Quadriceps Injury Monitoring: Thermography in a Premier League Team.

In this article, we showcase the case of a professional football player in the English Premier League and how thermography is proving to be a crucial tool in his recovery process.

We’re talking about a midfielder known for his free-kick prowess and defensive pressure tactics against opponents. He’s a player who covers a lot of ground and is very versatile. Therefore, his fitness level is essential for his performance, and recovering from the injury is the primary focus of the professionals supporting him in the club.

These professionals are using thermography as an auxiliary tool in the return-to-play process to monitor the tissue’s condition and, most importantly, to gain a better understanding of his situation since the injury occurred at another club, and his recovery was in intermediate stages. Hence, it’s an inherited injury.

Injury: Anterior rectus femoris muscle tear.

he player suffered an injury during one of the training sessions, which was diagnosed as a Grade 4 tear in the proximal region of the left rectus femoris muscle (his kicking leg) through an MRI scan. This required a surgical procedure.

A different team signed the player 8 weeks after the surgery, so there were some uncertainties about the current status of the player and the injury. Additionally, the schedule was tight.

To address this, the new Premier League club utilized thermography, GPS tracking, and force platforms to monitor the recovery process and ensure a satisfactory return to competition.

The most important metrics during the process were:

• GPS Data: A rigorous approach was implemented, including GPS usage to monitor external load, as well as specific gym work focused on strength development, running technique, speed, and other fundamental aspects. Progressing from 15 kilometers of accumulated distance covered in the early weeks to 30 kilometers in the final phases and from 200 meters at high-intensity to 1550 meters at high-intensity running.
• Force Platforms: These revealed consistent low asymmetries in isolated tests, indicating a low force production profile and slow contraction speed. However, asymmetry values increased in more global tests such as single-leg jumps or isometric squats, with asymmetries of up to 13% between the injured and non-injured legs.
• Thermography: Thermography emerged as an essential tool for tracking tissue status, thanks to the ability to compare the player’s situation with previous thermography-controlled injury records in the ThermoHuman database. An individualized thermal profile was generated, and the injury’s progress was monitored through asymmetries and the coefficient of variation to restore balance and normality between both legs.

Figure 1. Return to play

The recovery process lasted from week 8, when they inherited the injury, and the player had only engaged in low-intensity linear running, until week 14 (where GPS values were 80% of the group’s volume, and thermography was normalized), when the player reintegrated with the group. From week 15 onwards, the player has been competing regularly.

Figure 2. Injury Monitoring

It’s worth noting the injury management from a chaos continuum control methodology with work ratios evolving from 1:1 to 3:1, and thermography progressing with a tendency to reduce asymmetry, although the tissue reacts to training loads. Therefore, it’s crucial to put the data in perspective and analyze trend graphs.

Article Conclusions

This case illustrates how useful thermography can be in assessing and monitoring sports injuries, especially when dealing with inherited injuries where previous information is incomplete and can be complemented with objective data. Thanks to the evaluation using ThermoHuman software, we can assist professionals from different club departments involved in the health and performance of footballers in making data-driven decisions right from the start and without prior knowledge. Additionally, thermography not only provides information about injury tracking and progression but also helps identify potential risk areas for future injuries.

References

Case study extracted from the ThermoHuman database – Unpublished data.

Other references

Eliakim E, Morgulev E, Lidor R, et al Estimation of injury costs: financial damage of English Premier League teams’ underachievement due to injuries BMJ Open Sport & Exercise Medicine 2020;6:e000675.

Gómez-Carmona, P. M., Fernández-Cuevas, I., Sillero-Quintana, M., Arnáiz-Lastras, J., & Navandar, A. (2020). Infrared Thermography Protocol on Reducing the Incidence of Soccer Injuries. Journal of Sport Rehabilitation. doi: 10.1123/jsr.2019-0056

Majano, C., Garcia-Unanue, J., Fernández-Cuevas, I. et al. Association between physical demands, skin temperature and wellbeing status