Rectus Femoris Muscle Composition: Association with Sports Performance and Playing Position in Female Soccer Players

Abstract

Background Quadriceps muscle plays a relevant role in soccer as its function is determinant for sprinting, jumping and striking the ball. Although ultrasound demonstrated to be useful in risk of injury prevention and monitoring post-injury rehabilitation, no studies analyzed the ultrasound muscle histology with sports performance tests. We aimed to analyze the correlation between ultrasound findings related to rectus femoris morphology and composition with sports performance indicators and to analyze sociodemographic, sports performance and ultrasound differences according to playing position.

Methods An observational study was conducted at the CFF OLYMPIA soccer club (Madrid, Spain). Twenty-two semi-professional female soccer players were enrolled in this study. Sociodemographic data, bilateral ultrasound measurements of the rectus femoris muscle and sports performance tests (Counter Movement Jump -CMJ-, The Sprint Repeat Ability -SRA-, and one Repetition Maximum -1RM-) were collected.

Results No correlations between ultrasound imaging and sports performance indicators were found. Significant correlations between cross-sectional area and perimeter with age (p<0.05) and fatty infiltration with body mass index and tight perimeter (p<0.05) were seen. No muscle ultrasound morphology or quality differences were found between the playing positions (p>0.05). Finally, most of the functional tests showed no between-position differences (except SRA between goalkeepers and attackers).

Conclusion Although muscle morphology and quality are associated with demographic features, US should not be used as a predictor of sports performance in female football players since no association between US and sports performance were observed. Similar US and functional test scores were obtained among the different playing positions.

Zusammenfassung

Hintergrund und Ziel Der Musculus quadriceps femoris spielt beim Fußball eine wichtige Rolle, da seine Funktion für das Sprinten und Springen sowie das Schießen des Balls von entscheidender Bedeutung ist. Während der Nutzen von Ultraschalluntersuchungen für die Prävention potenzieller Verletzungen und die Überwachung des Rehabilitationsverlaufs nach Verletzungen nachgewiesen wurde, liegen keine Studien vor, in denen die Ultraschall-Muskelhistologie mit Tests zur Prüfung der sportlichen Leistung in Beziehung gesetzt wird. Unser Ziel war es, die Korrelation zwischen Ultraschallbefunden bezüglich der Morphologie und des Aufbaus des M. rectus femoris und Indikatoren der sportlichen Leistung zu ermitteln sowie Unterschiede in soziodemografischen Merkmalen, sportlicher Leistung und Ultraschalluntersuchungen nach Spielerposition zu analysieren.

Methodik Wir führten eine Beobachtungsstudie im Fußballverein CFF OLYMPIA (Madrid, Spanien) durch. In die Studie wurden 22 semiprofessionelle Fußballspielerinnen aufgenommen. Erhoben wurden soziodemografische Daten, Ultraschallmessungen des M. rectus femoris beidseits und Tests zur sportlichen Leistung (Counter-Movement Jump [CM], Sprint Repeat Ability [SRA] und 1-Wiederholungsmaximum [One-Repetition Maximum, 1RM].

Ergebnisse Es fanden sich keine Korrelationen zwischen Ultraschallmessungen und Indikatoren der sportlichen Leistung. Hingegen wurden signifikante Korrelationen zwischen Querschnittsfläche und Umfang mit dem Alter (p<0,05) und der Fetteinlagerung mit dem Body-Mass-Index und „Tight Perimeter“-Messungen (p<0,05) festgestellt. Zwischen den verschiedenen Spielerpositionen fanden sich bei der Ultraschalluntersuchung keine Unterschiede hinsichtlich Muskelmorphologie oder -qualität (p>0,05). Ebenso zeigten sich bei den meisten Funktionstests keine Unterschiede zwischen den Spielerpositionen (Ausnahme: SRA-Unterschied zwischen Torwart und Stürmer).

Schlussfolgerung Die Muskelmorphologie und –qualität sind mit demografischen Merkmalen assoziiert. Ultraschall sollte hingegen nicht als Prädiktor für die sportliche Leistung von Fußballspielerinnen verwendet werden, da kein Zusammenhang zwischen Ultraschallmessungen und sportlicher Leistung festgestellt wurde. Die für die verschiedenen Spielerpositionen ermittelten Ultraschallbefunde und Funktionstestergebnisse waren ähnlich.

Key words

Ultrasound Imaging - Quadriceps - Cross-sectional Area - Echo-Intensity - Sports performance - Soccer

Schlüsselwörter

Ultraschall-Bildgebung - M. quadriceps - Querschnittsfläche - Echointensität - sportliche Leistung - Fußball

• References

• 1 Flandry F, Hommel G. Normal anatomy and biomechanics of the knee. Sports Med Arthrosc Rev 2011; 19: 82-92
• 2 Bordoni B, Varacallo M. Anatomy, Bony Pelvis and Lower Limb, Thigh Quadriceps Muscle. 2021 Jul 22. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. 2021
• 3 Chan O, Del Buono A, Best TM. et al. Acute muscle strain injuries: a proposed new classification system. Knee Surg Sports Traumatol Arthrosc 2012; 20: 2356-2362
• 4 Baoge L, Van Den Steen E, Rimbaut S. et al. Treatment of skeletal muscle injury: a review. ISRN Orthop 2012; 2012: 689012
• 5 Hägglund M, Waldén M, Ekstrand J. Risk factors for lower extremity muscle injury in professional soccer: the UEFA Injury Study. Am J Sports Med 2013; 41: 327-335
• 6 Ekstrand J, Hägglund M, Waldén M. Injury incidence and injury patterns in professional football: the UEFA injury study. Br J Sports Med 2011; 45: 553-558
• 7 Rivière JR, Rossi J, Jimenez-Reyes P. et al. Where does the One-Repetition Maximum Exist on the Force-Velocity Relationship in Squat. Int J Sports Med 2017; 38: 1035-1043
• 8 Lehance C, Binet J, Bury T. et al. Muscular strength, functional performances and injury risk in professional and junior elite soccer players. Scand J Med Sci Sports 2009; 19: 243-251
• 9 Ruas CV, Minozzo F, Pinto MD. et al. Lower-extremity strength ratios of professional soccer players according to field position. J Strength Cond Res 2015; 29: 1220-1226
• 10 Daneshjoo A, Rahnama N, Mokhtar AH. et al. Bilateral and unilateral asymmetries of isokinetic strength and flexibility in male young professional soccer players. J Hum Kinet 2013; 36: 45-53
• 11 Steffen K, Nilstad A, Kristianslund EK. et al. Association between Lower Extremity Muscle Strength and Noncontact ACL Injuries. Med Sci Sports Exerc 2016; 48: 2082-2089
• 12 Valera-Calero JA, Al-Buqain-Ortega A, Arias-Buría JL. et al. Echo-intensity, fatty infiltration, and morphology ultrasound imaging assessment in healthy and whiplash associated disorders populations: an observational study. Eur Spine J 2021; 30: 3059-3067
• 13 Makrogiannis S, Fishbein KW, Moore AZ. et al. Image-Based Tissue Distribution Modeling for Skeletal Muscle Quality Characterization. IEEE Trans Biomed Eng 2016; 63: 805-813
• 14 Valera-Calero JA, Ojedo-Martín C, Fernández-de-Las-Peñas C. et al. Reliability and Validity of Panoramic Ultrasound Imaging for Evaluating Muscular Quality and Morphology: A Systematic Review. Ultrasound Med Biol 2021; 47: 185-200
• 15 Whittaker JL, Ellis R, Hodges PW. et al. Imaging with ultrasound in physical therapy: What is the PT’s scope of practice? A competency-based educational model and training recommendations. Br J Sports Med 2019; 53: 1447-1453
• 16 Fukumoto Y, Ikezoe T, Yamada Y. et al. Skeletal muscle quality assessed from echo intensity is associated with muscle strength of middle-aged and elderly persons. Eur J Appl Physiol 2012; 112: 1519-1525
• 17 Hides JA, Oostenbroek T, Franettovich Smith MM. et al. The effect of low back pain on trunk muscle size/function and hip strength in elite football (soccer) players. J Sports Sci 2016; 34: 2303-2311
• 18 Cuschieri S. The STROBE guidelines. Saudi J Anaesth 2019; 13: S31-S34
• 19 Scott JM, Martin DS, Ploutz-Snyder R. et al. Reliability and validity of panoramic ultrasound for muscle quantification. Ultrasound Med Biol 2012; 38: 1656-1661
• 20 Thomaes T, Thomis M, Onkelinx S. et al. Reliability and validity of the ultrasound technique to measure the rectus femoris muscle diameter in older CAD-patients. BMC Med Imaging 2012; 12: 7
• 21 Giles LS, Webster KE, McClelland JA. et al. Can ultrasound measurements of muscle thickness be used to measure the size of individual quadriceps muscles in people with patellofemoral pain?. Phys Ther Sport 2015; 16: 45-52
• 22 Valera-Calero JA, Arias-Buría JL, Fernández-de-Las-Peñas C. et al. Echo-intensity and fatty infiltration ultrasound imaging measurement of cervical multifidus and short rotators in healthy people: A reliability study. Musculoskelet Sci Pract 2021; 53: 102335
• 23 Vandewalle H, Pérès G, Monod H. Standard anaerobic exercise tests. Sports Med 1987; 4: 268-289
• 24 Balsalobre-Fernández C, Glaister M, Lockey RA. The validity and reliability of an iPhone app for measuring vertical jump performance. J Sports Sci 2015; 33: 1574-1579
• 25 Gallardo-Fuentes F, Gallardo-Fuentes J, Ramírez-Campillo R. et al. Intersession and Intrasession Reliability and Validity of the My Jump App for Measuring Different Jump Actions in Trained Male and Female Athletes. J Strength Cond Res 2016; 30: 2049-2056
• 26 Pedersen S, Welde B, Sagelv EH. et al. SA. Associations between maximal strength, sprint, and jump height and match physical performance in high-level female football players. Scand J Med Sci Sports 2021;
• 27 Sarmento H, Anguera MT, Pereira A. et al. Talent Identification and Development in Male Football: A Systematic Review. Sports Med 2018; 48: 907-931
• 28 Levinger I, Goodman C, Hare DL. et al. The reliability of the 1RM strength test for untrained middle-aged individuals. J Sci Med Sport 2009; 12: 310-316
• 29 Rønnestad BR, Nymark BS, Raastad T. Effects of in-season strength maintenance training frequency in professional soccer players. J Strength Cond Res 2011; 25: 2653-2660
• 30 Chan YH. Biostatistics 104: correlational analysis. Singapore Med J 2003; 44: 614-619
• 31 Fortin M, Rizk A, Frenette S. et al. Ultrasonography of multifidus muscle morphology and function in ice hockey players with and without low back pain. Physical Therapy in Sport [Internet]. 2019 May 1 [cited 2021; 37: 77-85 Available from: https://pubmed.ncbi.nlm.nih.gov/30897493/
• 32 DeJong AF, Mangum LC, Hertel J. Ultrasound Imaging of the Gluteal Muscles During the Y-Balance Test in Individuals With or Without Chronic Ankle Instability. J Athl Train 2020; 55: 49-57
• 33 Sipilä S, Suominen H. Ultrasound imaging of the quadriceps muscle in elderly athletes and untrained men. Muscle Nerve 1991; 14: 527-533
• 34 Calvo-Lobo C, Almazán-Polo J, Becerro-de-Bengoa-Vallejo R. et al. Ultrasonography comparison of diaphragm thickness and excursion between athletes with and without lumbopelvic pain. Phys Ther Sport 2019; 37: 128-137
• 35 Lin YF, Lin JJ, Cheng CK. et al. Association between sonographic morphology of vastus medialis obliquus and patellar alignment in patients with patellofemoral pain syndrome. J Orthop Sports Phys Ther 2008; 38: 196-202
• 36 Kumaravel M, Bawa P, Murai N. Magnetic resonance imaging of muscle injury in elite American football players: Predictors for return to play and performance. Eur J Radiol 2018; 108: 155-164
• 37 Mendiguchia J, Alentorn-Geli E, Idoate F. et al. Rectus femoris muscle injuries in football: a clinically relevant review of mechanisms of injury, risk factors and preventive strategies. Br J Sports Med 2013; 47: 359-366
• 38 Ryman Augustsson S, Arvidsson J, Haglund E. Jump height as performance indicator for the selection of youth football players to national teams. J. Sports Med. Phys. Fit 2019; 59: 1669-1675