Prevalence and predisposition to deep vein thrombosis in professional male soccer players

The long recovery time required after deep venous thrombosis (DVT), or other serious manifestations of venous thromboembolic disease, can lead to a reduction in sporting condition and economic losses. Neither are such events always free of clinical sequelae.ObjectiveThis study examines the prevalence of DVT in male, professional soccer players in Spain.MethodsA questionnaire on DVT events experienced by players in the ongoing 2015-16 season, and the previous 10 seasons, was sent to the medical services of all first and second division clubs in Spain. The genetic predisposition of those who suffered an event was investigated using the inCode thrombus test, as well as in 73 players who experienced no such event.ResultsFour subjects were diagnosed with DVT via clinical history and ultrasound or D-dimer determination. This associated prevalence (1.2/1000) is higher than reported (1/10,000) for this age group in the general population (18-35 years). All four affected players carried a risk allele (A1) at the ABO locus, three were homozygous for the risk allele of FactorXIII, and one was heterozygous for a risk allele of FactorXII. Among the 73 players who experienced no DVT, 3 high risk genetic variants associated with thromboembolic events were detected in 7 players (9.6%), either in the SERPINA_A10, FactorV, FactorXII, or FactorXIII genes.ConclusionDVT prevalence in professional soccer players is higher than expected for the same age segment, and highlights how genetic predisposition towards thromboembolic processes and sport-associated environmental risk factors work in tandem in the DVT appearance. (AU)

Injuries of the obturator muscles in professional soccer players.

PURPOSE: Obturator externus and internus muscular tears are uncommon injuries. Only a few case reports exist, mainly in high-level athletes. Our aim is to describe a series of obturator externus and internus muscular tears in professional soccer players. METHODS: Injury data from four teams from the First Division of the Spanish Soccer League were collected over a total of four seasons. Any soccer player who sustained an injury to either the obturator externus or internus identified on magnetic resonance (MRI) was included. All injured players were treated non-operatively with a goal of returning to play as fast as possible. RESULTS: Sixteen players sustained injuries to the obturator externus and internus during matches or training sessions. The main complaint was anterior hip pain with a physical examination showing pain during internal rotation or external rotation of the flexed hip. The MRI documented 12 muscular tears of the obturator externus, and 4 muscular tears of the obturator internus. All injuries were treated conservatively based on physical therapy, analgesic medications, and underwent a symptoms-based rehabilitation protocol. Mean return to play was 11.5  ±  8.8 days. CONCLUSION: Although uncommon, tears of the obturator externus and internus occur in professional soccer players. The MRI scan was essential to the location, classification, and evaluation of the injury size. The clinical relevance of our investigation is based on the relatively benign prognosis of these injuries. LEVEL OF EVIDENCE: IV.

Evaluación de factores de riesgo de lesión del ligamento cruzado anterior en jugadores de fútbol de alto nivel / Evaluation of risk factors for anterior cruciate ligament injury in high-level male football players

El objetivo del presente estudio es la detección de factores de riesgo de lesión de ligamento cruzado anterior (LCA) en jugadores de fútbol profesionales al comienzo de la pretemporada. Treinta y cinco jugadores de fútbol de alto nivel fueron analizados mediante un sistema de análisis del movimiento y 2 plataformas de fuerzas. Se analizó el ángulo de rodilla en el plano frontal (valgo-varo) y las fuerzas verticales de reacción de ambas extremidades durante la fase de aterrizaje del drop jump. Se determinó el coeficiente de correlación intraclase. La significación estadística fue considerada para p < 0,05. Se encontraron diferencias significativas entre la extremidad más fuerte y la débil en el impulso excéntrico (32,4 Ns; IC 95%, 22,9-41,8 Ns; p < 0,05) y en el impulso concéntrico (14,4 Ns; IC 95%, 9,8-19,1 Ns; p < 0,05). El 31,4% de los futbolistas presentaron valores de falta de balance entre extremidades superior al 15%, y el 14,2% de los jugadores aterrizaron con un ángulo de rodillas en el plano frontal mayor a 20°. La metodología propuesta en el presente estudio ha demostrado ser fiable y sensible en la detección de factores de riesgo asociados a la lesión del LCA

Anterior cruciate ligament (ACL) injury is one of the most serious time-loss injuries in football. The purpose of the present study is to evaluate risk factors of ACL injuries in high-level football players during the preseason. Thirty-five high-level players were captured by a video movement analysis system and a two-force platform. Frontal plane knee angle and vertical force were measured during the landing phase of the drop jump. Intraclass correlation coefficient was determined to assess test-retest reliability, and α level of 0.05 was considered statistically significant. There were significant differences between the stronger and weaker leg in eccentric (32.4 Ns; 95% CI; 22.9-41.8 Ns; P < 0.05) and concentric impulse (14.4 Ns; 95% CI, 9,8-19,1 Ns; P <0.05). Additionally, 31.4% of the subjects obtained a lower limb strength imbalance higher than 15%. Furthermore, 14.2% of the subjects obtained a frontal plane knee valgus angle higher than 20°. Findings of the present study are particularly significant as a functional deficit higher than 15% and an increased in valgus motion at the knee suggests an altered muscular control of the lower extremity. Furthermore, results confirmed that the test proposed in this study is reliable and sensitive to identify ACL injury intrinsic risk factors in high level male football players in order to introduce the necessary preventive measures

Lesión muscular de recto abdominal en un jugador de voleibol / Rectus abdominis muscle injury in a volleyball player

Se presenta y se discute un caso de ruptura de músculo recto abdominal en un jugador profesional de voleibol playa. La lesión se localiza próxima a aponeurosis profunda del vientre muscular superior en el lado no dominante. En la literatura epidemiológica pocas veces se contempla, de manera específica, esta lesión y existen pocos casos descritos. El mecanismo de lesión suele ser indirecto en el momento de la transición extensión flexión durante el gesto de saque o ataque en el caso del voleibol. En nuestro caso la ecografía es la herramienta de confirmación diagnóstica. A pesar de la lesión, el jugador se mantuvo activo, por lo cual debió modificarse la pauta de tratamiento(AU)

A case of ruptured rectus abdominis muscle in a professional volleyball player is presented and discussed. The injury was located near the deep fascia of the upper stomach muscle on the non-dominant side. This injury is rarely specifically mentioned in the literature and there are few reported cases. The injury mechanism is usually indirect at the time of the flexion/extension transition when serving or attacking in the case of volleyball. The player remains active despite the injury and for this reason the treatment had to be modified(AU)