2025 ISAKOS Biennial Congress ePoster
Mechanisms of Severe Lower Limb Muscle-Tendon Injuries in Professional Soccer Players: A Video Analysis of 72 Cases
Aleksi Jokela, MD, PhD, Pori FINLAND
Giulio Pasta, PHD, Parma ITALY
Jussi Kosola, MD, Helsinki FINLAND
Ricardo Pruna, MD, PhD, Barcelona SPAIN
Francesco Della Villa, MD, Bologna, BO ITALY
Arnaldo Abrantes, MD, London UNITED KINGDOM
Xavier Valle, MD, Barcelona SPAIN
Lasse Lempainen, MD, PhD, Adjunct Professor, Turku FINLAND
FinnOrthopaedics / Hospital Pihlajalinna, Turku, FINLAND
FDA Status Not Applicable
Summary
This systematic video analysis study shows that most of the severe lower limb muscle-tendon injuries in professional soccer players occur in non-contact situations, often during stretching, running, or kicking, providing important insights for targeted prevention and treatment strategies.
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Abstract
Background
Muscle-tendon injuries are common in soccer, as every team can expect suffering 15 muscle-tendon injuries per season. A significant portion (11%) are severe injuries causing more than 28 days absence from soccer. These injuries can dramatically impact team performance, economy, and players’ careers. The incidence of muscle-tendon injuries is higher during matches. Understanding the mechanisms behind severe muscle-tendon injuries in professional soccer players is crucial for prevention and treatment strategies. The aim of this study was to investigate these mechanisms using systematic video analysis.
Methods
We retrospectively studied 72 cases of male professional soccer players aged between 18-38 years (median age 26 years) who suffered severe muscle-tendon injuries in lower limbs during match play between September 2017 and August 2024, leading to orthopaedic consultations and >28 days of absence. The injuries included 20 adductor longus, 23 hamstring, 22 rectus femoris, five Achilles tendon, and two patellar tendon injuries. Injury mechanisms and situations were systematically analyzed from the video footage, based on a standardized scoring form.
Results
Our analysis showed that 72% of injuries were non-contact and 28% involved indirect contact with the opponent player. The right leg was affected in 56% of injuries. The injury mechanisms were predominantly closed kinetic chain stretching (38%), kicking (25%), running (21%), and open kinetic chain stretching (11%). In adductor injuries, 70% of the cases occurred during closed kinetic chain stretching movements, mainly when reaching for the ball. Hamstring injuries were due to closed kinetic chain stretching movements in 43% of the cases, sprinting in 35%, and open kinetic chain stretching in 22%. In rectus femoris injuries, 82% occurred during kicking. Non-contact injuries represented 65% of adductor injuries, 61% of hamstring injuries, 91% of rectus femoris injuries, and 100% of Achilles injuries. Both patellar tendon ruptures occurred during direct contusions when knee hitting the ground.
Conclusions
The results suggest that severe lower limb muscle-tendon injuries in professional football primarily occur due to non-contact mechanisms, most frequently during closed kinetic chain stretching movements, kicking, or running. The typical injury mechanisms differ based on the specific muscle involved. These findings can guide injury prevention strategies and highlight the need for appropriate management and rehabilitation protocols.