Abstract
OBJECTIVES: Achilles tendon ruptures are injuries with a high severity. Analyses of underlying biomechanical and situational patterns may promote a better understanding of Achilles tendon ruptures and aid in their management and prevention. However, a systematic biomechanical and situational video analysis of real-life Achilles tendon ruptures has not been performed to date. METHODS: Professional male football players with an acute Achilles tendon rupture were identified by using an online database (Transfermarkt.com, Hamburg, Germany). For every in-competition injury, the coinciding football match leading to injury was detected. Video files of the injuries were accessed using Wyscout.com (Wyscout.com, Genova, Italy). Situational patterns and injury biomechanics of the injury frame were independently analyzed by two reviewers using a standardized checklist and a motion analysis software (Kinovea v.0.8.15, www.kinovea.org). Finally, consensus was reached to describe the main injury patterns of Achilles tendon ruptures in professional male football. RESULTS: Overall, 80 injuries were included for video analysis. Most injuries (94%) were indirect or non- contact injuries. The kinematic analysis revealed a knee extension movement and an ankle dorsiflexion movement in most cases. Typical joint positions at the assumed injury frame were hip extension, knee extension and ankle dorsiflexion. Player actions identified as main injury patterns were stepping back, landing, running/sprinting, starting, and jumping. All main patterns were closed-chain movements (that is, fixation of the affected leg to the ground). CONCLUSIONS: Most Achilles tendon ruptures share characteristic injury features, that is, Achilles tendon elongation, closed-chain movements, and sudden loading. The findings of this study allow insight into injury mechanisms of Achilles tendon ruptures in professional male football and may support translation towards future development of prevention programs.