Case-Study: Muscle Atrophy and Hypertrophy in a Premier League Soccer Player During Rehabilitation From ACL Injury
The onset of injury and subsequent period of immobilisation and disuse present major challenges to maintenance of skeletal muscle mass and function. Although the characteristics of immobilisation-induced muscle atrophy are well documented in laboratory studies, comparable data from elite athletes in free-living conditions are not readily available. We present a six-month case-study account from a professional soccer player of the English Premier League characterising rates of muscle atrophy and hypertrophy (as assessed by DXA) during immobilisation and rehabilitation after ACL injury. During 8 weeks of inactivity and immobilisation (where the athlete adhered to a 'low carbohydrate-high protein diet'), total body mass decreased by 5 kg attributable to 5.8 kg loss and 0.8 kg gain in lean and fat mass, respectively. Changes in whole body lean mass was attributable to comparable relative decreases in the trunk (12%, 3.8 kg) and immobilised limb (13%, 1.4 kg) whereas the non-immobilised limb exhibited smaller declines (7%, 0.8 kg). In weeks 8-24, the athlete adhered to a 'moderate carbohydrate-high protein diet' combined with structured resistance and field based training for both the lower and upper body that resulted in whole body muscle hypertrophy (varying from 0.5-1 kg per week). Regional hypertrophy was particularly pronounced in the trunk and non-immobilised limb during weeks 8-12 (2.6 kg) and 13-16 (1.3 kg), respectively, whereas the previously immobilised limb exhibited slower but progressive increases in lean mass from week 12-24 (1.2 kg). The athlete presented after the totality of the injured period with an improved anthropometrical and physical profile.