Asymptomatic Foot and Ankle Abnormalities in Elite Professional Soccer Players.

BACKGROUND: Professional soccer players are often evaluated with asymptomatic lesions of the ankle and foot, and such abnormalities may eventually become clinically relevant. PURPOSE: To ascertain the prevalence of foot and ankle abnormalities in elite professional adult soccer players. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Professional adult male elite soccer players (n = 37) underwent magnetic resonance imaging (MRI) scans of both their feet and ankles. All competed for their respective national junior or adult soccer teams. MRI scans were performed with 1.5-T scanners and analyzed independently by 2 experienced radiologists. RESULTS: The MRI scans of 86.5% of the players showed degenerative joint disease (DJD) in at least 1 of the joints of the foot and ankle. Articular cartilage lesions in the joints of the foot and ankle were evident in 42% of the scans. Of all lesions, 17% were grade 3 or 4 (Noyes and Stabler classification) cartilage lesions and accompanied by subchondral bone marrow edema. The greater the age, weight, and height of the players, the greater was the odds ratio of DJD of the ankle joint. Synovitis in at least 1 of the joints of the foot was detected in 64% of the MRI scans. Leg dominance significantly correlated with bone marrow edema of the talus. CONCLUSION: Elite professional soccer players are often evaluated with a high prevalence of asymptomatic osteochondral lesions with subchondral bone marrow edema in the foot and ankle. These osteochondral lesions may remain asymptomatic or, with the continuing high-intensity stresses that modern professional soccer demands of its athletes, may evolve and cause foot and ankle pain. It is unclear whether and which interventions can be implemented to prevent the occurrence of these abnormalities in the first place.

Asymptomatic Degenerative Changes in the Lumbar Spine Among Professional Soccer Players.

STUDY DESIGN: Cross-sectional study. OBJECTIVE: The aim of this study was to evaluate the actual prevalence of degenerative spinal changes and their association with age in a cohort of professional soccer players. SUMMARY OF BACKGROUND DATA: Presently, there are data that athletes have more degenerative changes than nonathletes; however, the research examining the prevalence of degenerative spinal conditions among professional elite soccer players is scarce. METHODS: Professional male soccer players were included in the study (n = 40, average age 26,6 ±â€Š4,5 years, average height 18 ±â€Š0.07 m, weight 76.7 ±â€Š7.1 kg). Lumbosacral spine MRI scanning at the L1-S1 level has been performed. Two radiologists with at least 7 years of experience of working with athletes evaluated all images independently of each other. RESULTS: 92.5% (n = 37) of soccer players had ≥1 spinal degenerative condition. Thirty-five percent (n = 14) of players had three to five, and 50% (n = 20) had six or more conditions. The average age of players who had six or more conditions was significantly higher than those who had zero to five or three to five conditions-28.1 ±â€Š4.8 years versus 25.1 ±â€Š3.6 years (P = 0.029), and 24.8 ±â€Š3.6 years, respectively.Kruskal-Wallis test has shown no association between the number of degenerative conditions and weight (P = 0.98) as well as body mass index (P = 0.99). The age was associated with degenerative changes (P = 0.008).Disc desiccation was the most common pathologic condition, which was found in 82.5% of athletes. Facet joint arthropathy and spondylosis were present in 70, and 50% of the studied lumbar spine MRI scans, respectively. The spondylolysis prevalence of 20% was noted. CONCLUSION: Elite professional soccer players demonstrate a high prevalence of asymptomatic degenerative lumbar spinal degenerative changes, which are significantly associated with age. These conditions might lead to the development of symptomatic lower back pain, given the high-intensity exercise required in professional soccer. It is presently unclear what measures might be applied for the primary prevention of these degenerative spinal conditions.Level of Evidence: 4.