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

Br J Sports Med. 2023 Nov 30;57(24):1550-1558. doi: 10.1136/bjsports-2023-106850.

Abstract

Objective: The objective of this study is to describe the mechanism of injury and situational patterns (based on ball possession and playing action leading to injury) of severe (lay-off time >28 days) lower limb muscle injuries in professional male football (soccer) players during match play.

Methods: Players experiencing a severe muscle injury of the lower limb during Italian first (Serie A) division male football matches over three consecutive seasons (2018-2021) were identified. Video footage was obtained and three raters independently categorised injury mechanism and situational patterns using a standardised checklist. Injury epidemiology (month), timing of injuries within the match and location of injuries on the pitch were also examined.

Results: We identified 121 lower limb severe muscle injuries. Videos of sufficient quality were available for 103 (85%) cases, including 61 (60%) hamstring, 17 (16%) calf, 16 (15%) adductor and 9 (9%) quadricep muscle injuries. Nearly two-thirds of injuries involved the dominant/kicking leg (n=65, 63%). Eighty-five (83%) injuries were non-contact and 18 (17%) indirect contact. Four main situational patterns were identified and accounted for 88% of injuries: (1) running/acceleration (n=35, 34%); (2) closed kinetic chain stretching (n=21, 20%); (3) open kinetic chain stretching (n=19, 18%) and (4) kicking (n=16, 16%), with differences between muscle groups. 71% of injuries occurred in the first half of the match (p<0.01), with a gradual increase through the first half.

Conclusion: Most severe muscle injuries during football matches were non-contact and occurred in the first half during running/acceleration, open and closed kinetic chain stretching, or kicking.

Keywords: Athletic Injuries; Football; Muscle.

MeSH terms

  • Athletic Injuries* / epidemiology
  • Hamstring Muscles* / injuries
  • Humans
  • Lower Extremity / injuries
  • Male
  • Soccer* / injuries