Swedish researchers used ultrasound to discover that athletes who are more susceptible to emotional stress are also more likely to experience muscle injuries, according to a new study published online October 18 in the Journal of Sports Rehabilitation.
The team found that stress levels in male soccer athletes from Sweden's first league affect the incidence of muscle injuries they sustain.
A group led by Dr. Mattias Eckerman of the Karolinska Institute in Stockholm tracked muscle injuries sustained by male players between 2007 and 2015. The researchers evaluated and diagnosed all muscle injuries with ultrasound, and they asked players to complete a survey called the Swedish Universities Scales of Personality questionnaire to assess their propensity for emotional stress.
Eckerman's group found no significant difference in personality traits among noninjured players, rarely injured players, and frequently injured players regarding the number of muscle injuries, but the team did discover a trend in which frequently injured players scored higher on stress susceptibility than rarely injured players did.
"A player's stress susceptibility should be taken into consideration by the player, coaches, and medical staff when assessing the risk of a muscle injury," the study authors concluded. "Also, preventive measures available for these players may need to be considered."
![Examples of ultrasound findings and techniques. (A) Images in a 39-year-old male patient with a mass in the left thigh. The mass is heterogeneous on the B-mode US image (compared with the patient in D) and showed increased microvascularity (superb microvascular imaging [SMI]) and shear-wave elastography (SWE) values. Undifferentiated pleomorphic sarcoma was diagnosed at biopsy (with pleomorphic rhabdomyosarcoma in surgical specimen). (B) Images in an 18-year-old male patient with a mass in the left leg. The mass is hypoechoic on the B-mode image, with no other findings suggestive of malignancy. The lesion is in contact with the cortex of the tibia, which is slightly irregular. CT revealed a doubtful anteromedial tibial erosion. The microvascular study demonstrated high vascularization, suggestive of malignancy. Periosteal Ewing sarcoma was diagnosed with both histologic and immunohistochemical confirmation. (C) Images in a 69-year-old female patient with a lump growing on the outside of the left leg. Multiple SWE examinations were performed (please note the high values obtained in the measurements, whereas the color map highlights the stiffness relative to adjacent tissues). SMI showed areas of increased vascularization to target for sampling. Undifferentiated spindle cell sarcoma was diagnosed at biopsy, with residual leiomyosarcoma in the surgical specimen after neoadjuvant therapy. (D) Images in a 56-year-old female patient with a mass in the right thigh. The mass is heterogeneous at both B-mode ultrasound (similar to patient A) and MRI (coronal T2-weighted spectral attenuated inversion recovery [SPAIR]; T1-weighted pre-contrast and postcontrast imaging), which even shows uptake after the administration of paramagnetic contrast material, which is traditionally suggestive of malignancy. Low values at SMI and elastography are suggestive of benignity. Spindle cell lipoma was diagnosed at biopsy, with atypical spindle cell lipomatous tumor in the surgical specimen.](https://img.auntminnie.com/mindful/smg/workspaces/default/uploads/2026/08/images-radiol250278fig2.APCFLSvX6p.jpg?auto=format%2Ccompress&dpr=2&fit=crop&h=167&q=70&w=250)
