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Soccer is one of the most popular sports in the world, and is becoming more and more popular in the United States. With close to 27 million players in the United States and Canada alone, understanding injuries in this sport is vital. FIFA (Federation Internationale Football Association) began tracking injuries to soccer players in 1998. Since then several other organizations have followed suit and have begun taking a look at how many and what types of injuries are most prevalent in the sport.
A study by the Union of European Football Associations (UEFA) suggests that in professional soccer, a 25-player team can expect close to two injuries per player during any one season. Researchers state 70% of those injuries are lower extremity in nature, 15% are head and neck injuries, 8% are in the trunk/spine, and 7% are in the arms/upper extremity. Out of these injuries, they state 80% are player to player contact in nature and the other 20% are non-contact injuries.
Common injuries seen in the lower extremities include: MCL (Medial Collateral Ligament) Knee injuries, Achilles tendon and Ankle Injuries. ACL injuries are also a concern and are a serious injury, but are not seen as frequently as the other injuries listed. Common injuries to the head and neck include concussions (1/3 of all head injuries), and sprains, strains of the spine. Groin injuries are one of the most common muscle injuries in the sport. Injuries in this area can be adductor muscle strains, pelvic instability, or sports hernias. This can be a challenging injury to deal with as a player as many of these injuries turn into chronic issues.
Sports Physical Therapy & Injury Prevention
Rehabilitation of injuries should focus on a global approach to treatment. If the injury is to the knee, Therapists need to focus on not only the function specifically of the knee, but also on the flexibility, strength, and neuromuscular control of the entire lower extremity. They must also make sure there is stability in what we traditionally refer to as the “core”, which includes the abdominals, spine, and pelvis. Treatment should include Biomechanical Analysis of the lower body, and can include video analysis of movement, which helps identify break down in mechanics which can result in re-injury.
Concussion return to play is a staged program aimed at returning the player safely to play as they progress through a series of stages. These include full rest, working on aerobic capacity, strength, and progression to sport specific play, returning to non contact activity, and then resuming full sport activity. Based on current recommendations, this process should be a minimum of seven days. At any of the stages, if symptoms return, the player does not progress to the next level.
Injury Prevention techniques involve many approaches:
– FIFA has instituted the FIFA 11+ Injury Prevention Program that includes a warm-up, preventative exercises, balance and agility exercises
– Dynamic Warm Ups- These are active warm ups aimed at getting the body ready for activity. We no longer advocate jogging, then doing passive stretching before an event. Dynamic warm ups improve performance as well as decrease injury rates
– Biomechanical Analysis and Player Specific interventions- each individual player is different, and each player has weaknesses, tightness and biomechanical problems that may dispose him or her to injury. Using video analysis and functional screening tools, Therapists can identify areas of potential injury and intervene with a custom program for the individual player.
– The medical profession has begun to gather helpful information in the area of concussion and is identifying risk factors for concussion. At this time, we are developing concussion prevention activities based on the most current research, which includes core strengthening, postural control retraining, and specific cervical spine strengthening.
References:
Ekstrand J, Hagglund M, Walden M. Epidemiology of muscle injuries in professional football (soccer). Am Journal Sport Med. 2011;39:1226-32.
Jones N. Update: Soccer injury and prevention, concussion, and chronic groin pain. Current Sports Medicine Reports. 2014: 319-325.