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Football is one of the most popular competitive sports in America and it leads all other sports in the number of injuries sustained. Many children, teens, and adults play football, either recreationally or professionally. But, because the sport is so physically demanding, a number of football injuries can occur. Athletes may experience an acute injury (those that occur suddenly) or a chronic injury (those that happen as a result of overuse and repetitive motions).

Even with the associated risks, American football remains one of the most popular sports in the United States. Whether played professionally, collegiate, high school, middle school or even Pop Warner style, football can take a physical toll on an athlete’s body. Due to the high contact nature of the sport, players are typically at risk to injuries like sprains, strains, dislocations, and fractures. Although players wear a variety of padding and protective gear to help guard against injury, these conditions can still occur in practice and in games.

Thankfully, Physical therapy can provide treatment for numerous football injuries.


Did you know that football players are nearly seven times more likely to get injured during a game than in practice? Preseason has the highest injury rate compared with in-season or postseason.

Overuse injuries can occur from repetitive training and conditioning. However, many injuries that occur during football games and practice often occur because of the combination of full contact and high-speed running. Some of the most common causes of football injuries include the following:

  • Strain. Excessive stretching and tearing of muscle or tendon fibers from stress on the muscle or where the muscle attaches to the tendon.
  • Sprain. When excessive stress is placed upon ligaments who connect bone to bone of a joint to hold together and stabilize the joint.
  • Tear. A severe strain or sprain from sudden violent stress. Stress forcing a joint beyond its limits can result in a third-degree sprain, a complete tear of a ligament. Depending on the mechanism of the injury there can be a progression to joint dislocation or fracture of a bone of the joint.
  • Trauma. Colliding with another player, the ball, or the field can cause a traumatic injury like a fracture.
  • Concussion. Concussions can occur from blows to the body as well as to the head, even if the athlete is wearing a helmet. One can have suffered a concussion even without loss of consciousness.

Note: Severe injuries to the joints of 8 to 15-year old can result in an avulsion fracture that involves the growth plate. Due to the growth plate being weaker than the ligament or tendon attaching there, a fracture will occur prior to a sprain or strain when abnormal tension is place on the area. If not treated properly and immediately, this injury could result in adverse, long-term effects.

Risk Factors

Football injuries can occur from intrinsic and extrinsic risk factors.

  • Intrinsic factors would include a child’s individual musculoskeletal make up. Conditions such as skeletal immaturity (bones and joints that are still developing), age, year of playing experience, and Body Mass Index (BMI) may increase risk of injury.
  • Extrinsic factors would include coach-related factors, as teaching proper technique and playing within the rules is essential in avoiding injury. Environmental factors including heat, humidity, and playing surface must be considered for safe playing conditions. Being at the proper level of competition is needed to make sure the athlete is not playing with athletes who are bigger, faster, more experienced, and stronger.

Other common risk factors for football injuries include:

  • Improper warm up or cool-down. Muscle strains that occur when a player has not properly warmed up prior to a practice or game.
  • Overuse. Prolonged intense activity also puts muscles and tendons at risk of injury.
  • Improperly fitted protective equipment. At the beginning of the season, players should be properly outfitted in the necessary protective equipment.
  • Resuming play too soon after an injury. After having an injury or illness the athlete must rehabilitate completely to decrease the risk of re-injury.

Prevention and Performance

The best way to avoid football related injuries is for athletes to be trained in proper technique and mechanics for their respective positions. Additionally, the athletes should be conditioned so that they are prepared for the demands on the game. Whether playing recreationally or competitively, proper technique and conditioning is crucial to avoiding injury.

According to the NCAA, more injury prevention tips include:

  • All on-field personnel should review, practice, and follow their venue emergency plan for potential injuries, environmental factors, and other potential emergent situations. Included in the plan should be training in administering first aid, AED use, and cardiopulmonary resuscitation (CPR).
  • Regarding concussions, if in doubt, sit them out.
  • Athletes with a concussion must be removed from practice or competition and should not return that day and not until given clearance by an approved medical provider according to the institution’s concussion management plan.
  • Football players should have unrestricted access to water during practice or competition and replace every pound lost with 20 ounces of fluid before the next practice.
  • Football players should be given adequate time to acclimatize and recover during preseason training.
  • Practices should be avoided during the hottest times of day and have at least three hours between two-a-day practices.
  • Have a preseason physical examination and follow your doctor’s recommendations.
  • Wear properly fitted protective equipment, such as a helmet, pads, and mouthguard.
  • Tackle with the head up and do not lead with the helmet and head down.
  • Speak with a sports medicine professional including athletic trainers if you have any concerns about football injuries or football injury prevention strategies.

As always, speak with a sports health professional, including physicians, sports physical therapists, or athletic trainers, if you have any concerns about the prevention and treatment of sports related injuries.

Football Facts

Did You Know:

  • Young athletes are more likely to suffer a fracture than strain or sprain. The sites where ligaments and tendons attach are growth plates. Until these sites mature to bone, they are weaker than ligaments or tendons. Therefore, stress applied to these sites will fracture the growth plate before spraining ligaments or straining tendons.
  • Common muscles strained in football are the hamstring and quadriceps muscles of the thigh and the gastrocnemius (calf muscle). Injuries will generally occur at the start of exercise or at high intensity intervals during the exercise session.
  • The most common joints to be sprained in football are the ankle, knee, and shoulder.
  • Anterior Cruciate Ligament (ACL) injuries are one of several potential knee sprains. Medial Collateral Ligament (MCL) injuries also contribute to making knee sprains among the most common football injuries.
  • Linebackers are injured most often, accounting for 13.5 percent of all injuries. Running backs and receivers follow at just more than 11 percent each. Quarterbacks account for 5.8 percent of football related injuries.

Common Conditions

Sports-related injuries comprise a significant number of the injuries treated by physical therapists at Twin Boro. Of the sports played by our patients, football remains the leading cause of sports injuries such as:

  • Strains
    Muscles most involved in strains are the hamstring, quadriceps (thigh muscles), rotator cuff, and gastrocnemius (calf muscle).
  • Sprains
    Sprains are common football injuries caused by trauma to a ligament, such as at the ankle and knee.
  • Fractures
    Stress fractures are a common injury in football often due to direct trauma from a tackle, overuse, and excessive rotation, such as the metatarsal fracture of the foot.
  • Dislocations
    Dislocations, typically at the shoulder, can occur among football players due to the frequent contact and collision with an arm raised up overhead and to the side during play.

In the case of an injury, a medical professional should be consulted to properly diagnose the condition. If a sports health professional is not available during the occurrence of the injury, the coach will need to care for the injured athlete. It is important to provide immediate care of strains, sprains, dislocations, and fractures.

For treatment of an acute injury remember the acronym PRICE meaning: Protect, Rest, Ice, Compress, and Elevate the injured body part.

If you would like more information on the different causes of football injuries and how to properly care for them, call Twin Boro at1-732-444-3578.

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After submitting the form, a Twin Boro specialist will contact you within 24-48 hours to discuss your symptoms and schedule your evaluation appointment.

After submitting the form, a Twin Boro specialist will contact you within 24-48 hours to discuss your symptoms and schedule your evaluation appointment.

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