Background Muscle injuries frequently occur in both competitive and amateur sports. In soccer, muscle injuries are responsible for more than one third of all injuries. The smaller portion are the major injuries (muscle tear and tendinous avulsion).^{1 2} As the abdominal muscles give the necessary core stability for sports like soccer,² those injuries need special attention to enable athletes to a fast return to their sports.

Methods A literature review to look for articles dealing with internal oblique muscle injuries was performed. Analysis of the medical health records of the Institute for Sports Medicine, Frankurt between 2010 and 2012 was performed to analyse our special experience with abdominal muscle injuries in sport. The medical records were evaluated for injury cause, symptoms, operation, follow-up treatment and outcome.

Results There was no publication found dealing solely with abdominal wall injuries in soccer, in comparison to publications found for tennis players. Abdominal injuries as blunt trauma are reported to be more common in contact sports like soccer.³ The analysis of our health records revealed three cases of lateral abdominal muscles injuries in soccer players. Clinically patients uniformely showed tenderness at the anterior iliac crest and were no longer able to participate in training. Ultrasound detected hematoma. The diagnosis of a tendinous avulsion of the internal oblique muscle was confirmed by MRI. Operation was performed by making three bone anchoring sutures through the anterior iliac crest. Postoperative care included two-week rest and compressing lumbar bandage. Specific workout for the abdominal muscles was performed 2nd-6th postoperative week. After 6 weeks the transition to sport-specific training was possible. All three soccer players were able to fully participate the regular exercise before 12 weeks and have fully recovered and re-integrated in their soccer activity after that time.

Conclusion Muscular injuries of the abdominal wall in soccer are rare but serious.³ An accurate diagnosis made by MRI is essential for further treatment planning. In our cases, operation is the treatment of choice resulting in excellent results.