Relationship Between Spinal-Pelvic Sagittal Balance and Pelvic-Femoral Injuries in Professional Soccer Players

Abstract

Background: Pelvic-femoral injuries are a common problem in football (soccer) players. However, the risk factors for these injuries are unclear. Our knowledge of spinal-pelvic sagittal balance has increased considerably over the past few years, notably as a result of new radiographic techniques such the EOS radiographic imaging system. Purpose: To investigate the link between spinal-pelvic sagittal balance on EOS imaging and the incidence of pelvic-femoral injuries. Study Design: Cohort study; Level of evidence, 2. Methods: Players in a League 1 professional soccer team were observed for 5 consecutive seasons. All players included in the study underwent EOS radiographic imaging. All acute and microtraumatic injuries to the pelvic-femoral complex were recorded prospectively: hamstrings, psoas, quadriceps, adductors, obturators, and pubic symphysis. We analyzed the relationship between injury incidence and key radiographic parameters involved in pelvic balance. Results: A total of 61 players were included (mean age, 24.5 years; n = 149 injuries; mean pelvic tilt, 9.08° ± 5.6°). A significant link was observed between the incidence of pelvic-femoral injuries and pelvic tilt ( P = .02). A significant link was also observed between the incidence of acute pelvic-femoral injuries and pelvic tilt ( P = .05). In both cases, a high pelvic tilt was associated with a low incidence of injuries. Conclusion: In professional soccer players, a low pelvic tilt was associated with a high incidence of all pelvic-femoral injuries as well as acute pelvic-femoral injuries. These results could lead to new preventive methods for these musculotendinous injuries through physical therapy.

Analysis of Injury Patterns in Men’s Football between the English League and the Spanish League

“…For example, in the Italian league [ 52 ] it is indicated that any field position (excluding goalkeepers) is equally affected. In the French league, forwards [ 57 ], and in the German league, midfielders are the most frequently affected [ 1 ]. In Spain, the studies carried out indicate that defenders are the players most affected by injuries [ 33 , 35 ], which is consistent with the findings of this research in both LaLiga and the Premier League, although in Spain the percentage is higher (53.6% vs. 38.5%).…”

The Role of Hip Joint Clearance Discrepancy as Other Clinical Predictor of Reinjury and Injury Severity in Hamstring Tears in Elite Athletes

“…In recent studies [ 33 , 34 , 35 , 36 , 37 ], the hip has been shown to play a major role in optimal hamstring functioning, and an assessment of commonly used pelvic parameters such as pelvic incidence, pelvic tilt, sacral slope, pelvic obliquity, axial rotation of the pelvis, right femur torsion, left femur torsion, and leg length discrepancy, may help to identify morphological types at greater risk of this type of injury [ 38 ]. Nonetheless, previously, JCD has not been considered.…”

“…For our analysis, participants were stratified by grade of injury, grouped “small-to-moderate” (Grades 1 and 2) and “extensive-to-complete” (Grades 3 and 4), as well as by sex, race, event type (track distance, and with or without hurdles), and the number of times they had had this type of injury (<2, 2, >2). Lower limb length was measured on X-ray [ 38 ].…”

“…Furthermore, while some clinically useful diagnostic tests have been suggested [ 28 , 29 , 30 ], few studies have examined the association between HTI and hip range of movement [ 14 , 15 , 16 , 19 , 31 ] or pelvic parameters [ 31 , 32 ]. However, recent studies [ 33 , 34 , 35 , 36 , 37 ] have shown that the characteristics of the hip are critical for optimal hamstring function [ 38 ]. In this sense, it has been reported [ 39 ] that the hamstring muscles can restrict hip flexion, especially when the knees are extended.…”

Translational and Rotational Postural Aberrations Are Related to Pulmonary Functions and Skill-Related Physical Fitness Components in Collegiate Athletes

“…A recent study by Moustafa et al [13] reported that college athletes with forward head posture exhibited less efficient physical fitness and altered sensorimotor processing and integration compared to athletes with a normal sagittal head posture alignment [13]. Another study showed a correlation between sagittal pelvic balance and the incidence of acute and micro-traumatic injuries of the pelvic-femoral complex [14]. There are also studies that have shown that sagittal spinal subluxations can lead to decreased pulmonary function, suggesting a direct relationship between spinal subluxation and pulmonary function through a somatovisceral reflex pathway via the sympathetic nervous system [15,16].…”