Three Main Mechanisms Characterize Medial Collateral Ligament Injuries in Professional Male Soccer—Blow to the Knee, Contact to the Leg or Foot, and Sliding: Video Analysis of 37 Consecutive Injuries

Abstract

Objective To describe the mechanisms, situational patterns, and biomechanics (kinematics) of medial collateral ligament (MCL) injuries in professional male soccer players. Design Case series. Methods Fifty-seven consecutive MCL injuries across 2 seasons of professional soccer matches were identified. We obtained and reviewed 37 of 57 (65%) injury videos to establish the injury mechanism, situational pattern, and knee flexion angle. We used detailed biomechanical analysis to assess the indirect and noncontact injuries. Injury layoff times, timing of injuries during the match, and location of the injuries on the pitch were also reported. Results Twenty-three (62%) injuries were direct contact, 9 (24%) were indirect contact, and 5 (14%) were noncontact. Three main sprain mechanisms were noted: (1) direct contact/blow to the knee (n = 16), (2) contact to the leg or foot (lever like) (n = 7), and (3) sliding (n = 9). Seventy-three percent of MCL injuries occurred during 2 main situations: (1) pressing/tackling (n = 14, 38%) and (2) being tackled (n = 13, 35%). For indirect and noncontact injuries, knee valgus loading (100% of cases), hip abduction (73% of cases), and external foot rotation (92% of cases) were prominent injury kinematics, often with lateral trunk tilt (median, 10°; 64% of cases) and rotation (64% of cases). Knee flexion angles were higher for indirect and noncontact injuries (median, 100°) than for direct-contact injuries (median, 22°; P<.01). Conclusion Nearly two thirds of MCL injuries occurred after direct contact; 1 in every 4 MCL injuries occurred after indirect contact. Three sprain mechanisms characterized MCL injuries: (1) blow to the knee, (2) contact to the leg or foot (lever like), and (3) sliding. J Orthop Sports Phys Ther 2021;51(12):611–618. Epub 16 Nov 2021. doi:10.2519/jospt.2021.10529

Mechanisms of Achilles Tendon Rupture in National Basketball Association Players

“…While this method has its limitations, it is an accepted practice for in situ competition analysis. [16][17][18][19] The AT ruptures can be deleterious to professional basketball athletes. Extreme ankle dorsiflexion was identified with outward turning of the foot following a "false step" as the predominant mechanism of AT injury in NBA players.…”

“…13 The mechanism of injury has also been studied using 2D video analysis, 14 which can be a valuable tool for in situ evaluation during athletic competitions. For example, previous literature has used this method in soccer, [16][17][18] basketball, 19 and alpine ski racing 20,21 for epidemiological purposes. Lemme et al 14 examined contributing factors involved with AT ruptures in the NBA and noted that a large angle of ankle dorsiflexion occurred at the time of AT rupture (see Figure 1).…”

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

“…The same methodology of our previous video analysis studies was implemented6 10 17: video clips were independently evaluated by three different reviewers (FDV, AG, MB) according to a predetermined checklist (online supplemental table 1). All the reviewers are involved in sports medicine and orthopaedic rehabilitation practice and have experience with video analysis research.…”

“… 7 This methodological framework has been extensively used to study ACL injuries across various sports 6–9 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 No study has been published to date on football (soccer).…”

“…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.…”