Systematic Video Analysis of Anterior Cruciate Ligament Injuries in Professional Male Rugby Players: Pattern, Injury Mechanism, and Biomechanics in 57 Consecutive Cases

Villa, F.; Tosarelli, Filippo; Ferrari, Rocco; Grassi, Alberto; Ciampone, Luca; Nanni, Gianni; Zaffagnini, Stefano; Buckthorpe, Matthew

doi:10.1177/23259671211048182

Cited by 30 publications

(36 citation statements)

References 44 publications

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“…sling shot effect) [ 85 ], the gluteus maximus and hamstrings will likely contribute to controlling external hip flexion moment and to attenuating and distributing forces [ 31 , 81 ]. Indeed, in competitive matches, rapid horizontal decelerations during defensive pressing actions are one of the major situational patterns commonly associated with major lower extremity injuries, such as ACL rupture [ 43 , 45 , 47 , 48 , 86 , 87 ]. In these studies, a lack of trunk control, lowering of COM (i.e.…”

Section: Biomechanical Demands Of Horizontal Decelerationmentioning

confidence: 99%

Biomechanical and Neuromuscular Performance Requirements of Horizontal Deceleration: A Review with Implications for Random Intermittent Multi-Directional Sports

et al. 2022

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Rapid horizontal accelerations and decelerations are crucial events enabling the changes of velocity and direction integral to sports involving random intermittent multi-directional movements. However, relative to horizontal acceleration, there have been considerably fewer scientific investigations into the biomechanical and neuromuscular demands of horizontal deceleration and the qualities underpinning horizontal deceleration performance. Accordingly, the aims of this review article are to: (1) conduct an evidence-based review of the biomechanical demands of horizontal deceleration and (2) identify biomechanical and neuromuscular performance determinants of horizontal deceleration, with the aim of outlining relevant performance implications for random intermittent multi-directional sports. We highlight that horizontal decelerations have a unique ground reaction force profile, characterised by high-impact peak forces and loading rates. The highest magnitude of these forces occurs during the early stance phase (< 50 ms) and is shown to be up to 2.7 times greater than those seen during the first steps of a maximal horizontal acceleration. As such, inability for either limb to tolerate these forces may result in a diminished ability to brake, subsequently reducing deceleration capacity, and increasing vulnerability to excessive forces that could heighten injury risk and severity of muscle damage. Two factors are highlighted as especially important for enhancing horizontal deceleration ability: (1) braking force control and (2) braking force attenuation. Whilst various eccentric strength qualities have been reported to be important for achieving these purposes, the potential importance of concentric, isometric and reactive strength, in addition to an enhanced technical ability to apply braking force is also highlighted. Last, the review provides recommended research directions to enhance future understanding of horizontal deceleration ability.

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Section: Biomechanical Demands Of Horizontal Decelerationmentioning

confidence: 99%

Biomechanical and Neuromuscular Performance Requirements of Horizontal Deceleration: A Review with Implications for Random Intermittent Multi-Directional Sports

et al. 2022

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“…Video analysis is a frequently used tool to investigate injury mechanisms, playing situations and gross biomechanics preceding and during actual injuries 7. This methodological framework has been extensively used to study ACL injuries across various sports6–9 as well as other conditions within and outside football 10 11. To date, the authors are aware of only one study using video analysis to analyse ATR injuries, performed on a small sample of National Basketball Association (NBA) players (n=12) 12.…”

Section: Introductionmentioning

confidence: 99%

Video analysis of Achilles tendon rupture in male professional football (soccer) players: injury mechanisms, patterns and biomechanics

Villa¹,

Buckthorpe

Tosarelli³

et al. 2022

BMJ Open Sport Exerc Med

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BackgroundAchilles tendon rupture (ATR), while rare in football, is a severe career-threatening injury associated with long-layoff times. To date, no study has documented ATR’s mechanism in professional football players.AimTo describe the mechanisms, situational patterns and gross biomechanics (kinematics) of ATR injuries in professional male football players.MethodsEighty-six (n=86) consecutive ATR injuries in professional football players during official matches were identified. Sixty (70%) injury videos were identified for mechanism and situational pattern, with biomechanical analysis feasible in 42 cases. Three independent reviewers evaluated the injury videos. Distribution of ATR during the season, the match play and on the field were also reported.ResultsFifty (n=50, 83%) injuries were classified as non-contact and 10 (17%) as indirect contact. ATRs are injuries occurring during accelerations; three main situational patterns were identified: (1) forward acceleration from standing (n=25, 42%); (2) cross-over cutting (n=15, 25%) and (3) vertical jumping (n=11, 18%). Biomechanically, ATR injuries were consistent with a multiplanar loading at the injury frame consisting of a slightly flexed trunk (15.5°), extended hip (−19.5°), early flexed knee (22.5°) and end-range dorsiflexed (40°) ankle in the sagittal plane and foot pronation; 27 (45%) ATRs occurred in the first 30 min of effective match time.ConclusionsAll ATRs in professional football were either non-contact (83%) or indirect contact (17%) injuries. The most common situational patterns were forward acceleration from standing, cross-over cutting and vertical jumping. Biomechanics was consistent and probably triggered by a multiplanar, although predominantly sagittal, loading of the injured Achilles tendon.

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“…Despite the highlighted development of methods, it could be argued that all these assessments may still fail to provide representative testing conditions [ 22 ]. Sidestepping is beneficial to athletic performance but is a high-risk, high-reward movement due to its association with anterior cruciate ligament (ACL) injury risk [ 23 ] as evidenced by the number of non-contact ACL injuries experienced in team sports [ 24 , 25 ]. It is, therefore, an area of particular interest within sports medicine research.…”

Section: Introductionmentioning

confidence: 99%

Training for “Worst-Case” Scenarios in Sidestepping: Unifying Strength and Conditioning and Perception–Action Approaches

2023

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Sidesteps can impose high demands on the knee joint and lead to non-contact anterior cruciate ligament (ACL) injuries. Understanding how different constraints shape an athlete’s movement strategy and the associated joint demands can help design training interventions to increase injury resilience. Motor capacities, such as muscular strength and power, act as boundaries for the safe execution of perceptual–motor skills and co-determine the emergence of unique movement strategies. Increasing single- and multi-joint strength enables a broader solution space for movement strategies and increases load tolerance. Manipulating task constraints during sidesteps can be used in the training process to systematically expose athletes to increasing demands (on the knee joint or any joint or structure) in preparation for “worst-case” scenarios. In particular, the type and timing of information available influence the preparation time, subsequently affecting the movement strategy and the associated magnitude of external knee joint loading (e.g., knee valgus moment). While an athlete’s perceptual–cognitive skills contribute to the preparation time during in situ scenarios, attempts to further improve those skills with the aim of increasing athlete preparation time prior to “worst-case” scenarios are yet to demonstrate conclusive evidence of transfer to on-field situations. Therefore, in the current article, we reflect on the impact of different interacting constraints that influence the execution of sidesteps during in situ scenarios and impose high demands on the knee joint. Subsequently, we discuss how an integrated perspective, drawing on knowledge and perspectives from strength and conditioning and perception–action, may enhance an athlete’s ability to withstand “worst-case” scenarios and adapt to perform varied movement executions when sidestepping.

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Systematic Video Analysis of Anterior Cruciate Ligament Injuries in Professional Male Rugby Players: Pattern, Injury Mechanism, and Biomechanics in 57 Consecutive Cases

Cited by 30 publications

References 44 publications

Biomechanical and Neuromuscular Performance Requirements of Horizontal Deceleration: A Review with Implications for Random Intermittent Multi-Directional Sports

Biomechanical and Neuromuscular Performance Requirements of Horizontal Deceleration: A Review with Implications for Random Intermittent Multi-Directional Sports

Video analysis of Achilles tendon rupture in male professional football (soccer) players: injury mechanisms, patterns and biomechanics

Training for “Worst-Case” Scenarios in Sidestepping: Unifying Strength and Conditioning and Perception–Action Approaches

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