Soccer injuries occur predominantly in the legs, although occasionally injuries to the upper body do occur, often through falls or impacts. Soccer injuries may be either acute - where there is one incident that clearly causes the injury or chronic - where an injury develops gradually.
Hamstring strains commonly know as a pulled hamstring is a sudden sharp pain at the back of the thigh. Treatment for this injury involves immediate first aid of rest, ice and compression followed by a full rehabilitation and exercise program. Symptoms of a hamstring strain include pains whilst sprinting or a fast stretching movement or high kick. Read more on the treatment of hamstring strains.
A sprained ankle is one of the most common sports injuries and is also the most frequently re-injured. In the majority of cases, the ankle rolls inwards (inversion) under the weight of the rest of the body, resulting in damage to the ligaments on the outside of the ankle. Pain is usually felt around the ankle joint itself although more specifically on the outside of the ankle where the damaged ligaments are located. Read more on how to treat a sprained ankle.
Achilles tendonitis (also known as Achilles tendinopathy or Achilles tendinosis) is an overuse injury causing pain, inflammation and or degeneration of the Achilles tendon at the back of the ankle. If this type of injury is not caught early this can be difficult to cure but with the right treatment and particularly eccentric strengthening exercises, a full recovery can usually be achieved. Read more on treatment and rehabilitation of Achilles tendonitis.
Jumper's knee or patellar tendonitis is an overuse injury that results in pain at the front of the knee, localised at a point towards the bottom of the kneecap. Repetitive strain from too much running or jumping causes inflammation or degeneration of the patella tendon. Patellar tendonitis can be a tricky condition to treat and requires a substantial period of rest and a thorough treatment and rehabilitation program. Read more on the causes and treatment of Jumper's knee.
Medial knee ligament sprain
Medial ligament sprain or MCL injury is a tear of the ligament on the inside of the knee, it is usually a result of direct impact or twisting motion. A medial ligament injury is common in contact sports such as football and rugby, as well as martial arts. They can also occur in daily life through falls and twists of the knee joint. Read more on the treatment and rehabilitation of medial ligament sprain.
Pain at the front of the lower leg is commonly referred to as shin splints. Usually, symptoms occur at the front inside of the shin bone but can arise from a number of causes. We explain the symptoms, treatment and rehabilitation of medial tibial stress syndrome to cure and prevent it recurring. Read more on how to prevent and treat shin splints.
Metatarsal stress fractures
A metatarsal stress fractures is a fine fracture in one of the long metatarsal bones in the foot. A stress fracture can occur through overuse or poor foot biomechanics. Symptoms include pain in the foot which occurs gradually. The pain will be located towards the middle or front of the foot and is made worse by weight-bearing activities such as walking, running or dancing. Read more on metatarsal stress fractures.
Immediate first aid for acute injuries
The PRICE principles are the gold standard set for treating acute sports injuries. The acronym stands for Protection, Rest, Ice, Compression and Elevation and should be applied as early as possible and continued for at least the first 24-72 hours.
Protection of the damaged tissue is vital to prevent further damage and enable the healing process to start efficiently and effectively. There are a number of ways to protect the injured area all with the same aim of limiting further movement and use of the joint/muscle/ligament/tendon. One way this can be achieved is using a support or splint.
In the early stages, rest is one of the most important components of the P.R.I.C.E principle but is often neglected or ignored. It does not only refer to the prolonged period of time that the athlete will be out of action but also to the immediate period after the injury.
An athlete must know when to stop training and allow the injured area to heal otherwise repetitive minor injuries can often result in a more severe injury that keeps the athlete out for much longer.
If an injury is sustained during sporting activity some athletes have a tendency to 'run it off'. This implies that by continuing to participate in the exercise, the injury will simply go away. In fact, in the majority of cases, this is not true and is not advisable.
Ice therapy, also known as cryotherapy, is one of the most widely known and used treatment modalities for acute sports injuries. It is cheap, easy to use and requires very little time to or expertise to prepare.
The application of ice to an injury, in the acute phase, can substantially decrease the extent of the damage. It achieves this in a number of different ways:
Decreases the amount of bleeding by closing down the blood vessels (called vasoconstriction).
Reduces pain (pain gate theory)
Reduces muscle spasm
Reduces the risk of cell death (also called necrosis) by decreasing the rate of metabolism
Ice is usually applied to the injured site by means of a bag filled with crushed ice which is wrapped in a damp towel. The damp towel is essential as it forms a barrier between the bag of ice and the skin and reduces the risk of an “ice burn”. DO NOT leave the ice on for more than 15 minutes as you could cause an “ice burn”.
There are a small number of areas that you should not apply ice to which include the neck, the outside bone of the elbow, the collarbone (upper end), the front of the hip (bony part) and the outer bone of the knee. The reason for this is there is a superficial nerve just below the skin in these areas that can be damaged by applying ice to it. Always check for contraindications.
Applying compression to an injured area minimises the amount of swelling that forms after an injury in two ways and should be applied for the first 24 to 72 hours from the onset of injury. Compression can be applied through a number of methods. The most effective of these is by using a compression bandage which is an elasticated bandage that simply fits around the affected limb.
Elevation of the injured limb is the final principle of PRICE but is equally as important as the other 4. Elevation allows gravity to drain the fluid away from the injured site. This aids in decreasing the swelling which in turn may decrease the pain associated with oedema (swelling).
Read more on PRICE principles
Should I seek professional treatment?
If you have any of the following symptoms you should seek further medical assistance.
- Severe pain, especially on walking
- Severe swelling (oedema)
- Altered sensation in the foot – such as a feeling of “pins and needles” (paresthesia) or a “loss of feeling” (anaesthesia).
- Unable to complete normal daily activities after the initial 72 hours.
Further medical assistance can be sought through either your local GP or a private clinician such as a podiatrist, physiotherapist, sports therapist, osteopath or chiropractor. If you have followed the P.R.I.C.E. principles (see below) and are still unable to walk after 72 hours or still have severe pain that is not subsiding after the first 72 hours you should visit your local A&E department for further assessment.
Secondly, if you have applied for P.R.I.C.E. principles and still have weakness that lasts a long time (more than 2 weeks) or have ongoing discomfort in your foot or heel, you are highly recommended to seek advice from a specialist expert - such as a podiatrist or physiotherapist, osteopath, or chiropractor - who can provide you with advice and an appropriate and effective recovery and rehabilitation program.
Preventing Soccer Injuries
Probably 75% of Football injuries are preventable. The best protection from injury is correct warm up and conditioning which can help you avoid unnecessary injury that can ruin the season.
Warming up is often overlooked but should be part of your injury prevention routine. A good warm up will:
- Increase the temperature of muscles - they work better at a temperature of 40 degrees.
- Increase blood flow and oxygen to muscles.
- Increase the speed of nerve impulses - making you faster.
- Increase range of motion at joints reducing the risk of tearing muscles and ligaments.
Warm up will not only help avoid injury but will also improve performance.
A warm up should consist of:
- Gentle jog to circulate blood and oxygen supplying the muscles with more energy to work with.
- Stretching to increase the range of motion at joints (see below).
- Sports specific exercises and drills.
The warm up should last between 15 and 30 minutes. Do not warm up too early. The benefits are lost after about 30 minutes of inactivity.
The FIFA 11 is a programme developed to help reduce injuries in soccer. It consists of a series of exercises that should be used before training and matches.
This is also often overlooked in favour of the bar but can help avoid injuries and boost performance. The aim of the cool down is to:
- Gradually lower heart rate.
- Circulate blood and oxygen to muscles, restoring them to the condition they were in before exercise.
- Remove waste products such as lactic acid.
- Reduce the risk of muscle soreness.
The cool down should consist of a gentle jog followed by light stretching.
Getting a regular sports massage can flush the muscles of waste products and release tight knots, lumps and bumps in muscles that if left may cause strains and tears. It is possible for a good sports massage therapist to identify potential trouble spots long before they become injuries.
Not having the proper equipment for playing can cause injury. The ideal football boot should have:
- A rigid heel counter
- Good depth in the upper
- A flexible forefoot
- A wide sole and be slightly curved in shape.
Shin pads are also an essential piece of kit. Look after your legs!
Nutrition and Hydration
Proper nutrition is important. A bad diet will prevent you from recovering from training sessions making you more prone to injury. A balanced diet is what you should aim for:
- Carbohydrate is important for refuelling muscles.
- Protein rebuilds muscles.
- If you become dehydrated then less blood will flow through muscles. The muscles will be more prone to injury.
- Vitamins and minerals are required for a number of reasons related to recovery.
Much of what is discussed above should be part of your sporting routine. A biomechanical analysis can help identify possible injury risks. Orthotic devices can help. Also, an assessment from a sports therapist or specialist can identify weak areas and possible injury risks. A course of exercises specific to your needs can give you the best chance of avoiding injury.
This includes general conditioning, aerobic fitness and muscular strength. If you are in good condition then you are less likely to get injuries. Strong muscles are less likely to tear. A player that can keep going for the full 90 minutes is less likely to be late in a tackle. Good all-round conditioning will balance the body and help avoid necessary injuries. Footballers can get stronger hip flexor muscles through repeated kicking on one side. This twists the pelvis and lower back causing other problems including recurrent hamstring injuries.
Not allowing your body to recover properly from training will eventually result in injury. Your body needs time to rebuild itself stronger before the next training session. Remember - you are not training when you are training, you are training when you recover! Sleep is also an important part of your training. If you are not getting enough, get it sorted.
In the event that a sports injury does occur, having a sports insurance policy will mean you are covered for costs of treatment and lost earning!
Becoming a football physiotherapist
Neal Reynolds talks about being a sports physiotherapist, how to become on and the benefits and drawbacks of the job.
Knee Braces for Football
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