Acute muscle and tendon injuries

In soccer, you can sustain various injuries. Tissues such as muscle and tendon tissue can be damaged. An injury can occur suddenly (acutely) or develop over a longer period. In this article, only acute injuries are discussed.

Acute muscle and tendon injuries can be caused by external factors such as a blow, hit, or collision with another player. The cause can also lie within the body itself as in a muscle strain or tendon rupture.

Different acute muscle and tendon injuries

Acute injuries that can occur in muscle or tendon tissue are:

• Muscle strain.
• Muscle contusion.
• Muscle cramp.
• Tendon tear (partial or complete).
• Acute compartment syndrome.

Below we explain each of these acute muscle and tendon injuries. We then discuss how each injury is treated and what the risk factors are for acute muscle and tendon injuries.

Muscle strain
The most common acute muscle injury is a strain or tear. The terms muscle strain and muscle tear are often used interchangeably while the same thing is meant.
A muscle strain has different grades, with the highest grade being a muscle tear. In every muscle strain, muscle fibers are torn; the amount and size of the tears determine the grade.

The muscles most susceptible to strain during soccer are the quadriceps, the hamstrings, and the calf muscles. An acute muscle injury usually occurs when initiating or braking a movement. That rapid change in movement imposes too great a load at that moment. The muscle cannot adapt quickly enough and sustains a strain. This is felt immediately as a sharp pain at that location.

Muscle contusion
A muscle contusion arises from a blow or hit to the body. This blow causes local muscle injury with bleeding. The best-known muscle contusion in soccer players is the so-called dead leg. This is a contusion of the quadriceps muscle.

Muscle cramp
In muscle cramp, sudden painful involuntary muscle contractions occur. Muscle cramp occurs most often in the calf.
The exact cause of cramp is not yet entirely clear. It is probably due to excessive muscle activation. This also explains why soccer players often do not get cramp in regular time but do in extra time.

In addition, blood flow plays a role in the development of cramp. Blood flow ensures the supply of oxygen and nutrients and the removal of waste products. (Nutrients, mainly salts, are important to allow a muscle to function properly).

Tendon tear
A tendon can tear partially or completely. The most common tendon tear in soccer players is the Achilles tendon rupture, a tear in the tendon of the calf muscle. In addition, the tendons of the quadriceps or hamstrings can also tear. A torn shoulder tendon occurs rarely. Goalkeepers do have a slightly higher risk of a tendon tear in the shoulder.

A tendon tear occurs without warning. The tear is usually in the portion of the tendon where the blood supply is the least. Older soccer players are generally more susceptible to tendon tears because, as we age, blood supply decreases.

Acute compartment syndrome
A compartment is a group of one or more muscles that are enclosed by a fascia. In compartment syndrome, the pressure within a compartment increases.

A compartment syndrome usually develops over a longer period, but it can also occur acutely due to trauma. Because of a hard hit, blow, or major injury such as a fracture, the amount of fluid that develops can raise the pressure too high.

A compartment syndrome can have serious consequences for blood flow. The blood vessels in the compartment can be compressed.

It can happen that after a muscle contusion an acute compartment syndrome develops. In soccer players this can occur in the thigh or in the lower leg. Fortunately, this is very rare in soccer players.

Treatment of acute muscle and tendon injuries

Muscle strain
With an acute muscle strain the best treatment is immediate cooling and pressure (compression). Then a short period of rest (immobilization). This means that the muscle must not be loaded. The duration of this period depends on the severity of the strain.

Muscle contusion
After a muscle contusion it is important to limit bleeding and swelling. This can be done using ice and compression. In a later stage, stretching exercises and strengthening exercises follow. A muscle contusion should not be treated with heat or massage. This can increase the risk of myositis ossificans.

Muscle cramp
Stretch, stretch, stretch. By lengthening the muscles you break through the involuntary contraction of muscle fibers and relieve the cramp. After stretching, drinking water or a sports drink with the right salts is recommended. When someone often suffers from cramp, drinking water or using the right minerals (including magnesium) can help prevent it.

Tendon tear
After an acute tendon tear, loading is not allowed. If an Achilles tendon rupture or quadriceps tendon rupture is suspected, the athlete must go directly from the soccer field to the emergency department. Rapid treatment is important with a tendon tear. A physical therapist can already examine on the field whether there is a tendon tear or a suspicion of one.

A complete tendon tear is in most cases operated on. The tendon is then sutured back together. When the tendon is partially torn, a cast will more likely be chosen to rest the tendon. In this way the tendon can grow back together completely.

Acute compartment syndrome
With an acute compartment syndrome in the thigh, rest is sufficient. With an acute compartment syndrome in the lower leg, surgery is the only correct treatment.

Risk factors for acute muscle and tendon injuries

Risk factors for sustaining an acute muscle or tendon injury are:

• Insufficient warm-up. Good blood flow is necessary to allow a muscle to function properly.
• Joint stiffness.
• Increased muscle tension.
• Fatigue.
• Age. As we get older, blood supply to tissue decreases, making, for example, a tendon more likely to tear.

Advice

Acute muscle and tendon injuries can differ for every athlete. This means it is important to have an injury properly examined by a physical therapist. They will first determine what is going on and tell you what you can best do to prevent the symptoms from getting worse.