Soccer is one of the most popular sports in the World, played by men and women, children and adults alike. Whether playing for fun, or playing professionally, there are a variety of injuries that can occur in soccer players. Soccer-related injuries are either acute (occur suddenly) or happen as a result of overuse and repetitive motions.
Playing soccer puts a tremendous amount of stress on the lower extremity, particularly the knee and ankle joints. The most common type of soccer injury is an injury to the ligaments in one of these joints, or to the muscles in the leg. Knee injuries, particularly to the anterior cruciate ligament (ACL) in female soccer players are one of the most discussed and researched topics in sports medicine.
Injuries to the knee, or any joint, can often become complex if other structures like the ligaments, tendons, or articular cartilage are also damaged. Which injuries are most likely to occur often depends on the level of play, for high level players hamstring strains are the most common reason for loss of playing time, while in lower level players ankle sprains are the primary reason. A medical professional should always be consulted to properly diagnose soccer injuries and determine the right course of treatment.
- Traumatic force that pushes the knee inward often damages the medial collateral ligament (MCL) one of the four ligaments that supports the knee.
- Traumatic force that pushes the knee outward often damages the lateral collateral ligament (LCL).
- Traumatic force that causes the knee to slide forward can damage the ACL, or to slide backward can damage the posterior cruciate ligament (PCL).
- Rotation of the knee is a major contributing factor in ACL injury.
- Overuse, which can affect the tendons and muscles in the lower extremity.
- Rotational injuries that damage the menisci, crescent shaped cups that cushion the knee.
- Damage to the articular cartilage covering the ends of the long bones in the lower extremity.
There are intrinsic and extrinsic risk factors for injury. Intrinsic factors are a player’s individual musculoskeletal issues, which can include skeletal immaturity (bones and joints that are still developing) or muscle weakness. Extrinsic factors are the environment in which an athlete performs, which can include the level of competition: how much, how hard and how long play lasts.
Other common risk factors for soccer injuries include:
- The player’s own motor control. How and when a player moves on the soccer field can significantly contribute to the risk of injury, particularly to the knee during acceleration, deceleration and direction changes.
- The “position of no return” in which an athlete decelerates to either stop or turn and loses control of their body. This causes a chain reaction of lost control over a variety of structures in the body including the lumbar spine, pelvis, hip, thigh, knee, and ankle.
Prevention and Performance
The best way to avoid soccer related injuries is to be trained in proper technique and mechanics. Additionally, proper training and conditioning so that players are prepared for the demands on the game whether playing recreationally or competitively is crucial to avoiding the occurrence of injury. Players should also be properly outfitted in the necessary protective equipment.
Other ways to avoid injury include:
- The “athletic position” or “get down” or “hips and knees flexed” are all common terms used to encourage proper positioning to minimize the risk of injury.
- Lowering the center of gravity is a major factor in decreasing the risk of injury while increasing sports performance.
- Successful prevention programs combine core strengthening with neuromuscular motor control training. Controlling the position of the knee in landing and cutting is the principal goal of these programs.
- The basic ingredients of a prevention program may include:
- Warm-up: slow running including running forward, forward and backward, lateral, zigzags, and figure eights.
- Stretching: calves, hamstrings, hips, thighs all should be included.
- Plyometrics: jumping drills to teach and learn body control when landing from jumps and hops.
- Agilities: shuttle runs of various distances to encourage body control.
- Did you know that once an athlete has injured one ACL, they are at a higher risk of injuring the other knee than compared to a person that has not had an ACL injury? Also the athlete is more likely to injure the other knee than the same knee.
- Did you know that most ACL injuries in sports are essentially non-existent before puberty? After the age of 14 the number of ACL injuries begins to climb, and peaks during the high school years. There are three distinct injury rates based upon age:
- During the middle school and high school years, 14-18 years of age, the number of ACL injuries per year climbs to peak numbers.
- As the soccer players move into their college years the rate of ACL injuries drops to a new plateau.
- Upon completion of college the number of ACL injuries begins to decline once again.
- Did you know that although ACL injuries are a hot topic they are reported by US Soccer to be relatively rare? For male soccer players less than 1% of all injuries are to the ACL. Among females the percentage increases to 6%.
- Did you know that most ACL injuries occur with the knee extended, foot fixed, and direction is being changed? This position puts the ACL at considerable stress that if too great will cause the ACL to tear.
- Did you know there frequently is an audible “pop” when the ACL tears? This is followed by a period of pain and instability of the knee.
Anterior cruciate ligament (ACL) sprain, tear
Knee medial collateral ligament sprain (MCL)
Patellar femoral pain syndrome
Lumbar spine injuries