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 and 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) and MRI injury location. Results: Fourteen 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 (BF) (36%). Most frequent body positions at defined injury moments were neutral trunk (43%), hip flexion 45-90 degrees (57%), and knee flexion <45 degrees (93%). Magnetic resonance imaging findings showed that 79% were isolated single-tendon injuries. Conclusions: According to a video analysis, most hamstring injuries in soccer occur during high-speed movements. Physicians should suspect proximal and isolated single-tendon—most often BF—hamstring injury, if represented injury mechanisms are seen during game play. In addition to sprinting and stretching, also mixed-type injury mechanisms occur.
Purpose: Bioimpedance data through bioimpedance vector analysis (BIVA) is used to evaluate cellular function and body fluid content. This study aimed to (i) identify whether BIVA patters differ according to the competitive period and (ii) provide specific references for assessing bioelectric properties at the start of the season in male elite soccer players. Methods: The study included 131 male soccer players (age: 25.1 ± 4.7 yr, height: 183.4 ± 6.1 cm, weight: 79.3 ± 6.6) registered in the first Italian soccer division (Serie A). Bioimpedance analysis was performed just before the start of the competitive season and BIVA was applied. In order to verify the need for period-specific references, bioelectrical values measured at the start of the season were compared to the reference values for the male elite soccer player population. Results: The results of the two-sample Hotelling T2 tests showed that in the bivariate interpretation of the raw bioimpedance parameters (resistance (R) and reactance (Xc)) the bioelectric properties significantly (T2 = 15.3, F = 7.6, p ≤ 0.001, Mahalanobis D = 0.45) differ between the two phases of the competition analyzed. In particular, the mean impedance vector is more displaced to the left into the R-Xc graph at the beginning of the season than in the first half of the championship. Conclusions: For an accurate evaluation of body composition and cellular health, the tolerance ellipses displayed by BIVA approach into the R-Xc graph must be period-specific. This study provides new specific tolerance ellipses (R/H: 246 ± 32.1, Xc/H: 34.3 ± 5.1, r: 0.7) for performing BIVA at the beginning of the competitive season in male elite soccer players.
Muscle injuries and subsequent reinjuries significantly impact athletes, especially in football. These injuries lead to time loss, performance impairment, and long-term health concerns. This review aims to provide a comprehensive overview of the current understanding of muscle reinjuries, delving into their epidemiology, risk factors, clinical management, and prevention strategies. Despite advancements in rehabilitation programs and return-to-play criteria, reinjury rates remain alarmingly high. Age and previous muscle injuries are nonmodifiable risk factors contributing to a high reinjury rate. Clinical management, which involves accurate diagnosis, individualized rehabilitation plans, and the establishment of return-to-training and return-to-play criteria, plays a pivotal role during the sports season. Eccentric exercises, optimal loading, and training load monitoring are key elements in preventing reinjuries. The potential of artificial intelligence (AI) in predicting and preventing reinjuries offers a promising avenue, emphasizing the need for a multidisciplinary approach to managing these injuries. While current strategies offer some mitigation, there is a pressing need for innovative solutions, possibly leveraging AI, to reduce the incidence of muscle reinjuries in football players. Future research should focus on this direction, aiming to enhance athletes’ well-being and performance.
This study aimed to examine the agreement between asymmetries of dribble and change of direction (COD) deficits and to determine their potential difference to each other. Sixteen young elite football players were recruited and tested for sprint (over 10 m), dribbling (90°CODdribbling) and COD (90°CODrunning) performance in dominant (fastest) and non-dominant (slowest) directions. Dribble and COD deficits were computed to express dribbling and COD ability without the influence of acceleration. The asymmetric index (AI%) of both dribble and COD deficits were obtained for both directions. The level of agreement between dribble and COD deficits was assessed by Cohen’s kappa statistic (κ). Results showed that AI% measured by dribble and COD deficits presented a poor level of agreement (κ = −0.159), indicating their imbalance did not favor the same direction. Moreover, AI% of the dribble deficit was significantly higher than those of the COD deficit. This study demonstrated that asymmetries in dribbling and change of direction performance (measured by dribble and COD deficit) were not in agreement to favor the same direction, also displaying a significant difference to each other. Practitioners should consider the task-specificity of asymmetry to reduce the imbalance in dribbling and COD performance.
Easy-to-apply and quick methods for evaluate body composition are often preferred when assessing soccer teams. This study aimed to develop new equations for the somatotype quantification that would reduce the anthropometric measurements required by the Heath and Carter method, integrating the somatotype assessment to the bioelectrical impedance analysis (BIA). One hundred and seventy-six male elite soccer players (age 26.9 ± 4.5 years), registered in the Italian first division (Serie A), underwent anthropometric measurements and BIA. Endomorphy, mesomorphy, and ectomorphy were obtained according to the Heath and Carter method, while fat mass (FM) and fat free mass (FFM) estimated using a BIA-derived equation specific for athletes. The participants were randomly split into development (n = 117) and validation groups (n = 59, 1/3 of sample). The developed models including resistance2/stature, FM%, FFM, contracted arm and calf circumference, triceps, and supraspinal skinfolds had high predictive ability for endomorphy (R2 = 0.83, Standard Error of Estimate (SEE) = 0.16) mesomorphy (R2 = 0.80, SEE = 0.36), and ectomorphy (endomorphy (R2 = 0.87, SEE = 0.22). Cross validation revealed R2 of 0.80, 0.84, 0.87 for endomorphy, mesomorphy, and ectomorphy, respectively. The proposed strategy allows the integration of somatotype assessment to BIA in soccer players, reducing the number of instruments and measurements required by the Heath and Carter approach.
The present study compared changes in body composition during the COVID-19-associated lockdown with the same period of the following season in elite soccer players. Fifteen elite male soccer players (30.5 ± 3.6 years.) underwent a bioelectrical impedance analysis (BIA) before (end of February) and after (end of May) the lockdown, which occurred during the 2019/2020 season, and at the same period during the following competitive season in 2020/2021, when restrictions were lifted. Fat and muscle mass were estimated using predictive equations, while phase angle (PhA) and bioelectrical impedance vector analysis (BIVA) patterns were directly measured. After lockdown, fat mass remained unchanged (p > 0.05), while muscle mass (95%CI = −1.12/−0.64; ES = −2.04) and PhA (95%CI = 0.51/−0.24, ES = −1.56) decreased. A rightward displacement of the BIVA vector was also found (p < 0.001, ES = 1.50). After the same period during the regular season, FM% and muscle mass did not change (p > 0.05), while the PhA increased (95%CI = 0.01/0.22; ES = 0.63). A leftward vector displacement (p < 0.001, ES = 1.05) was also observed. The changes in muscle mass correlated with changes in PhA (“lockdown” season 2019/2020: ß = −1.128, p = 0.011; “regular” season 2020/21: ß = 1.963, p = 0.011). In conclusion, coaches and strength conditioners should monitor muscle mass in soccer players during detraining periods as this parameter appears to be mainly affected by changes in training plans.