The FSI Conference 2021: Mathew Buckthorpe
Injuries are problematic in football due to their impact on financial, team, and player performance.
Medial collateral ligament (MCL) injuries are the most common of all traumatic knee injuries and the most common severe injury subtype after hamstrings injuries.
To prevent them, establishing their aetiology and mechanisms is critical. 62% of MCL injuries are caused by direct contact, 24% by indirect contact, and 14% by non-contact mechanisms, 44% of them due to external blow, 24% to sliding, and 19% to lever-like (force applied distal to the knee) “sprain type” mechanisms. As most are contact-related injuries, the impact of training on their prevention seems to be minimal compared with other injuries, although indirect injuries are an opportunity that can be addressed. 73% MCL injuries happen during two main plating situations: 38% pressing/tackling, 35% being tackled. As for the ACL, these situations are dangerous for MCL injuries. Regarding biomechanical mechanisms, direct contact injuries occur with a shallow knee flexion angle (20º), while indirect and non-contact injuries occur at higher knee angles (100º), mainly due to the sliding mechanism injuries.
Except for the higher knee flexion angles (as this is protective of the ACL), MCL injuries occur at quite similar sagittal and frontal plane kinematics as ACL injuries. MCL injuries mostly affect central midfielders (36%), wide midfielders (21%), and centre forward (21%) positions (attacking players), most of them occurring in the middle corridor (57%) of the midfield and offensive thirds (92%). 48% occur in the final 30 minutes, which suggests, unlike ACL injuries, that fatigue might be playing a role in these injuries or that the situation of the game change towards the end (mental fatigue and increased collisions).
Question: The most interesting approach to prevent MCL injuries? Perturbation training to target neuromuscular control under realistic situations (good control to contact and being tackled techniques).
Key words: MCL injuries, video analysis, injury prevention, fatigue, perturbation training.