Before, during and after an ACL injury: a case study using thermography

Before, during and after an ACL injury: a case study using thermography

29/01/2021 By: Ismael Fernández Cuevas Home

In this case study, we show the ACL injury evolution in an amateur soccer player monitored by Infrared Thermography.

As you can see in the figure 1 and 3, we monitored the knee temperature taking thermal pictures before, during, and after the injury to see the evolution of the thermal asymmetries, not only in the knee area but also in the rest of the lower limb.

Figure 1. Thermal image evolution on key dates during the evolution of the ACL injury.

ThermoHuman software allows us to perform an intuitive and in-depth tracking report (figure 2). Before the injury, we can observe that the asymmetry was almost 0. Right after the injury, the inflammation in the region created an asymmetry of 1,19ºC difference. Then, an irregular tendency describes the long period before the surgery (amateur), due to the use of thermography to manage the workload to condition the limbs before the operation.

Figure 2. Thermal asymmetry tracking report with ThermoHuman software

After surgery, the knee asymmetry increased significantly for a long period (more than 2 months) with values over 1,5ºC difference. When those values decreased the subject got back to train again, suffering an injury relapse on the first day, increasing dramatically again asymmetry values and pain with more than 1,3ºC. Finally, we observe how the pain perception was reduced to 0 and the subject returned to play, maintaining a constant asymmetry of around 0,4ºC. This chronic thermal asymmetry is often observed in patients (athletes or not) having undergone surgery, mainly in joint, bone, and ligament injuries.

Figure 3. Pain and thermal asymmetry evolution of the knee region during the whole period (before, during, and after the ACL injury)

It is a good example of how infrared thermography can help to monitor an injury, not only from the clinical evolution on the affected area but also to manage the rehabilitation workload for compensation and healthy regions that might be a key to reduce the instability and relapse likelihood.


  • Piñonosa Cano, S., García de la Concepción, M. Á., Sillero Quintana, M., Gómez Carmona, P. M., Fernández Cuevas, I., Szendrei, B., & Granja, A. (2011, 6th-9th july). Thermographic profile for the rehabilitation of the total of ACL rupture. Paper presented at the 16th Annual Congress of the European College of Sport Sciences ECSS, Liverpool, United Kingdom.
  • Fernández-Cuevas, I; Arnáiz-Lastras, J. & Sillero-Quintana, M (2016) Monitoring of an anterior cruciate ligament injury through Infrared Thermography. Paper presented at the XXV International Conference of Sport Rehabilitation and Traumatology Football Medicine Strategies – Return to Play, Queen Elizabeth II Conference Centre – London, United Kingdom.

Europa Thermohuman ThermoHuman has had the support of the Funds of the European Union and the Community of Madrid through the Operational Programme on Youth Employment. Likewise, ThermoHuman within the framework of the Export Initiation Program of ICEX NEXT, had the support of ICEX and the co-financing of the European Regional Development Fund (ERDF).