Indirect Rectus Femoris Injury Mechanisms in Professional Soccer Players: Video Analysis and Magnetic Resonance Imaging Findings

Clin J Sport Med. 2023 Sep 1;33(5):475-482. doi: 10.1097/JSM.0000000000001131. Epub 2023 Feb 28.

Abstract

Objective: To describe injury mechanisms and magnetic resonance imaging (MRI) findings in acute rectus femoris (RF) injuries of soccer players using a systematic video analysis.

Design: Descriptive case series study of consecutive RF injuries from November 2017 to July 2022.

Setting: Two specialized sports medicine hospitals.

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

Independent variables: Rectus femoris injury mechanisms (specific scoring based on standardized models) in relation to RF muscle injury MRI findings.

Main outcome measures: Rectus femoris injury mechanism (playing situation, player/opponent behavior, movement, and biomechanics), location of injury in MRI.

Results: Twenty videos of RF injuries in 19 professional male soccer players were analyzed. Three different injury mechanisms were seen: kicking (80%), sprinting (10%), and change of direction (10%). Isolated single-tendon injuries were found in 60% of the injuries. Of the kicking injuries, 62.5% included complete tendon ruptures, whereas both running injuries and none of the change of direction injuries were complete ruptures. The direct tendon was involved in 33% of the isolated injuries, and the common tendon was affected in all combined injuries.

Conclusions: Rectus femoris injuries typically occur during kicking among football players. Most of the RF injuries involve a complete rupture of at least one tendon. Kicking injuries can also affect the supporting leg, and sprinting can cause a complete tendon rupture, whereas change of direction seems not to lead to complete ruptures.

MeSH terms

  • Athletic Injuries* / diagnostic imaging
  • Athletic Injuries* / etiology
  • Humans
  • Infant, Newborn
  • Magnetic Resonance Imaging
  • Male
  • Quadriceps Muscle / diagnostic imaging
  • Quadriceps Muscle / injuries
  • Rupture / complications
  • Soccer* / injuries
  • Tendon Injuries*