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Patterns of ankle injury in soccer: MRI clues to traumatic mechanism

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Abstract

Understanding the traumatic mechanisms of ankle injuries in soccer is crucial for an accurate and complete MRI diagnosis. Many ankle injuries share universal mechanisms seen in other athletic activities, but certain patterns are found to be more specific and relatively unique to soccer. Ankle impingement syndromes encountered in soccer encompass a spectrum of disorders that include anterior and posterior impingement categories, with anterior impingement representing pathology relatively specific to soccer. Lateral ligamentous sprains are one of the most common injuries; however, there is a higher rate of injuries to the medial structures in soccer as compared to other sports. Ankle fractures are uncommon in soccer while bone contusions and chondral and osteochondral injuries frequently accompany ligamentous sprains. Tendon abnormalities in soccer most commonly result from overuse injuries and typically affect peroneal tendons, posterior and anterior tibialis tendons, and Achilles tendon. Acute Achilles tendon ruptures occur in both recreational players and elite soccer athletes. Tibialis anterior friction syndrome may mimic tibial stress fractures. Long-term sequelae of acute traumatic and chronic overuse ankle injuries in professional soccer players manifest as ankle osteoarthritis that is more prevalent compared to not only the general population, but also to former elite athletes from other sports. This article examines the most common and specific injuries in soccer in order of their frequency.

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Acknowledgements

The authors would like to thank Meera Kasireddy for assistance in preparation of the manuscript.

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Authors and Affiliations

  1. Department of Radiology, Jefferson Einstein, 5501 Old York Road, Levy building, Philadelphia, PA, 19141, USA

    Tetyana Gorbachova

  2. Department of Musculoskeletal Radiology, Atlantic Medical Imaging, Galloway, NJ, USA

    Sherif S. Saad

  3. FC Barcelona Medical Department, Barcelona, Spain

    Ricard Pruna

  4. Department of Radiology, University of Alabama at Birmingham, UAB Medical Center, Birmingham, AL, USA

    Yulia V. Melenevsky

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  1. Tetyana Gorbachova
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Key points

• Lateral ligamentous sprains are one of the most common ankle injuries in soccer. The medial structures are injured at a higher rate compared to other sports.

• Anterior ankle impingement syndrome results from direct microtrauma to the anteromedial aspect of the ankle related to recurrent ball impact.

• Anterolateral impingement syndrome is produced by instability and morphologic changes in the ligaments following lateral ligamentous sprain.

• Tendon abnormalities in soccer most commonly result from overuse and affect peroneal, posterior and anterior tibialis tendons, and Achilles tendon.

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Gorbachova, T., Saad, S.S., Pruna, R. et al. Patterns of ankle injury in soccer: MRI clues to traumatic mechanism. Skeletal Radiol (2023). https://doi.org/10.1007/s00256-023-04547-6

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