Asymptomatic Foot and Ankle Abnormalities in Elite Professional Soccer Players

Abstract

Background: Professional soccer players are often evaluated with asymptomatic lesions of the ankle and foot, and such abnormalities may eventually become clinically relevant. Purpose: To ascertain the prevalence of foot and ankle abnormalities in elite professional adult soccer players. Study Design: Case series; Level of evidence, 4. Methods: Professional adult male elite soccer players (n = 37) underwent magnetic resonance imaging (MRI) scans of both their feet and ankles. All competed for their respective national junior or adult soccer teams. MRI scans were performed with 1.5-T scanners and analyzed independently by 2 experienced radiologists. Results: The MRI scans of 86.5% of the players showed degenerative joint disease (DJD) in at least 1 of the joints of the foot and ankle. Articular cartilage lesions in the joints of the foot and ankle were evident in 42% of the scans. Of all lesions, 17% were grade 3 or 4 (Noyes and Stabler classification) cartilage lesions and accompanied by subchondral bone marrow edema. The greater the age, weight, and height of the players, the greater was the odds ratio of DJD of the ankle joint. Synovitis in at least 1 of the joints of the foot was detected in 64% of the MRI scans. Leg dominance significantly correlated with bone marrow edema of the talus. Conclusion: Elite professional soccer players are often evaluated with a high prevalence of asymptomatic osteochondral lesions with subchondral bone marrow edema in the foot and ankle. These osteochondral lesions may remain asymptomatic or, with the continuing high-intensity stresses that modern professional soccer demands of its athletes, may evolve and cause foot and ankle pain. It is unclear whether and which interventions can be implemented to prevent the occurrence of these abnormalities in the first place.

Effect analysis of iliac bone autografting for Hepple V osteochondral lesions of the talus

“…Thus, any abnormal alignment of the ankle would lead to local stress concentration and accelerate the degeneration of ankle cartilage [ 2 , 3 ]. Many studies have shown that patients with repeated sprains or fractures of the ankle have a high probability of talar cartilage injury [ 4 , 5 ]. In the early stages of talar cartilage injury, there are no obvious signs and the pain is diffuse and poorly localized; in the late stages, the main clinical manifestations are ankle swelling and pain (aggravated during weight-bearing walking) and joint strangulation.…”

Changes in ultrasound imaging of joints, entheses, bursae and tendons 24 and 48 h after adjusted weight training

“…The participants had a mean BMI of 22.54 ± 3.07 (range: 18.61–36.55) kg/m 2 . The BIA revealed a mean FMI, mean FFMI and SMM/height 2 of 4.38 ± 1.77, 18.16 ± 2.51 and 8.59 ± 1.55 kg/m 2 , respectively. The mean hours of physical activity per week were 4.78 ± 3.02 (range: 1.00–15.00) h. Although the participants were asked not to perform any physical activity 48 h prior the study, two individuals reported medium level of physical activity.…”

“…Tetrapolar, single-frequency (5 kHz) impedance measurements were taken to acquire fat mass (FM), fat-free mass (FFM) and skeletal muscle mass (SMM). Values were divided by height squared creating the fat mass index (FMI), fat-free mass index (FFMI) and skeletal muscle mass/height 2 (SMM/height 2 ) for height adjustment. 10 , 11 …”

“…The time in days was included as a fixed effect. Further independent variables, such as age, sex, hours of physical activity per week, BMI, FMI, FFMI, SMM/height 2 , upper and lower body fitness indices were evaluated in separate models. As it was assumed that the influence of these variables might be time-dependent, a fixed term and a slope term (interaction with time) were included in the model.…”

“… 1 Synovitis was identified in asymptomatic professional soccer players by a magnetic resonance imaging (MRI) study in at least one joint in 67.6% of the examined feet. 2 Another study including professional soccer players observed one or more knee joint lesions, such as synovitis, cartilage and meniscal lesions in all examined joints. 3 Polat et al 4 reported a significantly higher prevalence of tendinopathy, meniscal injury and cartilage damage in the knees of kangoo jumpers compared with the control group by MRI imaging.…”