scholarly journals Systematic video analysis of ACL injuries in professional male football (soccer): injury mechanisms, situational patterns and biomechanics study on 134 consecutive cases

2020 ◽  
Vol 54 (23) ◽  
pp. 1423-1432 ◽  
Author(s):  
Francesco Della Villa ◽  
Matthew Buckthorpe ◽  
Alberto Grassi ◽  
Alberto Nabiuzzi ◽  
Filippo Tosarelli ◽  
...  
Keyword(s):  
Video Analysis ◽  
Direct Contact ◽  
Acl Injury ◽  
Injury Pattern ◽  
Biomechanical Analysis ◽  
Knee Valgus ◽  
Mechanical Perturbation ◽  
Indirect Contact ◽  
Acl Injuries ◽  
Injury Mechanisms

BackgroundA few small studies have reported on the mechanisms of ACL injury in professional male football.AimTo describe the mechanisms, situational patterns and biomechanics (kinematics) of ACL injuries in professional male football matches.MethodsWe identified 148 consecutive ACL injuries across 10 seasons of professional Italian football. 134 (90%) injury videos were analysed for mechanism and situational pattern, while biomechanical analysis was possible in 107 cases. Three independent reviewers evaluated each video. ACL injury epidemiology (month), timing within the match and pitch location at the time of injury were also reported.Results59 (44%) injuries were non-contact, 59 (44%) were indirect contact and 16 (12%) were direct contact. Players were frequently perturbed immediately prior to injury. We identified four main situational patterns for players who suffered a non-contact or an indirect contact injury: (1) pressing and tackling (n=55); (2) tackled (n=24); (3) regaining balance after kicking (n=19); and (4) landing from a jump (n=8). Knee valgus loading (n=83, 81%) was the dominant injury pattern across all four of these situational patterns (86%, 86%, 67% and 50%, respectively). 62% of the injuries occurred in the first half of the matches (p<0.01). Injuries peaked at the beginning of the season (September–October) and were also higher at the end of the season (March–May).Conclusions88% of ACL injuries occurred without direct knee contact, but indirect contact injuries were as frequent as non-contact injuries, underlying the importance of mechanical perturbation. The most common situational patterns were pressing, being tackled and kicking.

Mechanisms of acute ankle syndesmosis ligament injuries in professional male rugby union players: a systematic visual video analysis

2020 ◽  
pp. bjsports-2020-102281
Author(s):  
Eamonn Delahunt ◽  
Garreth Farrell ◽  
Andrew Boylan ◽  
Fearghal Kerin ◽  
Peter Tierney ◽  
...  
Keyword(s):  
Video Analysis ◽  
Direct Contact ◽  
External Rotation ◽  
Rugby Union ◽  
Qualitative Description ◽  
Ligament Injuries ◽  
Injured Limb ◽  
Indirect Contact ◽  
Injury Mechanisms ◽  
Hip Flexion

BackgroundThe mechanisms of acute ankle syndesmosis ligament injuries in professional rugby union are not well understood.AimTo describe the mechanisms of acute ankle syndesmosis ligament injuries in male professional rugby union players using systematic visual video analysis.MethodsAll time-loss acute ankle syndesmosis ligament injuries identified via retrospective analysis of the Leinster Rugby injury surveillance database across the 2013/2014 to 2017/2018 seasons were considered as potentially eligible for inclusion. Three Chartered Physiotherapists (analysts) independently assessed all videos with a final consensus meeting convened to describe the injury mechanisms. One of the analysts developed a qualitative description of each injury mechanism.ResultsThirteen acute ankle syndesmosis injuries were included in this study. The most common biomechanical presentation of the injured limb was characterised by hip flexion, knee flexion, knee valgus, ankle dorsiflexion, pronation and external rotation of the foot. Six of the included injuries (46%) were the result of an external load application to the injured limb (ie, direct contact injuries). In the other seven instances (54%), the injury was the result of a collapse of the injured player’s body mass over the injured ankle joint, while tackling or being tackled, without direct contact to the injured limb (ie, indirect contact injuries).ConclusionInjuries incurred while tackling were exclusively the result of suboptimal tackle mechanics. A majority of injuries incurred while being tackled involved a posterior tackle, which often resulted in a posterior collapse of the injured player’s centre of mass over a fixed externally rotated foot.

Systematic Video Analysis of Anterior Cruciate Ligament Injuries in Professional Female Soccer Players

2021 ◽  
pp. 036354652110081
Author(s):  
Simona Lucarno ◽  
Matteo Zago ◽  
Matthew Buckthorpe ◽  
Alberto Grassi ◽  
Filippo Tosarelli ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Direct Contact ◽  
Cruciate Ligament ◽  
Case Series ◽  
Biomechanical Analysis ◽  
Soccer Players ◽  
Indirect Contact ◽  
Acl Injuries ◽  
Anterior Cruciate ◽  
Women's Soccer

Background: Female soccer players are particularly susceptible to anterior cruciate ligament (ACL) injuries, accounting for 16% to 43% of the injury burden during the season. Despite the advancements in injury prevention programs, the rate of ACL injuries continues to rise. Purpose: To provide a comprehensive description of the mechanisms, situational pattern, and biomechanics of ACL injuries in women’s soccer. Study Design: Case series; Level of evidence, 4. Methods: We identified 57 consecutive ACL injuries that occurred in matches of 6 top female leagues across 3 seasons (2017-2020). A total of 35 (61%) injury videos were analyzed for the mechanism and situational pattern, while biomechanical analysis was possible in 29 cases. Three independent reviewers evaluated each video. The distribution of ACL injuries according to month, timing within the match, and field location at the time of injury was also reported. Results: In the 35 injury videos, there were 19 (54%) noncontact injuries, 12 (34%) indirect contact injuries, and 4 (11%) direct contact injuries. We identified 3 main situations in players who suffered a noncontact/indirect contact injury: (1) pressing and tackling (n = 18), (2) regaining balance after kicking (n = 7), and (3) being tackled (n = 4). Biomechanical analysis indicated multiplanar mechanisms with frequent knee valgus loading (88%). Additionally, 64% of injuries occurred in the first half of matches and most frequently within the first 30 minutes. Conclusion: Female athletes showed remarkable similarities with elite male players in terms of the ACL mechanism and situational pattern of injury, and 88% of injuries involved no direct contact to the knee, with noncontact injuries being highly prevalent. Injuries occurred during 3 main situations, with accompanying alterations in multiplanar biomechanics. Interventions aimed at reducing ACL injuries in women’s soccer should consider high-intensity defensive play at the beginning of a match. Instruction in the 3 main situations should be applied alongside appropriate neuromuscular training interventions.

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

2021 ◽  
Vol 9 (11) ◽  
pp. 232596712110481
Author(s):  
Francesco Della Villa ◽  
Filippo Tosarelli ◽  
Rocco Ferrari ◽  
Alberto Grassi ◽  
Luca Ciampone ◽  
...  
Keyword(s):  
Sagittal Plane ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Biomechanical Analysis ◽  
Indirect Contact ◽  
Acl Injuries ◽  
Change Of Direction ◽  
Knee Loading ◽  
Anterior Cruciate ◽  
Rugby Players

Background: Anterior cruciate ligament (ACL) injuries represent a significant burden to rugby players. Improving our understanding of the patterns and biomechanics that result in ACL injury may aid in the design of effective prevention programs. Purpose: To describe, using video analysis, the mechanisms, situational patterns, and biomechanics of ACL injuries in professional rugby matches. Further aims were to document injuries according to pitch location and timing within the match. Study Design: Case series; Level of evidence, 4. Methods: A total of 62 ACL injuries were identified in players of the 4 most important rugby leagues across 4 consecutive seasons. We analyzed 57 (92%) injury videos for injury mechanism and situational patterns; biomechanical analysis was performed on indirect and noncontact ACL injuries only (38 cases available). Three reviewers independently evaluated each video. Results: More injuries occurred while attacking than defending (41 [72%] vs 16 [28%]; P < .01). Regarding mechanism, 18 (32%) injuries were direct contact; 15 (26%), indirect contact; and 24 (42%), noncontact. Most direct contact injuries involved being tackled directly to the knee (n = 10). Three situational patterns were identified for players who had a noncontact or indirect contact injury: offensive change of direction (COD) (n = 18), being tackled (n = 10), and pressing/tackling (n = 8). Injuries generally involved a knee-loading strategy in the sagittal plane, which was accompanied by knee valgus loading in most cases (94%). Overall, 73% of injuries occurred during the first 40 minutes of effective playing time. Conclusion: Most ACL injuries in professional male rugby players happened through a noncontact or indirect contact mechanism (68%). Three situational patterns were described, including offensive change of direction, being tackled, and pressing/tackling. Biomechanical analysis confirmed a multiplanar mechanism, with a knee-loading pattern in the sagittal plane accompanied by dynamic valgus. As most injuries occurred in the first 40 minutes, accumulated fatigue appears not to be a major risk factor for ACL injury.

Contact — but not foul play — dominates injury mechanisms in men’s professional handball: a video match analysis of 580 injuries

2020 ◽  
Vol 54 (16) ◽  
pp. 984-990 ◽  
Author(s):  
Patrick Luig ◽  
Werner Krutsch ◽  
Thomas Henke ◽  
Christian Klein ◽  
Hendrik Bloch ◽  
...  
Keyword(s):  
Direct Contact ◽  
Knee Injuries ◽  
Central Zone ◽  
Ankle Injuries ◽  
Common Mechanism ◽  
Match Analysis ◽  
Severe Injuries ◽  
Indirect Contact ◽  
Injury Mechanisms ◽  
Video Material

AimWe aimed to identify patterns and mechanisms of injury situations in men’s professional handball by means of video match analysis.MethodsModerate and severe injuries (absence of >7 days) sustained in competition in one of six seasons (2010 to 2013 and 2014 to 2017) in men’s professional handball were prospectively analysed with a newly developed standardised observation form. Season 2013 to 2014 was excluded because of missing video material.Results580 injuries were identified: 298 (51.4%) contact injuries, 151 (26.0%) indirect contact injuries and 131 (22.6%) non-contact injuries. Head (87.5%), hand (83.8%), shoulder (70.2%) and ankle (62.9%) injuries were mainly sustained during direct contact. Typical contact injuries included collision with an opponent’s upper extremity or torso, and ankle injuries mainly consisted of foot-to-foot collisions. A large proportion (41.7%) of knee injuries were caused by indirect contact, whereas thigh injuries mainly occurred (56.4%) through non-contact mechanism. Wing (56.9%) and pivot (58.4%) players had the highest proportion of contact injuries, whereas backcourt players had a high proportion of indirect contact injuries (31.5%) and goalkeepers of non-contact injuries (48.9%). The injury proportion of foul play was 28.4%. Most injuries occurred in the central zone between the 6-metre and 9-metre lines (26.1%) and during the last 10 min of each match half (OR 1.71, p=0.016).ConclusionsIn men’s professional handball in a league setting, contact — but not foul play — was the most common mechanism associated with moderate and severe injuries. Head, hand, shoulder and ankle injury were mainly sustained during direct contact.

Video Analysis of ACL Injury Mechanisms Using a Model-Based Image-Matching Technique

2015 ◽  
pp. 109-120 ◽  
Author(s):  
Hideyuki Koga ◽  
Takeshi Muneta ◽  
Roald Bahr ◽  
Lars Engebretsen ◽  
Tron Krosshaug
Keyword(s):  
Video Analysis ◽  
Image Matching ◽  
Acl Injury ◽  
Model Based ◽  
Injury Mechanisms ◽  
Matching Technique

scholarly journals Stiff Landings, Core Stability, and Dynamic Knee Valgus: A Systematic Review on Documented Anterior Cruciate Ligament Ruptures in Male and Female Athletes

2021 ◽  
Vol 18 (7) ◽  
pp. 3826
Author(s):  
Joseph Larwa ◽  
Conrad Stoy ◽  
Ross S. Chafetz ◽  
Michael Boniello ◽  
Corinna Franklin
Keyword(s):  
Systematic Review ◽  
Anterior Cruciate Ligament ◽  
Injury Risk ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Core Stability ◽  
Knee Valgus ◽  
Acl Injuries ◽  
Male And Female ◽  
Anterior Cruciate

Anterior cruciate ligament (ACL) injuries are the most common ligament injury of the knee, accounting for between 100,000 and 200,000 injuries among athletes per year. ACL injuries occur via contact and non-contact mechanisms, with the former being more common in males and the later being more common in females. These injuries typically require surgical repair and have relatively high re-rupture rates, resulting in a significant psychological burden for these individuals and long rehabilitation times. Numerous studies have attempted to determine risk factors for ACL rupture, including hormonal, biomechanical, and sport- and gender-specific factors. However, the incidence of ACL injuries continues to rise. Therefore, we performed a systematic review analyzing both ACL injury video analysis studies and studies on athletes who were pre-screened with eventual ACL injury. We investigated biomechanical mechanisms contributing to ACL injury and considered male and female differences. Factors such as hip angle and strength, knee movement, trunk stability, and ankle motion were considered to give a comprehensive, joint by joint analysis of injury risk and possible roles of prevention. Our review demonstrated that poor core stability, landing with heel strike, weak hip abduction strength, and increased knee valgus may contribute to increased ACL injury risk in young athletes.

scholarly journals Mechanisms of ACL injury in professional rugby union: a systematic video analysis of 36 cases

2016 ◽  
Vol 52 (15) ◽  
pp. 994-1001 ◽  
Author(s):  
Connor Montgomery ◽  
Jeff Blackburn ◽  
Daniel Withers ◽  
Gregory Tierney ◽  
Cathal Moran ◽  
...  
Keyword(s):  
Video Analysis ◽  
Knee Flexion ◽  
Injury Risk ◽  
Acl Injury ◽  
Rugby Union ◽  
Heel Strike ◽  
Control Group ◽  
Ground Contact ◽  
Acl Injuries ◽  
Significant Difference

BackgroundThe mechanisms of ACL injury in rugby are not well defined.AimTo describe the mechanisms of ACL injury in male professional rugby players using systematic video analysis.Methods36 cases from games played in top professional leagues and international matches were analysed. 5 analysts independently assessed all videos to record the estimated frame/time of initial ground contact, frame/time of ACL tear and a range of play specific variables. This included contact versus non-contact ACL injuries, injury timing, joint flexion angles and foot contact with the ground. 37 side-stepping manoeuvres from a control game were analysed to allow comparison of non-injury versus injury situations.Results57% of ACL injuries occurred in a contact manner. 2 main scenarios were identified: (1) offensive running and (2) being tackled, indicating that the ball carrier might be at higher risk of ACL injury. The majority of non-contact ACL injuries resulted from a side-stepping manoeuvre. In most non-contact cases, initial ground contact was through heel strike. Statistical assessment of heel strike at initial ground contact versus non-heel strike cases showed a significant difference in injury versus non-injury outcomes, with heel strike associated with higher injury risk. Non-contact ACL injuries had lower median knee flexion angles and a more dorsiflexed ankle when compared with a control group (10° vs 20°, p≤0.001 and 10° vs 0°, p=0.033 respectively).ConclusionsOver half of ACL injuries in rugby in our analysis resulted from a contact mechanism. For non-contact injuries, lower knee flexion angles and heel-first ground contact in a side-stepping manoeuvre were associated with ACL injury.

ACL Injury Mechanism is Related to Articular Pressure Distribution: A Cadaveric and Finite Element Investigation

2012 ◽  
Author(s):  
Ata M. Kiapour ◽  
Constantine K. Demetropoulos ◽  
Ali Kiapour ◽  
Carmen E. Quatman ◽  
Jason W. Levine ◽  
...  
Keyword(s):  
Finite Element ◽  
Pressure Distribution ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
High Rate ◽  
Bone Bruise ◽  
Acl Injuries ◽  
Injury Mechanisms ◽  
Anterior Cruciate

Acute anterior cruciate ligament (ACL) injury can be devastating, and often results in clinical sequelae that include meniscal tears, chondral lesions and osteoarthritis. Various bone bruise patterns of the femur or tibia, and bone contusions of the lateral tibial plateau have been associated in more than 80% of partial or complete ACL ruptures [1]. As quantification of articular cartilage pressure distribution under high-rate loading conditions remains challenging, validated finite element (FE) models of the knee can be used to characterize the effects of different loading parameters on tibiofemoral (TF) joint pressure distribution. This study combines high-rate cadaveric experiments with FE analysis to simulate ACL injuries and associated bone bruise patterns following landing from a jump. We hypothesized that a potential relationship exists between ACL injury mechanisms and resultant tibial plateau bone bruise patterns. This relationship may enhance our understanding of ACL injury mechanisms, which may provide insight to improve current prevention strategies that aim to decrease the risk of ACL injury and damage to secondary anatomical structures. All of this may in turn minimize associated posttraumatic knee osteoarthritis.

scholarly journals Rapid Posterior Tibial Reduction After Noncontact Anterior Cruciate Ligament Rupture: Mechanism Description From a Video Analysis

2020 ◽  
Vol 12 (5) ◽  
pp. 462-469 ◽  
Author(s):  
Alberto Grassi ◽  
Filippo Tosarelli ◽  
Piero Agostinone ◽  
Luca Macchiarola ◽  
Stefano Zaffagnini ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Video Analysis ◽  
Knee Flexion ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Soccer Players ◽  
Initial Contact ◽  
Acl Injuries ◽  
Posterior Tibial ◽  
Anterior Cruciate

Background: The mechanisms of noncontact anterior cruciate ligament (ACL) injuries are an enormously debated topic in sports medicine; however, the late phases of injury have not yet been investigated. Hypothesis: A well-defined posterior tibial translation can be visualized with its timing and patterns of knee flexion after ACL injury. Study Design: Case series. Level of Evidence: Level 4. Methods: A total of 137 videos of ACL injuries in professional male football (soccer) players were screened for a sudden posterior tibial reduction (PTR) in the late phase of noncontact ACL injury mechanism. The suitable videos were analyzed using Kinovea software for sport video analysis. The time of initial contact of the foot with the ground, the foot lift, the start of tibial reduction, and the end of tibial reduction were assessed. Results: A total of 21 videos exhibited a clear posterior tibial reduction of 42 ± 11 ms, after an average of 229 ± 81 ms after initial contact. The tibial reduction occurred consistently within the first 50 to 60 ms after foot lift (55 ± 30 ms) and with the knee flexed between 45° and 90° (62%) or more than 90° (24%). Conclusion: A rapid posterior tibial reduction is consistently present in the late phases of noncontact ACL injuries in some male soccer players, with a consistent temporal relationship between foot lift from the ground and consistent degrees of knee flexion near or above 90°. Clinical Relevance: This study provides insight into the late phases of ACL injury. The described mechanism, although purely theoretical, could be responsible for commonly observed intra-articular lesions.

scholarly journals Biomechanical Effects of an Injury Prevention Program in Preadolescent Female Soccer Athletes

2016 ◽  
Vol 45 (2) ◽  
pp. 294-301 ◽  
Author(s):  
Julie A. Thompson ◽  
Andrew A. Tran ◽  
Corey T. Gatewood ◽  
Rebecca Shultz ◽  
Amy Silder ◽  
...  
Keyword(s):  
Risk Factors ◽  
Injury Prevention ◽  
Injury Risk ◽  
Intervention Group ◽  
Acl Injury ◽  
Prevention Programs ◽  
Control Group ◽  
Knee Valgus ◽  
Acl Injuries ◽  
Peak Knee

Background: Anterior cruciate ligament (ACL) injuries are common, and children as young as 10 years of age exhibit movement patterns associated with an ACL injury risk. Prevention programs have been shown to reduce injury rates, but the mechanisms behind these programs are largely unknown. Few studies have investigated biomechanical changes after injury prevention programs in children. Purpose/Hypothesis: To investigate the effects of the F-MARC 11+ injury prevention warm-up program on changes to biomechanical risk factors for an ACL injury in preadolescent female soccer players. We hypothesized that the primary ACL injury risk factor of peak knee valgus moment would improve after training. In addition, we explored other kinematic and kinetic variables associated with ACL injuries. Study Design: Controlled laboratory study. Methods: A total of 51 female athletes aged 10 to 12 years were recruited from soccer clubs and were placed into an intervention group (n = 28; mean [±SD] age, 11.8 ± 0.8 years) and a control group (n = 23; mean age, 11.2 ± 0.6 years). The intervention group participated in 15 in-season sessions of the F-MARC 11+ program (2 times/wk). Pre- and postseason motion capture data were collected during preplanned cutting, unanticipated cutting, double-leg jump, and single-leg jump tasks. Lower extremity joint angles and moments were estimated using OpenSim, a biomechanical modeling system. Results: Athletes in the intervention group reduced their peak knee valgus moment compared with the control group during the double-leg jump (mean [±standard error of the mean] pre- to posttest change, –0.57 ± 0.27 %BW×HT vs 0.25 ± 0.25 %BW×HT, respectively; P = .034). No significant differences in the change in peak knee valgus moment were found between the groups for any other activity; however, the intervention group displayed a significant pre- to posttest increase in peak knee valgus moment during unanticipated cutting ( P = .044). Additional analyses revealed an improvement in peak ankle eversion moment after training during preplanned cutting ( P = .015), unanticipated cutting ( P = .004), and the double-leg jump ( P = .016) compared with the control group. Other secondary risk factors did not significantly improve after training, although the peak knee valgus angle improved in the control group compared with the intervention group during unanticipated cutting ( P = .018). Conclusion: The F-MARC 11+ program may be effective in improving some risk factors for an ACL injury during a double-leg jump in preadolescent athletes, most notably by reducing peak knee valgus moment. Clinical Relevance: This study provides motivation for enhancing injury prevention programs to produce improvement in other ACL risk factors, particularly during cutting and single-leg tasks.

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