Mechanisms and situations of anterior cruciate ligament injuries in professional male soccer players: a YouTube-based video analysis

Grassi, Alberto; Smiley, Stephen; Sarsina, Tommaso Roberti di; Signorelli, Cecilia; Muccioli, Giulio Maria Marcheggiani; Bondi, Alice; Romagnoli, Matteo; Agostini, Alessandra Garcia de Figueiredo; Zaffagnini, Stefano

doi:10.1007/s00590-017-1905-0

Cited by 72 publications

(72 citation statements)

References 34 publications

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“…29 Also, the greatest number of injuries occurred in defenders (43%), which could reflect both the generally higher absolute numbers of defenders on normal rosters (which usually utilize modules with 4 defenders) and also indirectly pointing out pressing as one of the most common injury mechanisms. 3,8,15,37…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of Anterior Cruciate Ligament Injury in Italian First Division Soccer Players

et al. 2019

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Background: The burden of anterior cruciate ligament (ACL) injury in professional soccer players is particularly relevant as it represents a potentially career-threatening injury. Hypothesis: Our hypotheses were that (1) injury incidence rate would be similar to that reported in the literature, (2) we would identify a uniform distribution of the injuries along the season, and (3) injury incidence rate would be similar in high-ranked and lower ranked teams, based on final placement in the league. Study Design: Descriptive epidemiological study. Level of Evidence: Level 4. Methods: Professional male soccer players participating in the Serie A championship league in 7 consecutive seasons (2011-2012 to 2017-2018) were screened to identify ACL injuries through the online football archive transfermarkt.com . Exposure in matches and training were calculated. Results: There were 84 ACL injuries found (mean player age, 25.3 ± 4.2 years). Overall, 25% of ACL injuries were reruptures (15%) or contralateral injuries (10%). ACL incidence rate was 0.4215 per 1000 hours of play during Serie A matches, 0.0305 per 1000 hours of training (rate ratio [RR], 13.8; 95% CI, 8.4-22.7; P < 0.0001), and 0.0618 per 1000 hours of total play. Injury distribution had a bimodal peak, with the highest number of events in October and March. Alternatively, training injuries peaked in June and July. A significantly higher incidence rate was found for the teams ranked from 1st to 4th place compared with those ranked 5th to 20th (0.1256 vs 0.0559 per 1000 hours of play; RR, 2.2; 95% CI, 1.4-3.6; P = 0.0003). A similar finding was found for injury incidence proportion (3.76% vs 1.64%; P = 0.0003). Conclusion: The overall incidence rate of ACL injuries in Italian Serie A was 0.062 per 1000 hours, with a 14-fold risk in matches compared with training. Relevantly, 25% were second injuries. Most injuries occurred in October and March, and an almost 2-fold incidence rate and incidence proportion were noted in those teams ranked in the first 4 positions of the championship league. Clinical Relevance: Knowing the precise epidemiology of ACL injury in one of the most competitive professional football championship leagues could help delineate fields of research aimed to investigate its risk factors.

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Section: Discussionmentioning

confidence: 99%

Epidemiology of Anterior Cruciate Ligament Injury in Italian First Division Soccer Players

et al. 2019

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“…Interestingly, during the redirection phase greater hip abduction, greater trunk lean angles at IC and greater hip adductor moments were observed during the 90° cut [ 26 ]. Greater hip abduction has been reported to be a biomechanical risk factor associated with knee abduction moments (KAM—synonymous with knee valgus moments for the purpose of this review) [ 39 ], thus ACL injury risk [ 78 ], and is also a commonly observed visual characteristic of non-contact ACL injuries [ 9 , 79 ]. This abducted lower extremity position is often discouraged in ACL injury prevention programmes [ 44 ], but increased hip abduction is necessary to create a larger ML COM-COP (to create a lateral foot plant) distance [ 26 , 27 ] and subsequent lateral propulsion for executing sharper CODs [ 25 , 38 , 80 ].…”

Section: Effect Of Angle On Cod Biomechanicsmentioning

confidence: 99%

The Effect of Angle and Velocity on Change of Direction Biomechanics: An Angle-Velocity Trade-Off

et al. 2018

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Changes of direction (CODs) are key manoeuvres linked to decisive moments in sport and are also key actions associated with lower limb injuries. During sport athletes perform a diverse range of CODs, from various approach velocities and angles, thus the ability to change direction safely and quickly is of great interest. To our knowledge, a comprehensive review examining the influence of angle and velocity on change of direction (COD) biomechanics does not exist. Findings of previous research indicate the biomechanical demands of CODs are ‘angle’ and ‘velocity’ dependent and are both critical factors that affect the technical execution of directional changes, deceleration and reacceleration requirements, knee joint loading, and lower limb muscle activity. Thus, these two factors regulate the progression and regression in COD intensity. Specifically, faster and sharper CODs elevate the relative risk of injury due to the greater associative knee joint loading; however, faster and sharper directional changes are key manoeuvres for successful performance in multidirectional sport, which subsequently creates a ‘performance-injury conflict’ for practitioners and athletes. This conflict, however, may be mediated by an athlete’s physical capacity (i.e. ability to rapidly produce force and neuromuscular control). Furthermore, an ‘angle-velocity trade-off’ exists during CODs, whereby faster approaches compromise the execution of the intended COD; this is influenced by an athlete’s physical capacity. Therefore, practitioners and researchers should acknowledge and understand the implications of angle and velocity on COD biomechanics when: (1) interpreting biomechanical research; (2) coaching COD technique; (3) designing and prescribing COD training and injury reduction programs; (4) conditioning athletes to tolerate the physical demands of directional changes; (5) screening COD technique; and (6) progressing and regressing COD intensity, specifically when working with novice or previously injured athletes rehabilitating from an injury.

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“…Knee injuries are common in male professional soccer players, 1 where the anterior cruciate ligament (ACL) injury has interested many researchers. [2][3][4][5][6][7] There is, however, a paucity of studies which focus primarily on injuries to the other major knee ligaments. Previous studies from the Union of European Football Associations (UEFA) Elite Club Injury Study have reported on ACL injuries [8][9][10][11][12] and on medial collateral ligament (MCL) injuries.…”

Section: Introductionmentioning

confidence: 99%

<p>Epidemiological Data on LCL and PCL Injuries Over 17 Seasons in Men’s Professional Soccer: The UEFA Elite Club Injury Study</p>

Lundblad¹,

Hägglund²,

Thomeé³

et al. 2020

OAJSM

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Background: There is limited epidemiological information on injury rates and injury mechanisms for lateral collateral ligament (LCL) and posterior cruciate ligament (PCL) injuries in male professional soccer. In addition, time trends and lay-off times for these injuries have not yet been determined. Aim: To determine injury rates and circumstances of LCL and PCL injuries over 17 seasons in men's professional soccer. Methods: A prospective cohort study, in which 68 professional European soccer teams were followed over 17 consecutive seasons (2001/2002 to 2017/2018). The teams' medical staff recorded player exposure and time-loss injuries. Lay-off time was reported as the median and the first and third quartile. Injury rate was defined as the number of injuries per 1000 playerhours. Results: One hundred and twenty-eight LCL and 28 PCL injuries occurred during 2,554,686 h of exposure (rate 0.05 and 0.01/1000 h, respectively). The median lay-off time for LCL injuries was 15 (Q 1 =7, Q 3 =32) days, while it was 31 days for PCL injuries (Q 1 =15, Q 3 =74). The match injury rate for LCL injuries was 11 times higher than the training injury rate (0.21 vs 0.02/1000 h, rate ratio [RR] 10.5, 95% CI 7.3 to 15.1 p<0.001) and the match injury rate for PCL injuries was 20 times higher than the training injury rate (0.056 vs 0.003/1000 h, RR 20.1, 95% CI 8.2 to 49.6, p<0.001). LCL injuries saw a significant annual decrease of approximately 3.5% (p=0.006). In total, 58% (63/108) of all LCL injuries and 54% (14/26) of all PCL injuries were related to contact mechanism. Conclusion: This study with prospectively registered data on LCL and PCL injuries in men's professional soccer shows that the median lay-off from soccer for LCL and PCL injuries is approximately 2 and 4 weeks respectively. These rare knee ligament injuries typically occur during matches and are associated with a contact injury mechanism.

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Mechanisms and situations of anterior cruciate ligament injuries in professional male soccer players: a YouTube-based video analysis

Abstract: Level IV, case series.

Cited by 72 publications

References 34 publications

Epidemiology of Anterior Cruciate Ligament Injury in Italian First Division Soccer Players

Epidemiology of Anterior Cruciate Ligament Injury in Italian First Division Soccer Players

The Effect of Angle and Velocity on Change of Direction Biomechanics: An Angle-Velocity Trade-Off

<p>Epidemiological Data on LCL and PCL Injuries Over 17 Seasons in Men’s Professional Soccer: The UEFA Elite Club Injury Study</p>

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