espregueira – FIFA Medical Centre of Excellence, Porto, Portugal
| | - Renato Andrade
- Clínica Espregueira – FIFA Medical Centre of Excellence, Porto, Portugal
- Dom Henrique Research Centre, Porto, Portugal
- Porto Biomechanics Laboratory (LABIOMEP), University of Porto, Porto, Portugal
| | - José Afonso
- Centre of Research, Education Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Portugal
| | | | - Antonio Maestro
- Instituto Asturiano de Traumatologia Real Sporting de Gijon, Gijon, Spain
- Corresponding author.
| | - João Espregueira-Mendes
- Clínica Espregueira – FIFA Medical Centre of Excellence, Porto, Portugal
- Dom Henrique Research Centre, Porto, Portugal
- School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's–PT Government Associate Laboratory, Braga/Guimarães, Portugal
- 3B's Research Group – Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Barco, Guimarães, Portugal
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Lempainen L, Mechó S, Valle X, Mazzoni S, Villalon J, Freschi M, Stefanini L, García-Romero-Pérez A, Burova M, Pleshkov P, Pruna R, Pasta G, Kosola J. Management of anterior thigh injuries in soccer players: practical guide. BMC Sports Sci Med Rehabil 2022; 14:41. [PMID: 35303927 PMCID: PMC8932115 DOI: 10.1186/s13102-022-00428-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 03/02/2022] [Indexed: 11/10/2022]
Abstract
Most of the anterior thigh injuries are contusions or strains, however, some of these injuries can be career ending. Early diagnosis and correct treatment are key to successful outcome. Analyzing injury mechanism and adding both clinical and imaging findings, clinicians can make the right treatment decisions already often in the acute phase of the injury. Low grade contusions and muscle strains are treated well with planned rehabilitation, but complete tendon injuries or avulsions can require operative treatment. Also, neglected minor injuries could lead to chronic disabilities and time lost from play. Typical clinical presentation of anterior thigh injury is swelling and pain during hip flexion or knee extension. In more severe cases a clear gap can be palpated. Imaging methods used are ultrasound and magnetic resonance imaging (MRI) which are helpful for clinicians to determine more exact the extent of injury. MRI can identify possible tendon retractions which may need surgery. Clinicians should also be aware of other traumatic lesions affecting anterior thigh area such as myositis ossificans formation. Optimal treatment should be coordinated including acute phase treatment with rest, ice, and compression together with designed return-to-play protocol. The anatomical structure involved lines the treatment pathway. This narrative review describes these more common reasons for outpatient clinical visits for anterior thigh pain and injuries among soccer players.
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Affiliation(s)
- Lasse Lempainen
- Sports Trauma Research Unit, FinnOrthopaedics, Joukahaisenkatu 6, 20520, Turku, Finland. .,Department of Physical Activity and Health, Paavo Nurmi Centre, University of Turku, Turku, Finland.
| | - Sandra Mechó
- Radiology Department, SCIAS-Hospital de Barcelona, Barcelona, Spain
| | - Xavier Valle
- FC Barcelona, Medical Services, FIFA Center of Excellence, Barcelona, Spain
| | | | | | | | | | - Alvaro García-Romero-Pérez
- Injury Prevention and Rehabilitation Department, Watford FC, Watford, England.,Physiotherapy Department, Universidad Camilo José Cela, Madrid, Spain
| | | | | | - Ricard Pruna
- FC Barcelona, Medical Services, FIFA Center of Excellence, Barcelona, Spain
| | - Giulio Pasta
- Medical Department, Parma Calcio 1913, Parma, Italy
| | - Jussi Kosola
- Department of Physical Activity and Health, Paavo Nurmi Centre, University of Turku, Turku, Finland.,Department of Surgery, Kanta-Häme Central Hospital, Hämeenlinna, Finland
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Mechanisms of Achilles Tendon Rupture in National Basketball Association Players. J Appl Biomech 2022; 38:398-403. [DOI: 10.1123/jab.2022-0088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 08/15/2022] [Accepted: 08/29/2022] [Indexed: 11/15/2022]
Abstract
A systematic search was performed of online databases for any Achilles tendon (AT) injuries occurring within the National Basketball Association (NBA). Video was obtained of injuries occurring during competition and downloaded for analysis in Dartfish. NBA athletes (n = 27) were identified with AT rupture over a 30-year period (1991–2021). Of the 27 NBA athletes found to have AT ruptures (mean age: 29.3 [3.3] y; average time in the NBA: 8.5 [3.8] y), 15 in-game videos were obtained for analysis. Noncontact rupture was presumed to have occurred in 12/13 cases. Eight of the 13 athletes had possession of the ball during time of injury. The ankle joint of the injured limb for all 13 athletes was in a dorsiflexed position during the time of injury (47.9° [6.5°]). All 13 athletes performed a false-step mechanism at time of injury where they initiated the movement by taking a rearward step posterior to their center of mass with the injured limb before translating forward. NBA basketball players that suffered AT ruptures appeared to present with a distinct sequence of events, including initiating a false step with ankle dorsiflexion of the injured limb at the time of injury.
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