Objective
To describe the injury mechanisms and magnetic resonance imaging (MRI) findings in acute rectus femoris injuries of male soccer players using a systematic video analysis.
Design
Descriptive case series study of consecutive acute rectus femoris injuries from November 2017 to July 2022.
Setting
Two specialized sports medicine hospitals.
Participants
Professional male soccer players aged between 18-40 years, referred for injury assessment within 7 days after an acute rectus femoris injury, with an available video footage of the injury and positive finding on MRI.
Independent variables
Rectus femoris injury mechanisms (specific scoring based on standardized models) in relation to rectus femoris muscle injury MRI findings.
Main outcome measures
Rectus femoris injury mechanism (playing situation, player/opponent behavior, movement, and biomechanics), MRI injury location.
Results
20 videos of acute rectus femoris injuries in 19 professional male soccer players were analyzed. Three different injury mechanisms were seen: kicking (80%), sprinting (10%), and change of direction (10%). Isolated single-tendon injuries were found in 60% of the injuries and 40% affected several locations. 62.5% of the kicking injuries included complete tendon ruptures, whereas both running injuries and none of the change of direction injuries were complete ruptures. Direct tendon was involved in 33% of the isolated injuries and common tendon was affected in all combined injuries.
Conclusions
Most rectus femoris injuries occur during kicking among football players. Most of the rectus femoris injuries are complete ruptures and involve only one tendon, but also combined and partial injuries occur. Kicking injuries can affect also the supporting leg and maximal sprinting can cause a complete rectus femoris rupture.