1
|
Mechó S, Iriarte I, Lisbona R, Pérez-Andrés R, Pruna R, Rodríguez-Baeza A. Different anatomic patterns of the indirect tendon of the rectus femoris. Surg Radiol Anat 2024; 46:1421-1428. [PMID: 38890187 PMCID: PMC11322255 DOI: 10.1007/s00276-024-03411-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 06/10/2024] [Indexed: 06/20/2024]
Abstract
PURPOSE The rectus femoris forms the anterior portion of the quadriceps muscle. It has a proximal tendinous complex, which is constituted by a direct tendon, an indirect tendon, and a variable third tendon. Direct and indirect tendons converge into a common tendon. The purposes of this study are to add anatomical knowledge about the proximal tendinous complex and describe anatomical variants of the indirect tendon and, on these basis, categorize different anatomical patterns. METHOD In this study, 48 hemipelvis from bodies donated to the Universitat Autònoma de Barcelona have been dissected to examine the proximal tendinous complex of the rectus femoris. RESULTS The following anatomical variants of the indirect tendon were described: inferior aponeurotic expansion in 23/48 cases (47.9%); superior aponeurotic expansion in 21/48 cases (43.7%); and an unusual origin of the myotendinous junction of the rectus femoris in the free portion of the indirect tendon in 19/48 cases (39.6%). On the basis of the aponeurotic expansions, the following anatomical patterns of the indirect tendon were defined: standard (19/48 cases, 39.6%), superior and inferior complex (15/48 cases, 31.2%), inferior complex (8/48 cases, 16.7%), and superior complex (6/48 cases, 12.5%). CONCLUSION We can categorize four different anatomical patterns of the indirect tendon, three of which are complex. We suggest that complex patterns can cause an increased stiffness of the indirect tendon and so be considered non-modifiable risk factors for rectus femoris injuries. Finally, it would be useful to identify complex patterns and perform injury prevention actions through specific physical preparation programs.
Collapse
Affiliation(s)
- S Mechó
- Department of Morphological Sciences (Human Anatomy and Embriology Unit), Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
- Department of Radiology, Hospital of Barcelona, Barcelona, Spain.
- FIFA Medical Center of Excellence, Barcelona Football Club, Barcelona, Spain.
| | - I Iriarte
- Department of Physical Medicine and Rehabilitation, Ars Médica Clinics, Bilbao, Spain
| | - R Lisbona
- Department of Radiology, Germans Trias i Pujol Hospital, Badalona, Barcelona, Spain
| | - R Pérez-Andrés
- Department of Radiology, Germans Trias i Pujol Hospital, Badalona, Barcelona, Spain
| | - R Pruna
- FIFA Medical Center of Excellence, Barcelona Football Club, Barcelona, Spain
| | - A Rodríguez-Baeza
- Department of Morphological Sciences (Human Anatomy and Embriology Unit), Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| |
Collapse
|
2
|
Mechó S, Palomar-Garcia A, Wong M, Gallego JC, López F, Valle X, Ruperez F, Pruna R, González JR, Rodas G. Characterization of acute effects of football competition on hamstring muscles by muscle functional MRI techniques. PLoS One 2024; 19:e0308328. [PMID: 39190697 DOI: 10.1371/journal.pone.0308328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 07/22/2024] [Indexed: 08/29/2024] Open
Abstract
Muscle functional MRI identifies changes in metabolic activity in each muscle and provides a quantitative index of muscle activation and damage. No previous studies have analyzed the hamstrings activation over a football match. This study aimed at detecting different patterns of hamstring muscles activation after a football game, and to examine inter- and intramuscular differences (proximal-middle-distal) in hamstring muscles activation using transverse relaxation time (T2)-weighted magnetic resonance images. Eleven healthy football players were recruited for this study. T2 relaxation time mapping-MRI was performed before (2 hours) and immediately after a match (on average 13 min). The T2 values of each hamstring muscle at the distal, middle, and proximal portions were measured. The primary outcome measure was the increase in T2 relaxation time value after a match. Linear mixed models were used to detect differences pre and postmatch. MRI examination showed that there was no obvious abnormality in the shape and the conventional T2 weighted signal of the hamstring muscles after a match. On the other hand, muscle functional MRI T2 analysis revealed that T2 relaxation time significantly increased at distal and middle portions of the semitendinosus muscle (p = 0.0003 in both cases). By employing T2 relaxation time mapping, we have identified alterations within the hamstring muscles being the semitendinosus as the most engaged muscle, particularly within its middle and distal thirds. This investigation underscores the utility of T2 relaxation time mapping in evaluating muscle activation patterns during football matches, facilitating the detection of anomalous activation patterns that may warrant injury reduction interventions.
Collapse
Affiliation(s)
- Sandra Mechó
- Department of Radiology Hospital de Barcelona, SCIAS, Barcelona, Spain
- Medical Department of Futbol Club Barcelona (FIFA Medical Center of Excellence) and Barça Innovation Hub, Barcelona, Spain
| | | | - Manuel Wong
- Medical Department of Futbol Club Barcelona (FIFA Medical Center of Excellence) and Barça Innovation Hub, Barcelona, Spain
| | - Juan C Gallego
- Department of Radiology Hospital de Barcelona, SCIAS, Barcelona, Spain
- Medical Department of Futbol Club Barcelona (FIFA Medical Center of Excellence) and Barça Innovation Hub, Barcelona, Spain
| | - Francesc López
- Department of Radiology Hospital de Barcelona, SCIAS, Barcelona, Spain
- Medical Department of Futbol Club Barcelona (FIFA Medical Center of Excellence) and Barça Innovation Hub, Barcelona, Spain
| | - Xavier Valle
- Medical Department of Futbol Club Barcelona (FIFA Medical Center of Excellence) and Barça Innovation Hub, Barcelona, Spain
| | - Ferran Ruperez
- Medical Department of Futbol Club Barcelona (FIFA Medical Center of Excellence) and Barça Innovation Hub, Barcelona, Spain
| | - Ricard Pruna
- Medical Department of Futbol Club Barcelona (FIFA Medical Center of Excellence) and Barça Innovation Hub, Barcelona, Spain
| | - Juan R González
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Gil Rodas
- Medical Department of Futbol Club Barcelona (FIFA Medical Center of Excellence) and Barça Innovation Hub, Barcelona, Spain
- Sports Medicine Unit, Hospital Clinic and Sant Joan de Déu, Barcelona, Spain
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| |
Collapse
|
3
|
Pavlović B, Toskić L, Cicović V, Cicović B, Stanković V. The Effects of Dry-Needling Therapy on the Quality of Life in Athletes with Myofascial Pain Syndrome: Repeated Measures Design Study. J Clin Med 2024; 13:4969. [PMID: 39274182 PMCID: PMC11395707 DOI: 10.3390/jcm13174969] [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: 07/18/2024] [Revised: 08/15/2024] [Accepted: 08/16/2024] [Indexed: 09/16/2024] Open
Abstract
Background: This study aims to investigate the effects of dry-needling treatment on the quality of life in athletes with myofascial pain syndrome (MPS). Methods: The participants included in the study were 50 athletes (38 males and 12 females) diagnosed with MPS. The treatments were carried out in four sessions, 5/7 days apart on 55 muscles in total. A 36-item health survey (SF-36) was implemented to determine the participants' quality of life. The chi-square test was used to determine the differences between measurements. Results: Dry-needling treatment has a positive influence on self-perspective of physical functioning (p = 0.011, on average), physical problems (p = 0.001, on average), emotional problems (p = 0.004, on average), social functioning (p = 0.001, on average), pain (p = 0.001, on average), and mental health and vitality (p = 0.001, on average) in athletes with MPS. The only quality-of-life dimension not influenced by the dry-needling treatment is the general health perception (p = 0.340, on average). Conclusions: Dry-needling therapy has positive effects on the perception of quality of life in athletes with MPS.
Collapse
Affiliation(s)
- Bojan Pavlović
- Faculty of Physical Education and Sport, University of East Sarajevo, 71123 East Sarajevo, Bosnia and Herzegovina
| | - Lazar Toskić
- Faculty of Sport and Physical Education, University of Priština-Kosovska Mitrovica, 38218 Leposavić, Serbia
- Faculty of Sport, University "Union-Nikola Tesla", 11000 Belgrade, Serbia
| | - Vanja Cicović
- Faculty of Physical Education and Sport, University of East Sarajevo, 71123 East Sarajevo, Bosnia and Herzegovina
| | - Borislav Cicović
- Faculty of Physical Education and Sport, University of East Sarajevo, 71123 East Sarajevo, Bosnia and Herzegovina
| | - Veroljub Stanković
- Faculty of Sport and Physical Education, University of Priština-Kosovska Mitrovica, 38218 Leposavić, Serbia
| |
Collapse
|
4
|
Isern-Kebschull J, Mechó S, Pedret C, Pruna R, Alomar X, Kassarjian A, Luna A, Martínez J, Tomas X, Rodas G. Muscle Healing in Sports Injuries: MRI Findings and Proposed Classification Based on a Single Institutional Experience and Clinical Observation. Radiographics 2024; 44:e230147. [PMID: 39052498 DOI: 10.1148/rg.230147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024]
Abstract
MRI plays a crucial role in assessment of patients with muscle injuries. The healing process of these injuries has been studied in depth from the pathophysiologic and histologic points of view and divided into destruction, repair, and remodeling phases, but the MRI findings of these phases have not been fully described, to our knowledge. On the basis of results from 310 MRI studies, including both basal and follow-up studies, in 128 athletes with muscle tears including their clinical evolution, the authors review MRI findings in muscle healing and propose a practical imaging classification based on morphology and signal intensity that correlates with histologic changes. The proposed phases, which can overlap, are destruction (phase 1), showing myoconnective tissue discontinuity and featherlike edema; repair (phase 2), showing filling in of the connective tissue gaps by a hypertrophic immature scar; and remodeling (phase 3), showing scar maturation and regression of the edema. A final healed stage can be identified with MRI, which is characterized by persistence of a slight fusiform thickening of the connective tissue. This information can be obtained from a truncated MRI protocol with three acquisitions, preferably performed with a 3-T magnet. During MRI follow-up of muscle injuries, other important features to be assessed are changes in muscle edema and specific warning signs, such as persistent intermuscular edema, new connective tear, and scar rupture. An understanding of the MRI appearance of normal and abnormal muscle healing and warning signs, along with cooperation with a multidisciplinary team, enable optimization of return to play for the injured athlete. ©RSNA, 2024 See the invited commentary by Flores in this issue.
Collapse
Affiliation(s)
- Jaime Isern-Kebschull
- From the Department of Radiology, Hospital Clinic, University of Barcelona, C/Villarroel 170, E-08036 Barcelona, Spain (J.I.-K., X.T.); Department of Radiology, Hospital de Barcelona, Barcelona, Spain (S.M., J.M.); Department of Sports Medicine and Imaging, Clínica Diagonal, Barcelona, Spain (C.P.); FCBarcelona Medical Department (FIFA Medical Center of Excellence), Barça Innovation Hub, Barcelona, Spain (R.P., G.R.); Department of Radiology, Centres Mèdics Creu Blanca, Barcelona, Spain (X.A.); Elite Sports Imaging, SL, Pozuelo de Alarcón, Madrid, Spain (A.K.); Department of Radiology, Olympia Medical Center, Madrid, Spain (A.K.); Department of Radiology, Clínica Las Nieves, HTmédica, Jaén, Spain (A.L.); and Medicine Sport Unit, Hospital Clinic-Joan de Déu, Barcelona, Spain (G.R.)
| | - Sandra Mechó
- From the Department of Radiology, Hospital Clinic, University of Barcelona, C/Villarroel 170, E-08036 Barcelona, Spain (J.I.-K., X.T.); Department of Radiology, Hospital de Barcelona, Barcelona, Spain (S.M., J.M.); Department of Sports Medicine and Imaging, Clínica Diagonal, Barcelona, Spain (C.P.); FCBarcelona Medical Department (FIFA Medical Center of Excellence), Barça Innovation Hub, Barcelona, Spain (R.P., G.R.); Department of Radiology, Centres Mèdics Creu Blanca, Barcelona, Spain (X.A.); Elite Sports Imaging, SL, Pozuelo de Alarcón, Madrid, Spain (A.K.); Department of Radiology, Olympia Medical Center, Madrid, Spain (A.K.); Department of Radiology, Clínica Las Nieves, HTmédica, Jaén, Spain (A.L.); and Medicine Sport Unit, Hospital Clinic-Joan de Déu, Barcelona, Spain (G.R.)
| | - Carles Pedret
- From the Department of Radiology, Hospital Clinic, University of Barcelona, C/Villarroel 170, E-08036 Barcelona, Spain (J.I.-K., X.T.); Department of Radiology, Hospital de Barcelona, Barcelona, Spain (S.M., J.M.); Department of Sports Medicine and Imaging, Clínica Diagonal, Barcelona, Spain (C.P.); FCBarcelona Medical Department (FIFA Medical Center of Excellence), Barça Innovation Hub, Barcelona, Spain (R.P., G.R.); Department of Radiology, Centres Mèdics Creu Blanca, Barcelona, Spain (X.A.); Elite Sports Imaging, SL, Pozuelo de Alarcón, Madrid, Spain (A.K.); Department of Radiology, Olympia Medical Center, Madrid, Spain (A.K.); Department of Radiology, Clínica Las Nieves, HTmédica, Jaén, Spain (A.L.); and Medicine Sport Unit, Hospital Clinic-Joan de Déu, Barcelona, Spain (G.R.)
| | - Ricard Pruna
- From the Department of Radiology, Hospital Clinic, University of Barcelona, C/Villarroel 170, E-08036 Barcelona, Spain (J.I.-K., X.T.); Department of Radiology, Hospital de Barcelona, Barcelona, Spain (S.M., J.M.); Department of Sports Medicine and Imaging, Clínica Diagonal, Barcelona, Spain (C.P.); FCBarcelona Medical Department (FIFA Medical Center of Excellence), Barça Innovation Hub, Barcelona, Spain (R.P., G.R.); Department of Radiology, Centres Mèdics Creu Blanca, Barcelona, Spain (X.A.); Elite Sports Imaging, SL, Pozuelo de Alarcón, Madrid, Spain (A.K.); Department of Radiology, Olympia Medical Center, Madrid, Spain (A.K.); Department of Radiology, Clínica Las Nieves, HTmédica, Jaén, Spain (A.L.); and Medicine Sport Unit, Hospital Clinic-Joan de Déu, Barcelona, Spain (G.R.)
| | - Xavier Alomar
- From the Department of Radiology, Hospital Clinic, University of Barcelona, C/Villarroel 170, E-08036 Barcelona, Spain (J.I.-K., X.T.); Department of Radiology, Hospital de Barcelona, Barcelona, Spain (S.M., J.M.); Department of Sports Medicine and Imaging, Clínica Diagonal, Barcelona, Spain (C.P.); FCBarcelona Medical Department (FIFA Medical Center of Excellence), Barça Innovation Hub, Barcelona, Spain (R.P., G.R.); Department of Radiology, Centres Mèdics Creu Blanca, Barcelona, Spain (X.A.); Elite Sports Imaging, SL, Pozuelo de Alarcón, Madrid, Spain (A.K.); Department of Radiology, Olympia Medical Center, Madrid, Spain (A.K.); Department of Radiology, Clínica Las Nieves, HTmédica, Jaén, Spain (A.L.); and Medicine Sport Unit, Hospital Clinic-Joan de Déu, Barcelona, Spain (G.R.)
| | - Ara Kassarjian
- From the Department of Radiology, Hospital Clinic, University of Barcelona, C/Villarroel 170, E-08036 Barcelona, Spain (J.I.-K., X.T.); Department of Radiology, Hospital de Barcelona, Barcelona, Spain (S.M., J.M.); Department of Sports Medicine and Imaging, Clínica Diagonal, Barcelona, Spain (C.P.); FCBarcelona Medical Department (FIFA Medical Center of Excellence), Barça Innovation Hub, Barcelona, Spain (R.P., G.R.); Department of Radiology, Centres Mèdics Creu Blanca, Barcelona, Spain (X.A.); Elite Sports Imaging, SL, Pozuelo de Alarcón, Madrid, Spain (A.K.); Department of Radiology, Olympia Medical Center, Madrid, Spain (A.K.); Department of Radiology, Clínica Las Nieves, HTmédica, Jaén, Spain (A.L.); and Medicine Sport Unit, Hospital Clinic-Joan de Déu, Barcelona, Spain (G.R.)
| | - Antonio Luna
- From the Department of Radiology, Hospital Clinic, University of Barcelona, C/Villarroel 170, E-08036 Barcelona, Spain (J.I.-K., X.T.); Department of Radiology, Hospital de Barcelona, Barcelona, Spain (S.M., J.M.); Department of Sports Medicine and Imaging, Clínica Diagonal, Barcelona, Spain (C.P.); FCBarcelona Medical Department (FIFA Medical Center of Excellence), Barça Innovation Hub, Barcelona, Spain (R.P., G.R.); Department of Radiology, Centres Mèdics Creu Blanca, Barcelona, Spain (X.A.); Elite Sports Imaging, SL, Pozuelo de Alarcón, Madrid, Spain (A.K.); Department of Radiology, Olympia Medical Center, Madrid, Spain (A.K.); Department of Radiology, Clínica Las Nieves, HTmédica, Jaén, Spain (A.L.); and Medicine Sport Unit, Hospital Clinic-Joan de Déu, Barcelona, Spain (G.R.)
| | - Javier Martínez
- From the Department of Radiology, Hospital Clinic, University of Barcelona, C/Villarroel 170, E-08036 Barcelona, Spain (J.I.-K., X.T.); Department of Radiology, Hospital de Barcelona, Barcelona, Spain (S.M., J.M.); Department of Sports Medicine and Imaging, Clínica Diagonal, Barcelona, Spain (C.P.); FCBarcelona Medical Department (FIFA Medical Center of Excellence), Barça Innovation Hub, Barcelona, Spain (R.P., G.R.); Department of Radiology, Centres Mèdics Creu Blanca, Barcelona, Spain (X.A.); Elite Sports Imaging, SL, Pozuelo de Alarcón, Madrid, Spain (A.K.); Department of Radiology, Olympia Medical Center, Madrid, Spain (A.K.); Department of Radiology, Clínica Las Nieves, HTmédica, Jaén, Spain (A.L.); and Medicine Sport Unit, Hospital Clinic-Joan de Déu, Barcelona, Spain (G.R.)
| | - Xavier Tomas
- From the Department of Radiology, Hospital Clinic, University of Barcelona, C/Villarroel 170, E-08036 Barcelona, Spain (J.I.-K., X.T.); Department of Radiology, Hospital de Barcelona, Barcelona, Spain (S.M., J.M.); Department of Sports Medicine and Imaging, Clínica Diagonal, Barcelona, Spain (C.P.); FCBarcelona Medical Department (FIFA Medical Center of Excellence), Barça Innovation Hub, Barcelona, Spain (R.P., G.R.); Department of Radiology, Centres Mèdics Creu Blanca, Barcelona, Spain (X.A.); Elite Sports Imaging, SL, Pozuelo de Alarcón, Madrid, Spain (A.K.); Department of Radiology, Olympia Medical Center, Madrid, Spain (A.K.); Department of Radiology, Clínica Las Nieves, HTmédica, Jaén, Spain (A.L.); and Medicine Sport Unit, Hospital Clinic-Joan de Déu, Barcelona, Spain (G.R.)
| | - Gil Rodas
- From the Department of Radiology, Hospital Clinic, University of Barcelona, C/Villarroel 170, E-08036 Barcelona, Spain (J.I.-K., X.T.); Department of Radiology, Hospital de Barcelona, Barcelona, Spain (S.M., J.M.); Department of Sports Medicine and Imaging, Clínica Diagonal, Barcelona, Spain (C.P.); FCBarcelona Medical Department (FIFA Medical Center of Excellence), Barça Innovation Hub, Barcelona, Spain (R.P., G.R.); Department of Radiology, Centres Mèdics Creu Blanca, Barcelona, Spain (X.A.); Elite Sports Imaging, SL, Pozuelo de Alarcón, Madrid, Spain (A.K.); Department of Radiology, Olympia Medical Center, Madrid, Spain (A.K.); Department of Radiology, Clínica Las Nieves, HTmédica, Jaén, Spain (A.L.); and Medicine Sport Unit, Hospital Clinic-Joan de Déu, Barcelona, Spain (G.R.)
| |
Collapse
|
5
|
Cerezal A, Roriz D, Canga A, Cerezal L. Imaging of sports injuries in adolescents. Pediatr Radiol 2024:10.1007/s00247-024-05991-9. [PMID: 38995428 DOI: 10.1007/s00247-024-05991-9] [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: 05/16/2024] [Revised: 06/25/2024] [Accepted: 06/26/2024] [Indexed: 07/13/2024]
Abstract
Musculoskeletal injuries in adolescents tend to occur in particular locations and have distinct characteristics, as they affect an immature skeleton. Increased engagement in sports, extended training and competition periods, and early specialization in specific sports, among other factors, have contributed significantly to the rise in musculoskeletal sports injuries in adolescents. Furthermore, females show a particularly pronounced increase in sports participation, where anatomical and hormonal factors play crucial roles in the development and increased frequency of sports-related injuries. Consequently, there is a growing demand for diagnostic imaging techniques. Musculoskeletal and pediatric radiologists require a comprehensive understanding of intrinsic and extrinsic risk factors and the successive stages of skeletal development that can influence the specific characteristics of sports injuries in adolescents. These aspects are crucial for the diagnostic, prognostic, and therapeutic management of these injuries and for mitigating chronic conditions that could compromise future sports participation. This review analyzes the primary musculoskeletal injuries in adolescent athletes and highlights the pivotal role of different imaging methods in their diagnosis and management.
Collapse
Affiliation(s)
- Alvaro Cerezal
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitario La Paz, Madrid, Spain
| | - Diogo Roriz
- Department of Radiology, ULSAM, Viana Do Castelo, Portugal
| | - Ana Canga
- Department of Radiology, Valdecilla University Hospital, Santander, Spain
| | - Luis Cerezal
- Department of Radiology, Diagnóstico Médico Cantabria (DMC), Calle Castilla 6, 39002, Santander, Spain.
| |
Collapse
|
6
|
Bellosta-López P, Giner-Nicolás R, Molina-Molina A, Rubio-Peirotén A, Roche-Seruendo LE, Doménech-García V. Recovery of spatio-temporal gait and functional parameters following unilateral eccentric exercise-induced muscle damage in the hamstrings. J Sci Med Sport 2024; 27:387-393. [PMID: 38644066 DOI: 10.1016/j.jsams.2024.04.002] [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: 11/03/2023] [Revised: 03/26/2024] [Accepted: 04/03/2024] [Indexed: 04/23/2024]
Abstract
OBJECTIVES This study aimed to analyze how spatiotemporal gait parameters, active knee extension range of motion, muscle activity, and self-perceived function change over a seven-day period in healthy individuals after exercise-induced muscle damage (EIMD) in the hamstrings. DESIGN Longitudinal cohort study. METHODS Twenty-four healthy males participated in four sessions before and after EIMD (pre-EIMD, 48 h, 96 h, and 168 h post-EIMD). A single-leg deadlift exercise was performed to provoke EIMD in the hamstrings of the dominant leg. Lower limb function perception, spatiotemporal gait parameters, active knee extension range of motion, and electromyographic (EMG) activity of the semitendinosus and biceps femoris muscles during gait and maximal isometric contraction were assessed bilaterally. RESULTS At 48 h, the EIMD-side showed reduced step length, active knee extension range of motion, maximal strength and EMG activity compared to baseline (P < 0.042), while increased relative EMG activity in the biceps femoris during gait (P = 0.001). At 96 h, step length and EMG activity on the EIMD-side reached similar values to those at baseline, whereas lower limb function perception and active knee extension range of motion returned to baseline state at 168 h post-EIMD. No changes over time were observed on the control-side. CONCLUSIONS Recovery from EIMD requires a multimodal assessment since the different parameters affected by EIMD recover at different paces. Active range of motion appears to be the last variable to fully recover. Self-perceived function should not be considered in isolation as it does not represent complete functional recovery.
Collapse
Affiliation(s)
- Pablo Bellosta-López
- Universidad San Jorge, Autov A23 km 299, 50830 Villanueva de Gállego, Zaragoza, Spain
| | - Rafael Giner-Nicolás
- Universidad San Jorge, Autov A23 km 299, 50830 Villanueva de Gállego, Zaragoza, Spain
| | | | | | | | | |
Collapse
|
7
|
Calatayud Moscoso Del Prado J, Fernández-Gil MÁ, Bueno Horcajadas Á, Kassarjian A. Groin pain in soccer players: anatomy, clinical presentation, biomechanics, pathology and imaging findings. Skeletal Radiol 2024:10.1007/s00256-024-04699-z. [PMID: 38787402 DOI: 10.1007/s00256-024-04699-z] [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: 09/24/2023] [Revised: 04/10/2024] [Accepted: 04/29/2024] [Indexed: 05/25/2024]
Abstract
Groin pain is extremely common in soccer players, especially male soccer players, with nearly a third experiencing groin pain over the course of their careers. Despite its high prevalence, there continues to be some confusion and controversy regarding the detailed anatomy and recommended terminology related to groin pain in athletes. This article will review the anatomy, clinical presentation, biomechanics, pathology and imaging findings most commonly associated with groin pain in soccer players.
Collapse
Affiliation(s)
| | - María Ángeles Fernández-Gil
- Olympia Medical Center, Torre Caleido, Paseo de La Castellana 259 E, 28046, Madrid, Spain
- Elite Sport Imaging, SL, Madrid, Spain
| | - Ángel Bueno Horcajadas
- Olympia Medical Center, Torre Caleido, Paseo de La Castellana 259 E, 28046, Madrid, Spain
- Elite Sport Imaging, SL, Madrid, Spain
| | - Ara Kassarjian
- Olympia Medical Center, Torre Caleido, Paseo de La Castellana 259 E, 28046, Madrid, Spain
- Elite Sport Imaging, SL, Madrid, Spain
| |
Collapse
|
8
|
Vidal L, Vila I, Venegas V, Sacristán A, Contreras-Muñoz P, Lopez-Garzon M, Giné C, Rodas G, Marotta M. A Novel Minimally Invasive Surgically Induced Skeletal Muscle Injury Model in Sheep. Int J Mol Sci 2024; 25:5612. [PMID: 38891800 PMCID: PMC11171619 DOI: 10.3390/ijms25115612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 05/15/2024] [Accepted: 05/18/2024] [Indexed: 06/21/2024] Open
Abstract
Sports-related muscle injuries account for 10-55% of all injuries, which is a growing concern, especially given the aging world population. To evaluate the process of skeletal muscle injury and compare it with muscle lesions observed in humans, we developed a novel in vivo model in sheep. In this model, muscle injury was induced by an ultrasound-guided transverse biopsy at the myotendinous junction of the medial gastrocnemius muscle. Twelve male sheep were examined at 3, 7, 14, and 28 days post-injury. Histological, immunofluorescence, and MRI analyses indicate that our sheep model could resemble key human clinicopathological features. Statistically significant differences (p < 0.05) were observed in collagen I, dMHC, α-SMA, and CD68 immunohistochemical detection when comparing injured and healthy muscles. The injured gastrocnemius muscle exhibited elevated levels of type I collagen, infiltration of CD68(+) macrophages, angiogenesis, and the emergence of newly regenerated dMHC(+) myofibers, which persisted for up to 4 weeks post-injury. Similarly, the progression of muscle injury in the sheep model was assessed using advanced clinical 3 T MRI and compared with MRI scans from human patients. The data indicate that the sheep muscle injury model presents features similar to those observed in human skeletal muscle injuries. This makes it a valuable large animal model for studying muscle injuries and developing novel therapeutic strategies.
Collapse
Affiliation(s)
- Laura Vidal
- Leitat Technological Center, Carrer de la Innovació 2, 08225 Terrassa, Spain
- Bioengineering, Cell Therapy and Surgery in Congenital Malformations Laboratory, Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona (UAB), 08035 Barcelona, Spain
| | - Ingrid Vila
- Leitat Technological Center, Carrer de la Innovació 2, 08225 Terrassa, Spain
- Bioengineering, Cell Therapy and Surgery in Congenital Malformations Laboratory, Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona (UAB), 08035 Barcelona, Spain
| | - Vanesa Venegas
- Leitat Technological Center, Carrer de la Innovació 2, 08225 Terrassa, Spain
- Bioengineering, Cell Therapy and Surgery in Congenital Malformations Laboratory, Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona (UAB), 08035 Barcelona, Spain
| | - Anabel Sacristán
- Leitat Technological Center, Carrer de la Innovació 2, 08225 Terrassa, Spain
- Bioengineering, Cell Therapy and Surgery in Congenital Malformations Laboratory, Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona (UAB), 08035 Barcelona, Spain
| | - Paola Contreras-Muñoz
- Leitat Technological Center, Carrer de la Innovació 2, 08225 Terrassa, Spain
- Bioengineering, Cell Therapy and Surgery in Congenital Malformations Laboratory, Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona (UAB), 08035 Barcelona, Spain
| | - Maria Lopez-Garzon
- Leitat Technological Center, Carrer de la Innovació 2, 08225 Terrassa, Spain
- Bioengineering, Cell Therapy and Surgery in Congenital Malformations Laboratory, Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona (UAB), 08035 Barcelona, Spain
| | - Carles Giné
- Bioengineering, Cell Therapy and Surgery in Congenital Malformations Laboratory, Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona (UAB), 08035 Barcelona, Spain
| | - Gil Rodas
- Medical Department of Futbol Club Barcelona (FIFA Medical Center of Excellence) and Barça Innovation, 08970 Sant Joan Despí, Spain
- Sports Medicine Unit, Hospital Clínic and Sant Joan de Déu, 08950 Barcelona, Spain
- Faculty of Medicine and Health Sciences, University of Barcelona, 08007 Barcelona, Spain
| | - Mario Marotta
- Leitat Technological Center, Carrer de la Innovació 2, 08225 Terrassa, Spain
- Bioengineering, Cell Therapy and Surgery in Congenital Malformations Laboratory, Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona (UAB), 08035 Barcelona, Spain
| |
Collapse
|
9
|
Romero-Morales C, López-López D, Almazán-Polo J, Mogedano-Cruz S, Sosa-Reina MD, García-Pérez-de-Sevilla G, Martín-Pérez S, González-de-la-Flor Á. Prevalence, diagnosis and management of musculoskeletal disorders in elite athletes: A mini-review. Dis Mon 2024; 70:101629. [PMID: 37716840 DOI: 10.1016/j.disamonth.2023.101629] [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] [Indexed: 09/18/2023]
Abstract
Musculoskeletal injuries in elite sports are ones of the most impact issue because their remarkable impact on performance caused by drastic absence of training and competition and a progressive deterioration in physical health, emotional and social athletes' dimensions. Also, the prevalence of epidemiologic research found an incidence of musculoskeletal disorders vary within sports and in elite athletes which is even higher as a consequence of higher demand physical performance. This way, the loss of physical performance due to an sport injury impacts not only the individual economic sphere of the professional but also that ofsports entities, reaching, according to some studies, a loss estimated in the range of 74.7 million pounds. Thus, the purpose of this article is to review and to provide an overview of the most common musculoskeletal injuries in elite sports precipitating factors, clinical presentation, evidence-based diagnostic evaluation, and treatment recommendations with a view to preventing medical conditions or musculoskeletal injuries that may alter performance and general health in the elite athletes.
Collapse
Affiliation(s)
- Carlos Romero-Morales
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
| | - Daniel López-López
- Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Industrial Campus of Ferrol , Universidade da Coruña, 15403 Ferrol, Spain.
| | - Jaime Almazán-Polo
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
| | - Sara Mogedano-Cruz
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
| | - María Dolores Sosa-Reina
- Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
| | | | - Sebastián Martín-Pérez
- Faculty of Health Sciences, Universidad Europea de Canarias, La Orotava, Santa Cruz de Tenerife 38300, Spain
| | | |
Collapse
|
10
|
Palermi S, Vittadini F, Vecchiato M, Corsini A, Demeco A, Massa B, Pedret C, Dorigo A, Gallo M, Pasta G, Nanni G, Vascellari A, Marchini A, Lempainen L, Sirico F. Managing Lower Limb Muscle Reinjuries in Athletes: From Risk Factors to Return-to-Play Strategies. J Funct Morphol Kinesiol 2023; 8:155. [PMID: 37987491 PMCID: PMC10660751 DOI: 10.3390/jfmk8040155] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 10/31/2023] [Accepted: 11/02/2023] [Indexed: 11/22/2023] Open
Abstract
Muscle injuries and subsequent reinjuries significantly impact athletes, especially in football. These injuries lead to time loss, performance impairment, and long-term health concerns. This review aims to provide a comprehensive overview of the current understanding of muscle reinjuries, delving into their epidemiology, risk factors, clinical management, and prevention strategies. Despite advancements in rehabilitation programs and return-to-play criteria, reinjury rates remain alarmingly high. Age and previous muscle injuries are nonmodifiable risk factors contributing to a high reinjury rate. Clinical management, which involves accurate diagnosis, individualized rehabilitation plans, and the establishment of return-to-training and return-to-play criteria, plays a pivotal role during the sports season. Eccentric exercises, optimal loading, and training load monitoring are key elements in preventing reinjuries. The potential of artificial intelligence (AI) in predicting and preventing reinjuries offers a promising avenue, emphasizing the need for a multidisciplinary approach to managing these injuries. While current strategies offer some mitigation, there is a pressing need for innovative solutions, possibly leveraging AI, to reduce the incidence of muscle reinjuries in football players. Future research should focus on this direction, aiming to enhance athletes' well-being and performance.
Collapse
Affiliation(s)
- Stefano Palermi
- Public Health Department, University of Naples Federico II, 80131 Naples, Italy
| | | | - Marco Vecchiato
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, 35128 Padova, Italy
| | | | - Andrea Demeco
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Bruno Massa
- Public Health Department, University of Naples Federico II, 80131 Naples, Italy
| | - Carles Pedret
- Sports Medicine and Imaging Department, Clinica Diagonal, 08950 Barcelona, Spain;
| | - Alberto Dorigo
- Radiology Unit, Casa di Cura Giovanni XXIII, 31050 Monastier, Italy
| | - Mauro Gallo
- Radiology Unit, Casa di Cura Giovanni XXIII, 31050 Monastier, Italy
| | | | | | | | | | - Lasse Lempainen
- FinnOrthopaedics, Hospital Pihlajalinna, 20520 Turku, Finland;
| | - Felice Sirico
- Public Health Department, University of Naples Federico II, 80131 Naples, Italy
| |
Collapse
|
11
|
Jokela A, Mechó S, Pasta G, Pleshkov P, García-Romero-Pérez A, Mazzoni S, Kosola J, Vittadini F, Yanguas J, Pruna R, Valle X, Lempainen L. Indirect Rectus Femoris Injury Mechanisms in Professional Soccer Players: Video Analysis and Magnetic Resonance Imaging Findings. Clin J Sport Med 2023; 33:475-482. [PMID: 36853900 PMCID: PMC10467807 DOI: 10.1097/jsm.0000000000001131] [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: 08/14/2022] [Revised: 12/01/2022] [Accepted: 01/24/2023] [Indexed: 03/01/2023]
Abstract
OBJECTIVE To describe injury mechanisms and magnetic resonance imaging (MRI) findings in acute rectus femoris (RF) injuries of soccer players using a systematic video analysis. DESIGN Descriptive case series study of consecutive RF injuries from November 2017 to July 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 a RF injury, with an available video footage of the injury and a positive finding on an MRI. INDEPENDENT VARIABLES Rectus femoris injury mechanisms (specific scoring based on standardized models) in relation to RF muscle injury MRI findings. MAIN OUTCOME MEASURES Rectus femoris injury mechanism (playing situation, player/opponent behavior, movement, and biomechanics), location of injury in MRI. RESULTS Twenty videos of RF injuries in 19 professional male soccer players were analyzed. Three different injury mechanisms were seen: kicking (80%), sprinting (10%), and change of direction (10%). Isolated single-tendon injuries were found in 60% of the injuries. Of the kicking injuries, 62.5% included complete tendon ruptures, whereas both running injuries and none of the change of direction injuries were complete ruptures. The direct tendon was involved in 33% of the isolated injuries, and the common tendon was affected in all combined injuries. CONCLUSIONS Rectus femoris injuries typically occur during kicking among football players. Most of the RF injuries involve a complete rupture of at least one tendon. Kicking injuries can also affect the supporting leg, and sprinting can cause a complete tendon rupture, whereas change of direction seems not to lead to complete ruptures.
Collapse
Affiliation(s)
- Aleksi Jokela
- Faculty of Medicine, University of Turku, Turku, Finland
- Department of Orthopaedics and Traumatology, Turku University Hospital, Turku, Finland
| | - Sandra Mechó
- FC Barcelona, Medical Department, Barcelona, Spain
| | | | | | - Alvaro García-Romero-Pérez
- Watford FC, Injury Prevention and Rehabilitation Department, Watford, England
- Physiotherapy Department, Universidad Camilo José Cela, Madrid, Spain
| | | | - Jussi Kosola
- Department of Physical Activity and Health, Paavo Nurmi Centre, University of Turku, Turku, Finland
- Department of Orthopaedics and Traumatology, Kanta-Häme Central Hospital, Hämeenlinna, Finland
| | | | | | - Ricard Pruna
- FC Barcelona, Medical Department, Barcelona, Spain
| | - Xavier Valle
- FC Barcelona, Medical Department, Barcelona, Spain
| | - Lasse Lempainen
- Department of Physical Activity and Health, Paavo Nurmi Centre, University of Turku, Turku, Finland
- FinnOrthopaedics/Hospital Pihlajalinna, Turku, Finland; and
- Ripoll y De Prado, FIFA Medical Centre of Excellence, Madrid, Spain
| |
Collapse
|
12
|
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.
Collapse
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
| |
Collapse
|
13
|
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.
Collapse
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.
| |
Collapse
|
14
|
Mechó S, Lisbona Ortega R, Pruna R, Nescolarde Selva L, Morillas Pérez J, Rodríguez-Baeza A, Martínez Agea J, Pérez-Andrés R. Measuring direct and indirect tendon parameters to characterize the proximal tendinous complex of the rectus femoris in football and futsal players. Front Physiol 2023; 14:986872. [PMID: 36824472 PMCID: PMC9941635 DOI: 10.3389/fphys.2023.986872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 01/13/2023] [Indexed: 02/09/2023] Open
Abstract
Objective: To present unprecedented radiological parameters that characterize the angle between the direct and indirect tendons of the proximal rectus femoris (RF) and its inclinations and to evaluate the population variability according to demographic variables. Materials and methods: From September 2019 to July 2021, using MRI multiplanar reconstructions of the proximal thigh/hip, two blinded radiologists measured the direct and indirect tendon angle and the inclination of each tendon in different planes. The intra- and inter-observer agreements were assessed with Bland-Altman analysis and intraclass correlation coefficient (ICC). The correlations between radiological parameters and demographic variables were evaluated using linear regression, Student's t-test, and analysis of variance. Results: We performed 112 thigh/hip MRI scans on 91 football players of different age, gender, and disciplines (football and futsal). For observer 1 (the reference), the mean direct and indirect tendon angle was 56.74° ± 9.37, the mean indirect tendon slope was -7.90° ± 7.49, and the mean direct tendon slope was 22.16° ± 5.88. The three measurements showed inter- and intra-observer agreement (mean differences ∼0). No correlation was observed between age and the parameters. Likewise, no statistically significant differences were found for gender, dominant limb, examined limb, and sport. Conclusion: There is an inter- and intra-observer agreement in the measurements of the direct and indirect tendon angle and the inclination of each tendon. There is population variability in the proximal tendinous complex unrelated to demographic factors. These results allow further detection of morphological patterns that represent a risk factor for lesions in the RF in professional football and futsal players and other sports.
Collapse
Affiliation(s)
- Sandra Mechó
- Autonomous University of Barcelona, Barcelona, Spain,Department of Radiology Hospital de Barcelona, SCIAS, Barcelona, Spain,*Correspondence: Sandra Mechó,
| | | | - Ricard Pruna
- FC Barcelona Medical Services, Sant Joan Despí, Spain
| | - Lexa Nescolarde Selva
- Department of Electronic Engineering, Universitat Politècnica de Catalunya, Barcelona, Spain
| | | | - Alfonso Rodríguez-Baeza
- Department of Morphological Sciences (Human Anatomy and Embryology Unit), Faculty of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | | | | |
Collapse
|
15
|
Mechó S, Balius R, Bossy M, Valle X, Pedret C, Ruiz-Cotorro Á, Rodas G. Isolated Adductor Magnus Injuries in Athletes: A Case Series. Orthop J Sports Med 2023; 11:23259671221138806. [PMID: 36698789 PMCID: PMC9869219 DOI: 10.1177/23259671221138806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 09/13/2022] [Indexed: 01/18/2023] Open
Abstract
Background Little is known about injuries to the adductor magnus (AM) muscle and how to manage them. Purpose To describe the injury mechanisms of the AM and its histoarchitecture, clinical characteristics, and imaging features in elite athletes. Study Design Case series; Level of evidence, 4. Methods A total of 11 competitive athletes with an AM injury were included in the study. Each case was clinically assessed, and the diagnosis and classification were made by magnetic resonance imaging (MRI) according to the British Athletics Muscle Injury Classification (BAMIC) and mechanism, location, grade, and reinjury (MLG-R) classification. A 1-year follow-up was performed, and return-to-play (RTP) time was recorded. Results Different mechanisms of injury were found; most of the athletes (10/11) had flexion and internal rotation of the hip with extension or slight flexion of the knee. Symptoms consisted of pain in the posteromedial (7/11) or medial (4/11) thigh during adduction and flexion of the knee. Clinically, there was a suspicion of an injury to the AM in only 3 athletes. According to MRI, 5 lesions were located in the ischiocondylar portion (3 in the proximal and 2 in the distal myoconnective junction) and 6 in the pubofemoral portion (4 in the distal and 2 in the proximal myoconnective junction). Most of the ischiocondylar lesions were myotendinous (3/5), and most of the pubofemoral lesions were myofascial (5/6). The BAMIC and MLG-R classification coincided in distinguishing injuries of moderate and mild severity. The management was nonoperative in all cases. The mean RTP time was 14 days (range, 0-35 days) and was longer in the ischiocondylar cases than in the pubofemoral cases (21 vs 8 days, respectively). Only 1 recurrence, at <10 months, was recorded. Conclusion Posteromedial thigh pain after an eccentric contraction during forced adduction of the thigh from hip internal rotation should raise a suspicion of AM lesions. The identification of the affected portion was possible on MRI. An injury in the ischiocondylar portion entailed a longer RTP time than an injury in the pubofemoral portion.
Collapse
Affiliation(s)
- Sandra Mechó
- Department of Radiology, Hospital of Barcelona, Barcelona, Spain.,Medical Department, Football Club Barcelona, Barcelona, Spain.,Department of Surgery and Orthopedics, Autonomous University of Barcelona, Barcelona, Spain.,Sandra Mechó, MD, Department of Radiology, Hospital of Barcelona, Avinguda Diagonal 660, 08034 Barcelona, Spain () (Twitter: @mechomeca)
| | - Ramon Balius
- Catalan Sports Council, Government of Catalonia, Barcelona, Spain
| | - Mireia Bossy
- Clínica Creu Blanca, Barcelona, Spain.,Sports Medicine and Imaging Department, Clínica Diagonal, Barcelona, Spain.,Quiron Hospital, Barcelona, Spain
| | - Xavier Valle
- Medical Department, Football Club Barcelona, Barcelona, Spain.,Department of Surgery and Orthopedics, Autonomous University of Barcelona, Barcelona, Spain.,Dexeus University Hospital, Barcelona, Spain
| | - Carles Pedret
- Sports Medicine and Imaging Department, Clínica Diagonal, Barcelona, Spain
| | - Ángel Ruiz-Cotorro
- Royal Spanish Tennis Federation, Barcelona, Spain.,Clínica Mapfre de Medicina del Tenis, Barcelona, Spain
| | - Gil Rodas
- Medical Department, Football Club Barcelona, Barcelona, Spain.,Barça Innovation Hub, Football Club Barcelona, Barcelona, Spain.,Sports Medicine Unit, Sant Joan de Déu Hospital, Barcelona, Spain
| |
Collapse
|
16
|
Isern-Kebschull J, Pedret C, Mechó S, Pruna R, Alomar X, Yanguas X, Valle X, Kassarjian A, Martínez J, Tomas X, Rodas G. MRI findings prior to return to play as predictors of reinjury in professional athletes: a novel decision-making tool. Insights Imaging 2022; 13:203. [PMID: 36575363 PMCID: PMC9794673 DOI: 10.1186/s13244-022-01341-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 11/20/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Because MRI has shown great accuracy in assessing acute muscle injuries, identification of risk factors for reinjury before return to play (RTP) in professional athletes during the healing process could be very relevant. We assessed the value of MRI findings prior to RTP as predictors of reinjury. METHODS Retrospective observational study of 59 professional athletes, mean age 26 years, with first-time acute muscle injury and successful rehabilitation ready to RTP. They underwent MRI within 6 days of the injury and within 7 days prior to RTP. The primary outcome was reinjury. Risk of reinjury was assessed using radiological signs in control MRI scans before RTP. The risk was classified as low, medium or high when none, one or two radiological signs were observed, respectively. RESULTS Reinjury occurred in 9 participants, with a rate of 15.2%. None of the baseline MRI-related variables was significantly associated with reinjury. In the control MRI scan performed within 7 days prior to RTP, three independent findings were significantly associated with reinjury. These included transversal and/or mixed connective tissue gap (p = 0.002), intermuscular oedema (p = 0.015) and callus gap (p = 0.046). In the predictive model of the risk of reinjury, the presence of two of these radiological signs, together with interstitial feathery oedema, was associated with a high risk of recurrence (OR 29.58, 95% CI 3.86-226.64; p = 0.001). CONCLUSIONS In professional athletes with acute muscle injuries of the lower limbs successfully rehabilitated, some radiological signs on MRI performed shortly before RTP were associated with a high risk of reinjury.
Collapse
Affiliation(s)
- Jaime Isern-Kebschull
- grid.5841.80000 0004 1937 0247Department of Radiology, Hospital Clinic, University of Barcelona, C/Villarroel 170, 08036 Barcelona, Spain
| | | | - Sandra Mechó
- Department of Radiology, Hospital de Barcelona, Barcelona, Spain
| | - Ricard Pruna
- FCBarcelona Medical Department, Barcelona, Spain
| | - Xavier Alomar
- Department of Radiology, Centres Mèdics Creu Blanca, Barcelona, Spain
| | | | - Xavier Valle
- FCBarcelona Medical Department, Barcelona, Spain
| | - Ara Kassarjian
- Musculoskeletal Radiology, Elite Sports Imaging, SL, Pozuelo de Alarcón, Madrid, Spain
| | | | - Xavier Tomas
- grid.5841.80000 0004 1937 0247Department of Radiology, Hospital Clinic, University of Barcelona, C/Villarroel 170, 08036 Barcelona, Spain
| | - Gil Rodas
- FCBarcelona Medical Department, Barcelona, Spain ,grid.410458.c0000 0000 9635 9413Medicine Sport Unit, Hospital Clínic-Sant Joan de Déu, Barcelona, Spain
| |
Collapse
|
17
|
Huang Y, Huang S, Wang Y, Li Y, Gui Y, Huang C. A novel lower extremity non-contact injury risk prediction model based on multimodal fusion and interpretable machine learning. Front Physiol 2022; 13:937546. [PMID: 36187785 PMCID: PMC9520324 DOI: 10.3389/fphys.2022.937546] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 08/23/2022] [Indexed: 11/18/2022] Open
Abstract
The application of machine learning algorithms in studying injury assessment methods based on data analysis has recently provided a new research insight for sports injury prevention. However, the data used in these studies are primarily multi-source and multimodal (i.e., longitudinal repeated-measures data and cross-sectional data), resulting in the models not fully utilising the information in the data to reveal specific injury risk patterns. Therefore, this study proposed an injury risk prediction model based on a multi-modal strategy and machine learning algorithms to handle multi-source data better and predict injury risk. This study retrospectively analysed the routine monitoring data of sixteen young female basketball players. These data included training load, perceived well-being status, physiological response, physical performance and lower extremity non-contact injury registration. This study partitions the original dataset based on the frequency of data collection. Extreme gradient boosting (XGBoost) was used to construct unimodal submodels to obtain decision scores for each category of indicators. Ultimately, the decision scores from each submodel were fused using the random forest (RF) to generate a lower extremity non-contact injury risk prediction model at the decision-level. The 10-fold cross-validation results showed that the fusion model was effective in classifying non-injured (mean Precision: 0.9932, mean Recall: 0.9976, mean F2-score: 0.9967), minimal lower extremity non-contact injuries risk (mean Precision: 0.9317, mean Recall: 0.9167, mean F2-score: 0.9171), and mild lower extremity non-contact injuries risk (mean Precision: 0.9000, mean Recall: 0.9000, mean F2-score: 0.9000). The model performed significantly more optimal than the submodel. Comparing the fusion model proposed with a traditional data integration scheme, the average Precision and Recall improved by 8.2 and 20.3%, respectively. The decision curves analysis showed that the proposed fusion model provided a higher net benefit to athletes with potential lower extremity non-contact injury risk. The validity, feasibility and practicality of the proposed model have been confirmed. In addition, the shapley additive explanation (SHAP) and network visualisation revealed differences in lower extremity non-contact injury risk patterns across severity levels. The model proposed in this study provided a fresh perspective on injury prevention in future research.
Collapse
Affiliation(s)
- Yuanqi Huang
- Research and Communication Center for Exercise and Health, Xiamen University of Technology, Xiamen, China
- School of Physical Education and Sport Science, Fujian Normal University, Fuzhou, China
| | - Shengqi Huang
- School of Physical Education and Sport Science, Fujian Normal University, Fuzhou, China
| | - Yukun Wang
- School of Physical Education and Sport Science, Fujian Normal University, Fuzhou, China
| | - Yurong Li
- College of Electrical Engineering and Automation, Fuzhou University, Fuzhou, China
| | - Yuheng Gui
- Fujian Provincial Basketball and Volleyball Centre, Fuzhou, China
| | - Caihua Huang
- Research and Communication Center for Exercise and Health, Xiamen University of Technology, Xiamen, China
- *Correspondence: Caihua Huang,
| |
Collapse
|
18
|
Fitzpatrick JD, Chakraverty R, Patera E, James SLJ. Is there a need to reconsider the importance of myoaponeurotic injury within the nomenclature of sports-related muscle injury? Br J Sports Med 2022; 56:1328-1330. [PMID: 35680395 DOI: 10.1136/bjsports-2021-105336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2022] [Indexed: 11/04/2022]
Affiliation(s)
| | - Rob Chakraverty
- Performance and Medicine Department, Wolverhampton Wanderers Football Club, Wolverhampton, UK
| | - Eleni Patera
- Anatomy, University of Birmingham, Birmingham, UK
| | - Steven L J James
- Radiology Department, Royal Orthopaedic Hospital, Birmingham, UK
| |
Collapse
|
19
|
Valle X, Mechó S, Alentorn-Geli E, Järvinen TAH, Lempainen L, Pruna R, Monllau JC, Rodas G, Isern-Kebschull J, Ghrairi M, Yanguas X, Balius R, la Torre AMD. Return to Play Prediction Accuracy of the MLG-R Classification System for Hamstring Injuries in Football Players: A Machine Learning Approach. Sports Med 2022; 52:2271-2282. [PMID: 35610405 DOI: 10.1007/s40279-022-01672-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND AND OBJECTIVE Muscle injuries are one of the main daily problems in sports medicine, football in particular. However, we do not have a reliable means to predict the outcome, i.e. return to play from severe injury. The aim of the present study was to evaluate the capability of the MLG-R classification system to grade hamstring muscle injuries by severity, offer a prognosis for the return to play, and identify injuries with a higher risk of re-injury. Furthermore, we aimed to assess the consistency of our proposed system by investigating its intra-observer and inter-observer reliability. METHODS All male professional football players from FC Barcelona, senior A and B and the two U-19 teams, with injuries that occurred between February 2010 and February 2020 were reviewed. Only players with a clinical presentation of a hamstring muscle injury, with complete clinic information and magnetic resonance images, were included. Three different statistical and machine learning approaches (linear regression, random forest, and eXtreme Gradient Boosting) were used to assess the importance of each factor of the MLG-R classification system in determining the return to play, as well as to offer a prediction of the expected return to play. We used the Cohen's kappa and the intra-class correlation coefficient to assess the intra-observer and inter-observer reliability. RESULTS Between 2010 and 2020, 76 hamstring injuries corresponding to 42 different players were identified, of which 50 (65.8%) were grade 3r, 54 (71.1%) affected the biceps femoris long head, and 33 of the 76 (43.4%) were located at the proximal myotendinous junction. The mean return to play for grades 2, 3, and 3r injuries were 14.3, 12.4, and 37 days, respectively. Injuries affecting the proximal myotendinous junction had a mean return to play of 31.7 days while those affecting the distal part of the myotendinous junction had a mean return to play of 23.9 days. The analysis of the grade 3r biceps femoris long head injuries located at the free tendon showed a median return to play time of 56 days while the injuries located at the central tendon had a shorter return to play of 24 days (p = 0.038). The statistical analysis showed an excellent predictive power of the MLG-R classification system with a mean absolute error of 9.8 days and an R-squared of 0.48. The most important factors to determine the return to play were if the injury was at the free tendon of the biceps femoris long head or if it was a grade 3r injury. For all the items of the MLG-R classification, the intra-observer and inter-observer reliability was excellent (k > 0.93) except for fibres blurring (κ = 0.68). CONCLUSIONS The main determinant for a long return to play after a hamstring injury is the injury affecting the connective tissue structures of the hamstring. We developed a reliable hamstring muscle injury classification system based on magnetic resonance imaging that showed excellent results in terms of reliability, prognosis capability and objectivity. It is easy to use in clinical daily practice, and can be further adapted to future knowledge. The adoption of this system by the medical community would allow a uniform diagnosis leading to better injury management.
Collapse
Affiliation(s)
- Xavier Valle
- FC Barcelona Medical Department, Barcelona, Spain. .,Hospital Universitari Dexeus (ICATME), Barcelona, Spain. .,PhD Student at the "Departament de Cirurgia i Ortopèdia", Universitat Autonoma de Barcelona, Barcelona, Spain.
| | - Sandra Mechó
- FC Barcelona Medical Department, Barcelona, Spain.,Department of Radiology, Hospital de Barcelona, SCIAS, Barcelona, Spain
| | - Eduard Alentorn-Geli
- Instituto Cugat, Barcelona, Spain.,Fundación García Cugat, Barcelona, Spain.,Mutualidad Española de Futbolistas, Delegación Cataluña, Federación Española de Fútbol, Barcelona, Spain
| | - Tero A H Järvinen
- Tampere University and Tampere University Hospital, Tampere, Finland
| | - Lasse Lempainen
- Sports Trauma Research Unit, Hospital Mehiläinen NEO, Turku, Finland
| | - Ricard Pruna
- FC Barcelona Medical Department, Barcelona, Spain
| | - Joan C Monllau
- Department of Orthopedic Surgery, Parc de Salut Mar, Hospital del Mar I L'Esperança, Barcelona, Spain.,ICATME, Hospital Universitari Dexeus, Bellaterra, Spain.,Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Gil Rodas
- FC Barcelona Medical Department, Barcelona, Spain
| | - Jaime Isern-Kebschull
- Musculoskeletal Imaging Specialist, Barcelona, Spain.,Department of Radiology at Hospital Clinic, Universitat de Barcelona, Barcelona, Spain
| | - Mourad Ghrairi
- FIFA Medical Centre of Excellence, Dubai, United Arab Emirates
| | | | - Ramon Balius
- Catalan Sports Council, Generalitat de Catalunya, Barcelona, Spain.,Department of Sports Medicine, Clínica Diagonal, Barcelona, Spain
| | - Adrian Martinez-De la Torre
- Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, ETH Zurich, Zurich, Switzerland
| |
Collapse
|
20
|
A newly discovered membrane at the origin of the proximal tendinous complex of the rectus femoris. Surg Radiol Anat 2022; 44:835-843. [PMID: 35536396 PMCID: PMC9246800 DOI: 10.1007/s00276-022-02954-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 04/21/2022] [Indexed: 10/25/2022]
Abstract
PURPOSE The rectus femoris (RF) forms the anterior portion of the quadriceps muscle group. It has a proximal tendinous complex (PTC) which is constituted by a direct tendon (DT), an indirect tendon (IT), and a variable third head. Direct and indirect tendons finally converge into a common tendon (CT). All the PTC shows a medially sloping in its proximal insertion.We investigated several anatomical specimens and discovered a new component: a membrane connecting the CT with the anterior superior iliac spine. Such membrane constitutes a new origin of the PTC. The aim of this study was to clarify whether this membrane was an anatomical variation of the PTC or a constant structure and to describe its morphology and trajectory. MATERIAL AND METHODS We dissected 42 cadaveric lower limbs and examined the architecture of the PTC. We paid special attention to the morphology and interaction patterns between the tendons and the membrane. RESULTS We demonstrated that the membrane is a constant component of the PTC. It has a lateral to medial trajectory and is in relation to the common tendon, the DT, and IT, which present a medial slope. This suggests that the membrane has an stabilizer role for the PTC, acting as a corrector of the inclined vector of the complex. CONCLUSION The RF injuries are frequent in football. The newly discovered membrane is a constant component of the PTC and its integrity should be included in the algorithm to diagnose injuries.
Collapse
|
21
|
Force, Power, and Morphology Asymmetries as Injury Risk Factors in Physically Active Men and Women. Symmetry (Basel) 2022. [DOI: 10.3390/sym14040787] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
This study aimed to investigate whether asymmetry of force, power, and tissue morphology are lower limbs (LL) injury risk factors in physically active adults. Fifty-eight men aged 23.8 ± 1.2 years and forty-seven women aged 23.3 ± 1.0 years were examined. Physical activity level was measured by the International Physical Activity Questionnaire, and injury data were collected with the Injury History Questionnaire. The countermovement jump was performed to evaluate force and power. LL tissue composition was evaluated by a bioimpedance analyzer. The symmetry indices were calculated. A comparison between injured and non-injured subjects in both sexes was conducted to determine indices associated with injuries. The symmetry indices cut-off points were calculated to establish values indicating a significant injury risk increase, and logistic regression was performed. The relative peak force asymmetry above 4.049% was associated with increased injury risk in men. The LL skeletal muscle mass asymmetry above 3.584% was associated with a higher injury risk in women. Increased asymmetry in indicated indices by 1% was associated with 19.8% higher injury risk in men and 82.6% in women. Asymmetry proved to be an injury risk factor. However, a more suitable index for men is relative peak force asymmetry, whereas LL skeletal muscle mass asymmetry is more suitable for women.
Collapse
|
22
|
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.
Collapse
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
| |
Collapse
|
23
|
Pruning Growing Self-Organizing Map Network for Human Physical Activity Identification. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:9972406. [PMID: 35028128 PMCID: PMC8749378 DOI: 10.1155/2022/9972406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 08/06/2021] [Accepted: 12/03/2021] [Indexed: 11/18/2022]
Abstract
Human physical activity identification based on wearable sensors is of great significance to human health analysis. A large number of machine learning models have been applied to human physical activity identification and achieved remarkable results. However, most human physical activity identification models can only be trained based on labeled data, and it is difficult to obtain enough labeled data, which leads to weak generalization ability of the model. A Pruning Growing SOM model is proposed in this paper to address the limitations of small-scale labeled dataset, which is unsupervised in the training stage, and then only a small amount of labeled data is used for labeling neurons to reduce dependency on labeled data. In training stage, the inactive neurons in network can be deleted by pruning mechanism, which makes the model more consistent with the data distribution and improves the identification accuracy even on unbalanced dataset, especially for the action categories with poor identification effect. In addition, the pruning mechanism can also speed up the inference of the model by controlling its scale.
Collapse
|
24
|
Vazquez F, Marrufo O, Solis-Najera SE, Martin R, Rodriguez AO. External Waveguide Magnetic Resonance Imaging for lower limbs at 3 T. Med Phys 2021; 49:158-168. [PMID: 34633673 DOI: 10.1002/mp.15281] [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: 05/11/2021] [Revised: 09/01/2021] [Accepted: 09/21/2021] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION We report a method based on the travelling-wave MRI approach, in order to acquire images of human lower limbs with an external waveguide at 3 T. METHOD We use a parallel-plate waveguide and an RF surface coil for reception, while a whole-body birdcage is used for transmission. The waveguide and the surface coil are located right outside the magnet, in the MR conditional devices zone. We ran numerical simulations to investigate the B1 field generated by the surface coil located at one of the waveguides, as well as a saline-solution phantom positioned on the opposite side (150 cm away) inside the magnet. RESULTS We obtained phantom images by varying the distance between the coil and the phantom, in order to investigate the signal-to-noise ratio and to validate our numerical simulations. Lower limb images of a healthy volunteer were also acquired, demonstrating the viability of this approach. Standard pulse sequences were used and no physical modifications were made to the MR imager. CONCLUSIONS These numerical and experimental results show that travelling-wave MRI can produce high-quality images with only a simple waveguide and an RF coil located outside the magnet. This can be particularly favorable when acquiring images of lower limbs requiring a larger field of view.
Collapse
Affiliation(s)
- F Vazquez
- Departamento de Fisica, Facultad de Ciencias, Universidad Nacional Autonoma de Mexico, Mexico City, 04510, Mexico
| | - O Marrufo
- Department of Neuroimage, Instituto Nacional de Neurologia y Neurocirugia MVS, Mexico City, 14269, Mexico
| | - S E Solis-Najera
- Departamento de Fisica, Facultad de Ciencias, Universidad Nacional Autonoma de Mexico, Mexico City, 04510, Mexico
| | - R Martin
- Departamento de Fisica, Facultad de Ciencias, Universidad Nacional Autonoma de Mexico, Mexico City, 04510, Mexico
| | - A O Rodriguez
- Department of Electrical Engineering, Universidad Autonoma Metropolitama Iztapalapa, Mexico City, 09340, Mexico
| |
Collapse
|
25
|
Upadhyaya V, Choudur HN. Update on sports imaging. J Clin Orthop Trauma 2021; 21:101555. [PMID: 34458092 PMCID: PMC8379491 DOI: 10.1016/j.jcot.2021.101555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 12/27/2022] Open
Abstract
Sports Imaging has dramatically increased in the past decade with increasing number of adolescents, young and middle-aged adults participating in non-competitive/hobby sports. Therefore, sports injuries are no longer confined to elite athletes. Furthermore, newer forms of sports such as mountain climbing, pickle ball and curling etc. are gaining popularity. Majority of the injuries in sports medicine are from musculoskeletal trauma. Therefore, it is imperative that the musculoskeletal radiologist becomes familiar with various sports related injury patterns as these are commonly encountered in daily practice. This update aims to briefly encapsulate the major aspects of sports imaging. It includes the imaging manifestations of various types of musculoskeletal injuries on different modalities (commonly US and MRI) and briefly mentions the various image guided interventions, performed both on the sports field and in the hospital setting.
Collapse
Affiliation(s)
- Vaishali Upadhyaya
- MRI Division, Department of Radiology, Vivekananda Polyclinic and Institute of Medical Sciences, Lucknow, 226007, India
| | - Hema N. Choudur
- Division of MSK Imaging, McMaster University, Staff MSK Radiologist: Hamilton General Hospital, Hamilton Health Sciences, 237 Barton St.E, Hamilton, Ontario L9L 2X2, Canada,Corresponding author.
| |
Collapse
|