Youth Sector, Associazione Calcio Milan, Milan, Italy.
Department of Mechanics, Politecnico di Milano, Milan, Italy.
Am J Sports Med. 2021 Jun;49(7):1794-1802. doi: 10.1177/03635465211008169. Epub 2021 May 14.
Female soccer players are particularly susceptible to anterior cruciate ligament (ACL) injuries, accounting for 16% to 43% of the injury burden during the season. Despite the advancements in injury prevention programs, the rate of ACL injuries continues to rise.
To provide a comprehensive description of the mechanisms, situational pattern, and biomechanics of ACL injuries in women's soccer.
Case series; Level of evidence, 4.
We identified 57 consecutive ACL injuries that occurred in matches of 6 top female leagues across 3 seasons (2017-2020). A total of 35 (61%) injury videos were analyzed for the mechanism and situational pattern, while biomechanical analysis was possible in 29 cases. Three independent reviewers evaluated each video. The distribution of ACL injuries according to month, timing within the match, and field location at the time of injury was also reported.
In the 35 injury videos, there were 19 (54%) noncontact injuries, 12 (34%) indirect contact injuries, and 4 (11%) direct contact injuries. We identified 3 main situations in players who suffered a noncontact/indirect contact injury: (1) pressing and tackling (n = 18), (2) regaining balance after kicking (n = 7), and (3) being tackled (n = 4). Biomechanical analysis indicated multiplanar mechanisms with frequent knee valgus loading (88%). Additionally, 64% of injuries occurred in the first half of matches and most frequently within the first 30 minutes.
Female athletes showed remarkable similarities with elite male players in terms of the ACL mechanism and situational pattern of injury, and 88% of injuries involved no direct contact to the knee, with noncontact injuries being highly prevalent. Injuries occurred during 3 main situations, with accompanying alterations in multiplanar biomechanics. Interventions aimed at reducing ACL injuries in women's soccer should consider high-intensity defensive play at the beginning of a match. Instruction in the 3 main situations should be applied alongside appropriate neuromuscular training interventions.
女性足球运动员特别容易发生前交叉韧带（ACL）损伤，占赛季伤病负担的 16%至 43%。尽管在预防损伤计划方面取得了进展，但 ACL 损伤的发生率仍在上升。
全面描述女性足球 ACL 损伤的机制、情况模式和生物力学。
病例系列；证据水平，4 级。
我们在 3 个赛季（2017-2020 年）的 6 个顶级女子联赛中确定了 57 例连续 ACL 损伤的比赛。对 35 个（61%）损伤视频进行了机制和情况模式分析，而对 29 个案例进行了生物力学分析。三位独立的审查员评估了每个视频。还报告了 ACL 损伤按月份、比赛时间和受伤时的场地位置的分布情况。
在 35 个损伤视频中，有 19 个（54%）是非接触性损伤，12 个（34%）是间接接触性损伤，4 个（11%）是直接接触性损伤。我们在遭受非接触/间接接触损伤的运动员中发现了 3 种主要情况：（1）紧逼和铲球（n=18），（2）踢球后恢复平衡（n=7），（3）被铲球（n=4）。生物力学分析表明，有多个平面的机制，频繁出现膝关节外翻负荷（88%）。此外，64%的损伤发生在比赛的上半场，最常发生在比赛的前 30 分钟内。
女性运动员在 ACL 损伤的机制和情况模式方面与精英男性运动员有显著的相似性，88%的损伤没有直接接触到膝关节，非接触性损伤非常普遍。损伤发生在 3 种主要情况下，伴有多平面生物力学的改变。旨在减少女性足球 ACL 损伤的干预措施应考虑在比赛开始时高强度的防守比赛。应结合适当的神经肌肉训练干预措施，在这 3 种主要情况下进行指导。
