Muscle strain in professional footballers made easy with illustrations

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Congress:

ECR 2015

Poster Number:

C-1289

Type:

Educational Exhibit

Keywords:

Musculoskeletal soft tissue, Trauma, MR, Ultrasound, Diagnostic procedure, Connective tissue disorders

Authors:

B. Coquart ¹, A. Massein², J. Renoux², G. Mercy², J. L. Brasseur²; ¹Marseille/FR, ²Paris/FR

DOI:

10.1594/ecr2015/C-1289

DOI-Link:

https://dx.doi.org/10.1594/ecr2015/C-1289

Fig. 1: Topography classification

Fig. 14: Grading of muscle strains

Fig. 9: Lesion focused on the sagittal conjunctive wall of the rectus femoris...

Fig. 5: Lesion focused on the distal part of the frontal conjunctive wall of the long...

Fig. 12: Aponeurotic detachment between medial gastrocnemius and soleus (“2c”)....

Learning objectives

The aims of this work are: To localize and clearly classify muscle strains in footballers. To present an iconographic description (ultrasound and MRI) of these lesion and their preferential locations.

Background

Introduction Muscle strains represent 32 % of injuries (1st cause) in footballers (1) and can be opposed to extrinsic muscular injuries resulting from a direct shock. These lesions arise during an eccentric effort (active contraction occuring simultaneous with lengthening of muscle). The characterization of muscle strains in footballer is key to guide their therapeutic care. Ultrasound (US) and MRI, guided by clinical examination, are very usefull tools to precisely asses muscle strains. Topographic and pathologic classification Topography ( Fig. 1 ) - At the myoconjunctive...

Findings and procedure details

Generalities and procedure details Muscle strains ususally occur (92%) among 4 main groups of lower limb muscles in football players (37% hamstrings, 23% adductors, 19% quadriceps, 13% calf) (1). Every muscle has peculiar anatomy and conjunctive structure, which causes a unique lesional spectrum. Knowledge can lead to better identification of these lesions. Ultrasound examination must be performed first between the 2nd and the 7th day to avoid underestimating a "fresh" isoechoic lesion. MRI can be added in case of clinico-ultrasound conflict, suspicion of complete muscular...

Conclusion

Conjunctive lesions are frequent but often under-recognized or misunderstood. Identify lesions focused on the conjunctive structure is key because they have worse prognosis than myoconjunctival lesions, with longer time to return to play. Precise initial grading by ultrasound +/- MRI improves therapeutic guidelines and prognosis on th return to play timeframe among footballers.

Personal information

References

(1) Ekstrand J, Hagglund M, Walden M. Epidemiology of Muscle Injuries in Professional Football (Soccer). Am J Sports Med. 2011 Jun 1;39(6):1226–32. (2) Brasseur JL, Bach G, Renoux J, Zeitoun-Eiss D. Classification des lésions musculaires ; de quoi parle t-on ? in Sans N, Lhoste-Trouilloud A, Cohen M, Guerini H, Coudreuse JM, Catonné Yeds. L'imagerie en traumatologie sportive. Sauramps Médical, Montpellier, 2010 ; pp 145-68 (3) Rodineau J, Durey A. Le traitement médical des lésions musculaires. JAMA suppl, IV/2e Journée nationale de la médecine de...