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Semin Musculoskelet Radiol 2005; 09(4): 289-301
DOI: 10.1055/s-2005-923375
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Common Injuries Related to Weightlifting: MR Imaging Perspective

Joseph S. Yu1 , Paula A. Habib1
  • 1Department of Radiology, Ohio State University Medical Center, Columbus, Ohio
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Publication History

Publication Date:
29 November 2005 (online)

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ABSTRACT

Weightlifting has evolved to become a ubiquitous form of exercise. Resistance training has been shown to have beneficial effects on both muscle and osseous maintenance and development. Competitive weightlifting sports continue to enjoy tremendous popularity, with participants striving to establish new standards in performance and more demanding personal goals. Thus, it is not surprising that we have also seen an increase in injuries related to weightlifting. Many of these injuries are radiographically occult and are best suited for evaluation by magnetic resonance (MR) imaging because many involve the soft tissues. In this article, we discuss some of the factors that contribute to these injuries and address the mechanisms of injury and the MR imaging manifestations of the more common injuries.

KEYWORDS

Injury - weightlifting - magnetic resonance imaging

REFERENCES

  • 1 Powell K E, Heath G W, Kresnow M J, Sacks J J, Branche C M. Injury rates from walking, gardening, weightlifting, outdoor bicycling, and aerobics.  Med Sci Sports Exerc. 1998;  30 1246-1249
    PubMedGoogle Scholar
  • 2 Hortobagyi T, Devita P, Money J, Barrier J. Effects of standard and eccentric overload strength training in young women.  Med Sci Sports Exerc. 2001;  33 1206-1212
    PubMedGoogle Scholar
  • 3 Hortobagyi T, Devita P. Favorable neuromuscular and cardiovascular responses to seven days of exercise with an eccentric overload in elderly women.  J Gerontol A Biol Sci Med Sci. 2000;  55 B401-B410
    PubMedGoogle Scholar
  • 4 Brown M, Holloszy J O. Effects of low intensity exercise program on selected physical performance characteristics of 60- to 71-year olds.  Aging (Milano). 1991;  3 129-139
    PubMedGoogle Scholar
  • 5 Krebs D E, Jette A M, Assmann S F. Moderate exercise improves gait stability in disabled elders.  Arch Phys Med Rehabil. 1998;  79 1489-1495
    CrossrefPubMedGoogle Scholar
  • 6 Tsuzuku S, Ikegami Y, Yabe K. Effects of high-intensity resistance training on bone mineral density in young male powerlifters.  Calcif Tissue Int. 1998;  63 283-286
    CrossrefPubMedGoogle Scholar
  • 7 Raske A, Norlin R. Injury incidence and prevalence among elite weight and power lifters.  Am J Sports Med. 2002;  30 248-256
    PubMedGoogle Scholar
  • 8 Mazur L J, Yetman R J, Risser W L. Weight-training injuries. Common injuries and preventative methods.  Sports Med. 1993;  16 57-63
    PubMedGoogle Scholar
  • 9 Garrett Jr W E. Muscle strain injuries.  Am J Sports Med. 1996;  24(6 suppl) S2-S8
    CrossrefPubMedGoogle Scholar
  • 10 Verrall G M, Slavotinek J P, Barnes P G, Fon G T, Spriggins A. Clinical risk factors for hamstring muscle strain injury: a prospective study with correlation of injury by magnetic resonance imaging.  Br J Sports Med. 2001;  35 435-439
    CrossrefPubMedGoogle Scholar
  • 11 Verrall G M, Slavotinek J P, Barnes P G, Fon G T. Diagnostic and prognostic value of clinical findings in 83 athletes with posterior thigh injury: comparison of clinical findings with magnetic resonance imaging documentation of hamstring muscle strain.  Am J Sports Med. 2003;  31 969-973
    PubMedGoogle Scholar
  • 12 Heiss D G, Shields R K, Yack J. Balance loss when lifting a heavier-than-expected load: effects of lifting technique.  Arch Phys Med Rehabil. 2002;  83 48-59
    CrossrefPubMedGoogle Scholar
  • 13 Garrett Jr W E, Califf J C, Bassett F H. Histochemical correlates of hamstring injuries.  Am J Sports Med. 1984;  12 98-102
    CrossrefPubMedGoogle Scholar
  • 14 Yu J S, Petersilge C, Sartoris D, Pathria M, Resnick D. MR imaging of injuries of the extensor mechanism of the knee.  Radiographics. 1994;  14 541-551
    PubMedGoogle Scholar
  • 15 Noonan T J, Garrett Jr W E. Injuries at the myotendinous junction.  Clin Sports Med. 1992;  11 783-806
    PubMedGoogle Scholar
  • 16 Shellock F G, Fukunaga T, Mink J H, Edgerton V R. Acute effects of exercise on skeletal muscle: concentric vs eccentric actions.  AJR Am J Roentgenol. 1991;  156 765-768
    PubMedGoogle Scholar
  • 17 El-Khoury G Y, Brandser E A, Kathol M H, Tearse D S, Callaghan J J. Imaging of muscle injuries.  Skeletal Radiol. 1996;  25 3-11
    CrossrefPubMedGoogle Scholar
  • 18 Garrett Jr W E. Muscle strain injuries: clinical and basic aspects.  Med Sci Sports Exerc. 1990;  22 436-443
    PubMedGoogle Scholar
  • 19 Palmer W E, Kuong S J, Elmadbouh H M. MR imaging of myotendinous strain.  AJR Am J Roentgenol. 1999;  173 703-709
    CrossrefPubMedGoogle Scholar
  • 20 Greco A, McNamara M T, Escher R MB, Trifilio G, Parienti J. Spin-echo and STIR MR imaging of sports-related muscle injuries at 1.5T.  J Comput Assist Tomogr. 1991;  15 994-999
    CrossrefPubMedGoogle Scholar
  • 21 Ferretti A, Ippolito E, Mariani P, Puddu G. Jumper's knee.  Am J Sports Med. 1983;  11 58-62
    CrossrefPubMedGoogle Scholar
  • 22 Towers J D, Russ E V, Golla S K. Biomechanics of tendons and tendon failure.  Semin Musculoskelet Radiol. 2003;  7 59-65
    Article in Thieme ConnectPubMedGoogle Scholar
  • 23 Kannus P, Jozsa L. Histopathological changes preceding spontaneous rupture of a tendon. A controlled study of 891 patients.  J Bone Joint Surg Am. 1991;  73 1507-1525
    PubMedGoogle Scholar
  • 24 Kannus P, Natri A. Etiology and pathophysiology of tendon ruptures in sports.  Scand J Med Sci Sports. 1997;  7 107-112
    CrossrefPubMedGoogle Scholar
  • 25 Steinbach L S, Fleckenstein J L, Mink J H. Magnetic resonance imaging of muscle injuries.  Semin Musculoskelet Radiol. 1997;  1 127-141
    PubMedGoogle Scholar
  • 26 Fleckenstein J L, Weatherall P T, Parkey R W, Payne J A, Peshock R M. Sports-related muscle injuries: evaluation with MR imaging.  Radiology. 1989;  172 793-798
    PubMedGoogle Scholar
  • 27 Zarins B, Ciullo J V. Acute muscle and tendon injuries in athletes.  Clin Sports Med. 1983;  2 167-182
    PubMedGoogle Scholar
  • 28 Deutsch A L, Mink J H. Magnetic resonance imaging of musculoskeletal injuries.  Radiol Clin North Am. 1989;  27 983-1002
    PubMedGoogle Scholar
  • 29 De Smet A A. Magnetic resonance findings in skeletal muscle tears.  Skeletal Radiol. 1993;  22 479-484
    PubMedGoogle Scholar
  • 30 Keeves R K, Laskowski E R, Smith J. Weight training injuries. Part 1: diagnosing and managing acute conditions.  Physician Sportsmed. 1998;  26 67-83
    PubMedGoogle Scholar
  • 31 Keeves R K, Laskowski E R, Smith J. Weight training injuries. Part 1: diagnosing and managing chronic conditions.  Physician Sportsmed. 1998;  26 54-63
    PubMedGoogle Scholar
  • 32 Brady T A, Cahill B R, Bodnar L M. Weight training-related injuries in the high school athlete.  Am J Sports Med. 1982;  10 1-5
    PubMedGoogle Scholar
  • 33 Cahill B R. Osteolysis of the distal part of the clavicle in male athletes.  J Bone Joint Surg Am. 1982;  64 1053-1058
    PubMedGoogle Scholar
  • 34 de la Puente R, Boutin R B, Theodorou D J, Hooper A, Schweitzer M, Resnick D. Post-traumatic and stress-induced osteolysis of the distal clavicle: MR imaging findings in 17 patients.  Skeletal Radiol. 1999;  28 202-208
    CrossrefPubMedGoogle Scholar
  • 35 Kaplan P A, Resnick D. Stress-induced osteolysis of the clavicle: a case report.  Radiology. 1986;  158 139-140
    PubMedGoogle Scholar
  • 36 Scavenius M, Iversen B F. Nontraumatic clavicular osteolysis in weight lifters.  Am J Sports Med. 1992;  20 463-467
    PubMedGoogle Scholar
  • 37 Slawski D P, Cahill B R. Atraumatic osteolysis of the distal clavicle: results of open surgical excision.  Am J Sports Med. 1994;  22 267-271
    PubMedGoogle Scholar
  • 38 Yu Y S, Dardani M, Fischer R A. MR observations of post-traumatic osteolysis of the distal clavicle after traumatic separation of the acromioclavicular joint.  J Comput Assist Tomogr. 2000;  24 159-164
    CrossrefPubMedGoogle Scholar
  • 39 Haupt H A. Upper extremity injuries associated with strength training.  Clin Sports Med. 2001;  20 481-490
    CrossrefPubMedGoogle Scholar
  • 40 Wadhwa S S, Mansberg R, Fernandes V B, Qasim S. Forearm splints seen on bone scan in a weightlifter.  Clin Nucl Med. 1997;  22 711-712
    CrossrefPubMedGoogle Scholar
  • 41 Hamilton H K. Stress fracture of the diaphysis of the ulna in a body builder.  Am J Sports Med. 1984;  12 405-406
    PubMedGoogle Scholar
  • 42 Van der Wall H, McLaughlin A, Bruce W, Frater C J, Kannangara S, Murray I PC. Scintigraphic patterns of injury in amateur weight lifters.  Clin Nucl Med. 1999;  24 915-920
    PubMedGoogle Scholar
  • 43 Gumbs V L, Segal D, Halligan J B, Lower G. Bilateral distal radius and ulnar fractures in adolescent weight lifters.  Am J Sports Med. 1982;  10 375-379
    PubMedGoogle Scholar
  • 44 Cholewicki J, McGill S M. Mechanical stability of the in vivo lumbar spine: implications for injury and chronic low back pain.  Clin Biomech (Bristol, Avon). 1996;  11 1-15
    CrossrefPubMedGoogle Scholar
  • 45 Bach Jr B R, Warren R F, Wickiewicz T L. Triceps rupture. A case report and literature review.  Am J Sports Med. 1987;  15 285-289
    PubMedGoogle Scholar
  • 46 Kelly D W, Carter V S, Jobe F W, Kerlan R K. Patellar and quadriceps tendon ruptures-jumper's knee.  Am J Sports Med. 1984;  12 375-380
    CrossrefPubMedGoogle Scholar
  • 47 Fees M, Decker T, Snyder-Mackler L, Axe M J. Upper extremity weigh-training modifications for the injured athlete.  Am J Sports Med. 1998;  26 732-742
    PubMedGoogle Scholar
  • 48 Kretzler Jr H H, Richardson A B. Rupture of the pectoralis major muscle.  Am J Sports Med. 1989;  17 453-458
    CrossrefPubMedGoogle Scholar
  • 49 Wolfe S W, Wickiewicz T L, Cavanaugh J T. Ruptures of the pectoralis major muscle. An anatomic and clinical analysis.  Am J Sports Med. 1992;  20 587-593
    CrossrefPubMedGoogle Scholar
  • 50 Connell D A, Potter H G, Sherman M F, Wickiewicz T L. Injuries of the pectoralis major muscle: evaluation with MR imaging.  Radiology. 1999;  210 785-791
    PubMedGoogle Scholar
  • 51 Miller M D, Johnson D L, Fu F H, Thaete F L, Blanc R O. Rupture of the pectoralis major muscle in a collegiate football player: use of magnetic resonance imaging in early diagnosis.  Am J Sports Med. 1993;  21 475-477
    CrossrefPubMedGoogle Scholar
  • 52 Ohashi K, El-Khoury G Y, Albright J P, Tearse D S. MRI of complete rupture of the pectoralis major muscle.  Skeletal Radiol. 1996;  25 625-628
    CrossrefPubMedGoogle Scholar
  • 53 Lee J, Brookenthanl K R, Ramsey M L, Kneeland J B, Herzog R. MR imaging assessment of the pectoralis major myotendinous unit: an MR imaging-anatomic correlative study with surgical correlation.  AJR Am J Roentgenol. 2000;  174 1371-1375
    PubMedGoogle Scholar
  • 54 Carrino J A, Chandnani V P, Mitchell D B, Choi-Chinn K, DeBerardino T M, Miller M D. Pectoralis major muscle and tendon tears: diagnosis and grading using magnetic resonance imaging.  Skeletal Radiol. 2000;  29 305-313
    CrossrefPubMedGoogle Scholar
  • 55 McEntire J E, Hess W E, Coleman S S. Rupture of the pectoralis major muscle: a report of eleven injuries and review of fifty-six.  J Bone Joint Surg Am. 1972;  54 1040-1046
    PubMedGoogle Scholar
  • 56 Robertsen K, Kristensen O, Vejen L. Manubrium sterni stress fracture: an unusual complication of non-contact sport.  Br J Sports Med. 1996;  30 176-177
    PubMedGoogle Scholar
  • 57 McCurdie I, Etherington J, Buchanan N. Sternal fracture in a female army officer cadet.  Br J Sports Med. 1997;  31 164
    PubMedGoogle Scholar
  • 58 Neviaser T J. Weight lifting. Risks and injuries to the shoulder.  Clin Sports Med. 1991;  10 615-621
    PubMedGoogle Scholar
  • 59 Yu J S, Ashman C J, Jones G. The POLPSA lesion: MR imaging findings with arthroscopic correlation with posterior instability.  Skeletal Radiol. 2002;  31 396-399
    CrossrefPubMedGoogle Scholar
  • 60 Cresswell T R, Smith R B. Bilateral anterior shoulder dislocations in bench pressing: an unusual cause.  Br J Sports Med. 1998;  32 71-72
    PubMedGoogle Scholar
  • 61 Heggland E, Parker R D. Simultaneous bilateral glenoid fractures associated with glenohumeral subluxation/dislocation in a weightlifter.  Orthopedics. 1997;  20 1180-1183
    PubMedGoogle Scholar
  • 62 Maffulli N, Mikhail H. Bilateral anterior glenohumeral dislocation in a weightlifter.  Injury. 1990;  21 254-256
    CrossrefPubMedGoogle Scholar
  • 63 Mair S D, Zarzour R H, Speer K P. Posterior labral injury in contact athletes.  Am J Sports Med. 1998;  26 753-758
    PubMedGoogle Scholar
  • 64 Amadio P C. Epidemiology of hand and wrist injuries in sports.  Hand Clin. 1990;  6 379-381
    PubMedGoogle Scholar
  • 65 Wood M B, Dobyns J H. Sports-related extraarticular wrist syndromes.  Clin Orthop Relat Res. 1986;  (202) 93-102
    PubMedGoogle Scholar
  • 66 Farooki S, Seeger L L. MR imaging of sports injuries of the shoulder.  Semin Musculoskelet Radiol. 1997;  1 51-63
    PubMedGoogle Scholar
  • 67 D’Alessandro D F, Shields Jr C L, Tibone J E, Chandler R W. Repair of distal biceps tendon ruptures in athletes.  Am J Sports Med. 1993;  21 114-119
    PubMedGoogle Scholar
  • 68 Fitzgerald S W, Curry D R, Erickson S J, Quinn S F, Friedman H. Distal biceps tendon injury: MR imaging diagnosis.  Radiology. 1994;  191 203-206
    PubMedGoogle Scholar
  • 69 Falchook F S, Zlatkin M B, Erbacher G E, Moulton J S, Bisset G S, Murphy B J. Rupture of the distal biceps tendon: evaluation with MR imaging.  Radiology. 1994;  190 659-663
    PubMedGoogle Scholar
  • 70 Pearl M L, Besso K, Wong K. Strength deficits related to distal biceps tendon rupture and repair: a case report.  Am J Sports Med. 1998;  26 295-296
    PubMedGoogle Scholar
  • 71 Andrews J R, Whiteside J A. Common elbow problems in the athlete.  J Orthop Sports Phys Ther. 1993;  17 289-295
    PubMedGoogle Scholar
  • 72 Sherman O H, Snyder S J, Fox J M. Triceps tendon avulsion in a professional body builder. A case report.  Am J Sports Med. 1984;  12 328-329
    PubMedGoogle Scholar
  • 73 Sollender J L, Rayan G M, Barden G A. Triceps tendon rupture in weight lifters.  J Shoulder Elbow Surg. 1998;  7 151-153
    CrossrefPubMedGoogle Scholar
  • 74 Tarsney F F. Rupture and avulsion of the triceps.  Clin Orthop Relat Res. 1972;  83 177-183
    PubMedGoogle Scholar
  • 75 Farrar E LI, Lippert F GI. Avulsion of the triceps tendon.  Clin Orthop. 1981;  161 242-246
    PubMedGoogle Scholar
  • 76 Michna H. Organization of collagen fibrils in tendon: changes induced by anabolic steroid. II: a morphometric and stereologic analysis.  Virchows Arch B Cell Pathol Incl Mol Pathol. 1986;  52 75-86
    PubMedGoogle Scholar
  • 77 Michna H. Tendon injuries induced by exercise and anabolic steroids in experimental mice.  Int Orthop. 1987;  11 157-162
    PubMedGoogle Scholar
  • 78 Wood T O, Cooke P H, Goodship A E. The effect of exercise and anabolic steroids on the mechanical properties and crimp morphology of the rat tendon.  Am J Sports Med. 1988;  16 153-158
    CrossrefPubMedGoogle Scholar
  • 79 Stannard J P, Bucknell A L. Rupture of the triceps tendon associated with steroid injections.  Am J Sports Med. 1993;  21 482-485
    CrossrefPubMedGoogle Scholar
  • 80 Fritz R C. MR imaging in sports medicine: the elbow.  Semin Musculoskelet Radiol. 1997;  1 29-49
    PubMedGoogle Scholar
  • 81 Herrick R T, Herrick S. Ruptured triceps in a powerlifter presenting as cubital tunnel syndrome. A case report.  Am J Sports Med. 1987;  15 514-516
    CrossrefPubMedGoogle Scholar
  • 82 Klemme W R, Petersen S. Avulsion of the triceps brachii with selective radial neuropathy.  Orthopedics. 1995;  18 285-287
    PubMedGoogle Scholar
  • 83 Tiger E, Mayer D P, Glazer R. Complete avulsion of the triceps tendon: MRI diagnosis.  Comput Med Imaging Graph. 1993;  17 51-54
    PubMedGoogle Scholar
  • 84 Russell P J, Phillips S J. A preliminary comparison of front and back squat exercises.  Res Q Exerc Sport. 1989;  60 201-208
    PubMedGoogle Scholar
  • 85 Agre J C. Hamstring injuries. Proposed aetiological factors, prevention, and treatment.  Sports Med. 1985;  2 21-33
    CrossrefPubMedGoogle Scholar
  • 86 Kujala U M, Orava S, Jarvinen M. Hamstring injuries. Current trends in treatment and prevention.  Sports Med. 1997;  23 397-404
    CrossrefPubMedGoogle Scholar
  • 87 Orava S, Kujala U M. Rupture of the ischial origin of the hamstring muscles.  Am J Sports Med. 1995;  23 702-705
    CrossrefPubMedGoogle Scholar
  • 88 Kerr R. MR imaging of sports injuries of the hip and pelvis.  Semin Musculoskelet Radiol. 1997;  1 65-82
    PubMedGoogle Scholar
  • 89 Brandser E A, El-Khoury G Y, Kathol M H, Callaghan J J, Tearse D S. Hamstring injuries: radiographic, conventional tomographic, CT, and MR imaging characteristics.  Radiology. 1995;  197 257-262
    PubMedGoogle Scholar
  • 90 Pomeranz S J, Heidt Jr R S. MR imaging in the prognostication of hamstring injury. Work in progress.  Radiology. 1993;  189 897-900
    CrossrefPubMedGoogle Scholar
  • 91 Kingzett-Taylor A, Tirman P F, Feller J et al.. Tendinosis and tears of gluteus medius and minumus muscles as a cause of hip pain: MR imaging findings.  AJR Am J Roentgenol. 1999;  173 1123-1126
    CrossrefPubMedGoogle Scholar
  • 92 Cvitanic O, Henzie G, Skezas N, Lyons J, Minter J. MRI diagnosis of tears of the hip abductor tendons (gluteus medius and gluteus minimus).  AJR Am J Roentgenol. 2004;  182 137-143
    CrossrefPubMedGoogle Scholar
  • 93 Waters P M, Millis M B. Hip and pelvic injuries in the young athlete.  Clin Sports Med. 1988;  7 513-526
    PubMedGoogle Scholar
  • 94 El-Dieb A, Yu J S, Huang G S, Farooki S. Pathologic conditions of the ligaments and tendons of the knee.  Radiol Clin North Am. 2002;  40 1061-1079
    CrossrefPubMedGoogle Scholar
  • 95 Zeiss J, Saddemi S R, Ebraheim N A. MR imaging of the quadriceps tendon: normal layered configuration and its importance in cases of tendon rupture.  AJR Am J Roentgenol. 1992;  159 1031-1034
    CrossrefPubMedGoogle Scholar
  • 96 El-Khoury G Y, Wira R L, Berbaum K S, Pope T L, Monu J UV. MR imaging of patellar tendonitis.  Radiology. 1992;  184 849-854
    PubMedGoogle Scholar
  • 97 Reiff D B, Heenan S D, Heron C W. MRI appearances of the asymptomatic patellar tendon on gradient echo imaging.  Skeletal Radiol. 1995;  24 123-126
    PubMedGoogle Scholar
  • 98 Davies S G, Baudouin C J, King J B, Perry J D. Ultrasound, computed tomography, and magnetic resonance imaging in patellar tendonitis.  Clin Radiol. 1991;  43 52-56
    CrossrefPubMedGoogle Scholar
  • 99 Starok M, Lenchil L, Trudell D, Resnick D. Normal patellar retinaculum: MR and sonographic imaging with cadaveric correlation.  AJR Am J Roentgenol. 1997;  168 1493-1499
    PubMedGoogle Scholar
  • 100 Yu J S, Popp J E, Kaeding C C, Lucas J. Correlation of MR imaging and pathologic findings in athletes undergoing surgery for chronic patellar tendonitis.  AJR Am J Roentgenol. 1995;  165 115-118
    CrossrefPubMedGoogle Scholar
  • 101 Popp J E, Yu J S, Kaeding C C. Recalcitrant patellar tendonitis: MRI, histological evaluation and surgical treatment.  Am J Sports Med. 1997;  25 218-222
    CrossrefPubMedGoogle Scholar
  • 102 Munshi N I, Mbubaebu C E. Simultaneous rupture of the quadriceps tendon with contralateral rupture of the patellar tendon in an otherwise healthy athlete.  Br J Sports Med. 1996;  30 177-178
    PubMedGoogle Scholar
  • 103 Nance E P, Kaye J J. Injuries of the quadriceps mechanism.  Radiology. 1982;  142 301-307
    PubMedGoogle Scholar
  • 104 Siwek C W, Rao J P. Ruptures of the extensor mechanism of the knee joint.  J Bone Joint Surg. 1981;  63-A 932-937
    PubMedGoogle Scholar
  • 105 Quinn S F, Brown T R, Demlow T A. MR imaging of patellar retinacular ligament injuries.  J Magn Reson Imaging. 1993;  3 843-847
    CrossrefPubMedGoogle Scholar

Joseph S YuM.D. 

Professor of Radiology, The Ohio State University Medical Center

Department of Radiology, 633 Means Hall, 1654 Upham Drive, Columbus, Ohio 43210

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