Relations between sagittal spino-pelvic balance with EOS imaging system and pelvi-femoral musculotendinous injuries among professional footballers

Abstract

Musculo-tendinous injuries are a recurrent problem presented by professional athletes, especially by footballers. However, understanding of their risk factors is currently limited. At the same time, our knowledge of spino-pelvic sagittal balance has developed considerably in recent years through the use of new radiographic studies such as EOS system. This sagittal balance has never, as far as we know, been related to the traumatology of athletes. The goal of our study was to find a link between the spino-pelvic sagittal balance in EOS and the incidence of acute and micro-traumatic musculo-tendinous injuries. Footballers of a league 1 team have been included for 5 consecutive seasons. All players completed an EOS radiograph. The acute and micro-traumatic injuries of the hamstrings, psoas, quadriceps, adductors, obturators and pubic symphysis were prospectively recorded during the 5 seasons. The incidence of injury was calculated and then correlated with the EOS parameters with a 95% CI. Sixty one players were included in the study. The average age was 24.5 years. The mean BMI was 23 kg/m 2 . A total of 148 injuries were recorded. The overall incidence of injuries was 32 injuries/1000 hours of play. We found a statistically significant relationship between the overall incidence of pelvic-femoral musculo-tendon injuries and the pelvic tilt (PT) ( P = 0.022), a high PT being associated with a lower incidence of injury. A significant relationship was found between the pelvic tilt and the incidence of pelvic-femoral injuries. Pelvic retroversion therefore associated with a lower incidence of injuries. These results could open up new preventive methods for these musculo-tendinous injuries, by proposing a suitable postural rehabilitation.