Achilles Tendon Pain in Male Professional Football Players - A Prospective Five-Season Study of 88 Injuries from the UEFA Elite Club Injury Study

Abstract

Markus Waldén,1,2 Mariann Gajhede Knudsen,1 Jan Ekstrand,1,2 Martin Hägglund,1,3 Pieter D’Hooghe,4 Håkan Alfredson,5,6 Håkan Bengtsson1,2 1Football Research Group, Linköping University, Linköping, Sweden; 2Unit of Public Health, Department of Medical, Health and Caring Sciences, Linköping University, Linköping, Sweden; 3Unit of Physiotherapy, Department of Medical, Health and Caring Sciences, Linköping University, Linköping, Sweden; 4Orthopaedic Surgery, Aspetar Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar; 5Department of Community Medicine and Rehabilitation, Sports Medicine, Umeå University, Umeå, Sweden; 6Alfredson Tendon Clinic, Malmö, SwedenCorrespondence: Markus Waldén, Unit of Public Health, Department of Medical, Health and Caring Sciences, Linköping University, Linköping, 581 83, Sweden, Email [email protected]: The objective was to describe the location, examination procedures, diagnoses, and treatment for gradual-onset Achilles tendon pain in male professional football (soccer) players.Patients and Methods: Forty-seven teams were followed prospectively for at least one season from 2013/14 to 2017/18. Time-loss injuries were recorded by the teams’ medical staffs. For all non-contact Achilles tendon injuries, a specific Achilles tendon form was sent to teams.Results: There were 88 time-loss injuries recorded with gradual-onset Achilles tendon pain amongst 72 players; 22 (25%) of them were severe lasting more than four weeks including one career-ending injury. The specific form was returned for 78 injuries (89%) with 55 cases (71%) having midportion and 23 cases (29%) insertional pain. There were 51 cases (65%) being examined with ultrasound and 29 cases (37%) with magnetic resonance imaging, both modalities being used in 18 cases (23%). Tendinopathy was the most frequently reported main diagnosis both for midportion and insertional pain with 60 cases (77%), but multiple diagnoses were recorded in 21 cases (27%). Surgery was performed in six cases (8%), and the majority of players were exposed to several non-surgical treatments in various combinations, with eccentric training and cryotherapy being most frequent with 52 cases (72%) each.Conclusion: Tendinopathy was the most frequent diagnosis both for midportion and insertional pain. Imaging was carried out for most injuries. A majority of injuries were managed non-surgically, with eccentric training and cryotherapy being the most frequently applied treatments.Keywords: athletic injuries, elite, imaging, rehabilitation, tendinopathy

Keywords

• athletic injuries
• elite
• imaging
• rehabilitation
• tendinopathy