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Mechanisms of Hamstring Injury in Professional Soccer Players: Video Analysis and MRI Findings

Mechanisms of Hamstring Injury in Professional Soccer Players: Video Analysis and MRI Findings

Aleksi Jokela, MD, FINLAND Jussi Kosola, MD, PhD, FINLAND Xavier Valle, MD, SPAIN Ricardo Pruna, MD, PhD, SPAIN Lasse Lempainen, MD, PhD, Adjunct Professor, FINLAND

Department of Orthopaedics and Traumatology, Turku University Hospital, Turku, FINLAND


2023 Congress   ePoster Presentation   2023 Congress   Not yet rated

 

Diagnosis / Condition

Treatment / Technique

Patient Populations

Anatomic Location

Anatomic Structure

Diagnosis Method

MRI


Summary: A detailed video analysis combined with MRI findings revealed that the most common hamstring injury mechanisms are sprint-type, stretch-type and mixed-type, and most frequent body positions at injury moments are neutral trunk, hip flexion 45°-90° and knee flexion <45°.


Objective

To describe the injury mechanisms and magnetic resonance imaging (MRI) findings in acute hamstring injuries of male soccer players using a systematic video analysis.

Design
Descriptive case series study of consecutive acute hamstring injuries from September 2017 to January 2022.

Setting
Two specialized sports medicine hospitals.

Participants
Professional male soccer players aged between 18-40 years, referred for injury assessment within 7 days after an acute hamstring injury, with an available video footage of the injury and positive finding on MRI.

Independent variables
Hamstring injury mechanisms (specific scoring based on standardized models) in relation to hamstring muscle injury MRI findings.

Main outcome measures
Hamstring injury mechanism (playing situation, player/opponent behavior, movement, and biomechanical body positions), MRI injury location.

Results

14 videos of acute hamstring injuries in 13 professional male soccer players were analyzed. Three different injury mechanisms were seen: mixed-type (both sprint-related and stretch-related, 43%), stretch-type (36%), and sprint-type (21%). Most common actions during injury moments were change of direction (29%), kicking (29%), and running (21%). Most injuries occurred at high or very high horizontal speed (71%) and affected isolated proximal biceps femoris (36%). Most frequent body positions at defined injury moments were neutral trunk (43%), hip flexion 45°-90° (57%), and knee flexion <45° (93%). MRI findings showed that 79% were isolated single-tendon injuries.

Conclusions

According to video analysis, most hamstring injuries in soccer occur during high-speed movements. Physicians should suspect proximal and isolated single-tendon – most often biceps femoris - hamstring injury, if represented injury mechanisms are seen during game play. In addition to sprinting and stretching, also mixed-type injury mechanisms occur.


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