The major pars of cruciate ligament injuries occur during physical contacts, however 25% occur without contact. The latter are the most serious injuries (2,3) , they are essentially due to central fatigue, which is measurable and predictable using the inCORPUS® technology.

Central fatigue is directly associated to cruciate ligament injuries. Measuring central fatigue allows to avoid those types of injuries, keep the player on the field, increase the team performances and significantly reduce the financial risks.

A serious injury which cannot be anticipated

Only two third of the players who suffered a cruciate ligament rupture play again at their initial level and only after three years! The incidence of this injury remained stable in the past decade, none of the prevention strategies was efficient. There is an urgent necessity to find a prevention strategy (4) which protects the players, increase their performances and improve team rank and the club benefits. Keeping the players on the field is a direct reduction of the risk of financial loss associated with players’ unavailability.

With and without physical contact

Two third of the cruciate ligaments injury result from a physical contact (essentially the tackled player and the tackling player) but one third of those injuries result from a torsion or a blockage, without any external intervention (4). In the latter case, it has been demonstrated that central fatigue plays a pivotal role in the risk of cruciate ligament injury (5).

Central fatigue is… central

Increase in central fatigue inhibits the neuro-muscular control, especially the spinal and supra-spinal pathways, which results in inadequate perception, decision and movement control, which in turn results in increased risk of injury (knee and hip in the study (5). When perception, decision and movement control are altered by central fatigue, it is highly probable that the risk of injury is also increased, perception and decision being essential.

In the context of physical contact, the external factor that provokes the joint deformation must trigger muscle contraction to protect the joint and withdraw from the contact zone. With perception and decision altered by central fatigue, the process of contraction and withdrawal becomes inefficient and insufficient to prevent the injury. Measuring and predicting central fatigue is therefore a key factor in cruciate ligament injury prevention in soccer.

inCORPUS®, measure and predict central fatigue in professional soccer

inCORPUS® is the only technology able to measure and predict internal load, thanks to a last generation approach of HRV. Identifying the fatigue profile and predicting the next one, inCORPUS® allows the players, the coaches, and the staff to measure the physiological implications of the training plan and the successive games, to adapt and anticipate the upcoming events, keep the players on the field, high-performing, protect their health and improve the club benefits.

Scientific references

(1)          Eliakim, E.; Morgulev, E.; Lidor, R.; Meckel, Y. Estimation of Injury Costs: Financial Damage of English Premier League Teams’ Underachievement Due to Injuries. BMJ Open Sport Exerc. Med. 2020, 6 (1), e000675.

(2)          Quatman, C. E.; Kiapour, A. M.; Demetropoulos, C. K.; Kiapour, A.; Wordeman, S. C.; Levine, J. W.; Goel, V. K.; Hewett, T. E. Preferential Loading of the ACL Compared with the MCL during Landing: A Novel in Sim Approach Yields the Multiplanar Mechanism of Dynamic Valgus during ACL Injuries. Am. J. Sports Med. 2014, 42 (1), 177–186.

(3)          Jacobson, K. E.; Chi, F. S. Evaluation and Treatment of Medial Collateral Ligament and Medial-Sided Injuries of the Knee. Sports Med. Arthrosc. Rev. 2006, 14 (2), 58–66.

(4)          Waldén, M.; Hägglund, M.; Magnusson, H.; Ekstrand, J. ACL Injuries in Men’s Professional Football: A 15-Year Prospective Study on Time Trends and Return-to-Play Rates Reveals Only 65% of Players Still Play at the Top Level 3 Years after ACL Rupture. Br. J. Sports Med. 2016, 50 (12), 744–750.

(5)          McLean, S. G.; Samorezov, J. E. Fatigue-Induced ACL Injury Risk Stems from a Degradation in Central Control. Med. Sci. Sports Exerc. 2009, 41 (8), 1661–1672.

article author image
Nicolas Bourdillon
Chief Research Officer – PhD in Physiology