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

Abstract

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.

Injury mechanisms and situational patterns of severe lower limb muscle injuries in male professional football (soccer) players: a systematic video analysis study on 103 cases

“…Calf injuries were common while accelerating from stand-still or low velocities. This situational pattern is similar to the reported pattern we detailed for Achilles tendon rupture20 and likely involves high forces through the triceps surae at long muscle lengths/end joint range during the transition from eccentric to concentric actions of the stretch-shortening cycle (SSC),20 35 36 indicative of muscle injury causation 26 27…”

“…Virtually all indirect contact injuries were associated with contact to the upper body leading to stretching or reaching type injuries. Upper body perturbation has been associated with anterior cruciate ligament (ACL),19 21 23 31 medial collateral ligament (MCL)18 and Achilles tendon rupture (ATR)20 injuries and likely results in loss of neuromuscular control, leading to altered kinematics, and more extreme joint position, leading to overstretching of the muscle group. Maintaining neuromuscular control in response to upper body mechanical perturbation appears to be an important factor potentially in preventing numerous lower limb injuries.…”

“…The location of the injury on the pitch was estimated by taking the field lines as a reference 19. The pitch was divided up into 11 zones 20. The size (m 2 ) of each zone was calculated considering the official FIFA football field size (105×70 m) (see online supplemental material for additional details).…”

“…Video analysis, while not being the gold standard method of investigating the kinematics of injuries,14–16 is a valid tool16 for studying the injury context (eg, mechanisms and situational patterns, a term which describes the situation leading to injuries, based on ball possession and playing action). Video analysis has been used to detail injury mechanism and situational patterns across a range of pathologies in different sports 17–24. Regarding muscle injuries in football, only four video analysis studies have been published 25–27.…”

Video Analysis of Anterior Cruciate Ligament Injuries in Male Professional Basketball Players: Injury Mechanisms, Situational Patterns, and Biomechanics

“…Each ACL injury video was downloaded onto a personal computer, opened using open-source software (Kinovea), and analyzed using an evaluation flow adapted to basketball from previous research. [11][12][13]24 In brief, each reviewer evaluated the original video to define the playing phase of the injury (defensive or offensive), which was categorized based on ball possession and the specific playing situation. The injured leg was determined based on injury history and video data.…”