Article Text

Three distinct mechanisms predominate in non-contact anterior cruciate ligament injuries in male professional football players: a systematic video analysis of 39 cases
  1. Markus Waldén1,2,
  2. Tron Krosshaug3,
  3. John Bjørneboe3,
  4. Thor Einar Andersen3,
  5. Oliver Faul3,
  6. Martin Hägglund2,4
  1. 1Division of Community Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
  2. 2Football Research Group, Linköping, Sweden
  3. 3Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway
  4. 4Division of Physiotherapy, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
  1. Correspondence to Dr Markus Waldén, Division of Community Medicine, Department of Medical and Health Sciences, Linköping University, Linköping 581 83, Sweden; markus.walden{at}telia.com

Abstract

Background Current knowledge on anterior cruciate ligament (ACL) injury mechanisms in male football players is limited.

Aim To describe ACL injury mechanisms in male professional football players using systematic video analysis.

Methods We assessed videos from 39 complete ACL tears recorded via prospective professional football injury surveillance between 2001 and 2011. Five analysts independently reviewed all videos to estimate the time of initial foot contact with the ground and the time of ACL tear. We then analysed all videos according to a structured format describing the injury circumstances and lower limb joint biomechanics.

Results Twenty-five injuries were non-contact, eight indirect contact and six direct contact injuries. We identified three main categories of non-contact and indirect contact injury situations: (1) pressing (n=11), (2) re-gaining balance after kicking (n=5) and (3) landing after heading (n=5). The fourth main injury situation was direct contact with the injured leg or knee (n=6). Knee valgus was frequently seen in the main categories of non-contact and indirect contact playing situations (n=11), but a dynamic valgus collapse was infrequent (n=3). This was in contrast to the tackling-induced direct contact situations where a knee valgus collapse occurred in all cases (n=3).

Conclusions Eighty-five per cent of the ACL injuries in male professional football players resulted from non-contact or indirect contact mechanisms. The most common playing situation leading to injury was pressing followed by kicking and heading. Knee valgus was frequently seen regardless of the playing situation, but a dynamic valgus collapse was rare.

  • ACL
  • Anterior cruciate ligament
  • Football
  • Soccer
  • Prevention

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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