If you’re a dedicated soccer player, there’s every chance that you’ve experienced a frustrating lay-off due to one or more of the injuries commonly associated with the game. While these mishaps can’t be totally prevented, there are steps that can be taken to minimise the risks.

Football injuries are common due to the stop-start nature of the game, the hastily applied multi-directional stresses imposed on the body, and the unpredictability of what other players do. Injuries from running are frequent, and contributed to by the pivoting and lateral movements of soccer. They involve the lower extremities and account for over 50% of total injuries, sprains being commonest. The ankle is the joint most frequently injured, closely followed by the knee. Other injuries include minor contusions (bruising a ligament, tendon or muscle), strains (stretching or tearing a muscle or tendon), and fractures (broken bones), which are much less common but more serious.

WHAT INCREASES RISK?

Soccer players who lack flexibility are at increased risk of injury, and if you’ve had an injury it will tend to recur. Overuse injuries are common problems, especially towards the end of a long and gruelling season. These result from constant overloading of the body, making certain structures unable to perform their normal biomechanical duties.

OVERUSE INJURIES

Groin muscle strain/inner-thigh pain Adductor-related inner-thigh pain usually requires a lengthy period of rehabilitation. Prolonged muscle use may cause very small tears in the muscle that may lead to overuse injury. Watch out for these early warning signs to help prevent a groin strain:

no relief from stretching tight muscles after activity
decrease in sprinting ability
loss of distance with long kick
pain with deceleration.
Hamstring muscle strain
A strained hamstring muscle is often caused by maximal sprints down the pitch. Reduced stride length when sprinting, particularly at the end of the match, may be related to hamstring shortness as a result of sitting at a desk or in a vehicle during your working day.

Calf muscle strain
This typically occurs as a result of chronic overuse or acute strain as the player attempts to accelerate from a stationary position or lunges forward, forcing the ankle into a toes-up position (dorsiflexion).

Here’s a tip: Good flexibility can lower your chances of muscle strain. Always stretch well after warming up. Focus on stretching the areas most susceptible to strain, but don’t neglect other areas. The more flexible you are, the less likely you are to stretch beyond your capacity and pull or tear a muscle.

Here’s a tip: The best immediate treatment for sprains and strains is the RICE method (rest, ice, compression, elevation).

Iliotibial band friction syndrome/lateral knee pain
This involves friction between the femur (thigh bone) and the iliotibial band (the connective tissue on the outside of the thigh). Friction occurs near the foot strike.

Downhill running and poor lower extremity alignment may predispose a player to this type of injury.

Patellofemoral/anterior knee pain
Pain in and around the kneecap has many causes, including volume/intensity of training and the overall position of the body over the lower limb. Shin splints/medial tibial traction periostitis Shin pain may be the result of flat feet, training errors and poor flexibility.

Achilles tendon injuries/tendinopathy
Pain in the back of the ankle can arise from increased training volume or intensity, but may also arise insidiously due to micro-tears in the muscle fibres. If left untreated, this injury could lead to Achilles tendon rupture.

Plantar fasciitis
Pain under the heel is usually of insidious onset. It’s typically worse in the morning, improves with exercise at first, and is aggravated by standing.

Back and neck pain
Spinal pain is common in soccer players because of the dynamic nature of the game.

Here’s a tip: Instead of slumping in the changing room after a hard game, sit with your lumbar spine in extension. This will help avoid lower back pain and disc problems. Watch your posture at all times, but particularly during training.

EXTRINSIC OR TRAUMATIC INJURIES

Extrinsic or traumatic injuries, caused by a sudden force or impact, can be quite dramatic.

Knee ligament injuries
The two cruciate ligaments (anterior and posterior) are often referred to as the ‘crucial ligaments’ in sporting activity because of their role in preventing pivoting, forward and backward motion.

Cruciate ligament injuries don’t always cause pain, but typically cause a loud ‘pop’ or ‘snap’ sound. Anterior cruciate ligament injuries are more common in soccer and are usually the result of landing from a jump, pivoting or sudden deceleration.

The collateral knee ligaments (medial and lateral) also stabilise the knee from sideways motion, and the medial collateral ligament is commonly injured by extreme sideways opening of the knee, when the knee is slightly bent.

Knee cartilage injuries
Meniscal injury may result from compressing, twisting or pivoting the bent knee with extreme force. This will cause a tear in the cartilage between the tibia (shin bone) and femur (thigh bone).

Good muscle balance, aided by an appropriate strength-training programme in the gym, will allow the body to absorb sudden changes of direction and reduce the potential for injury. The correct footwear and good field conditions will also help.

Ankle sprains/lateral ligament injuries
Ankle sprains (stretching and tearing of ligaments) are common in soccer players due to rapid changes in direction on an uneven surface. A good warm-up and careful stretching may help prevent some sprains. To avoid unnecessary risk, always check the condition of the field before you play. Don’t play on fields with holes or loose stones.

When a soccer player sprains an ankle, it will also eventually affect other areas such as the foot, leg, hip, pelvis and spine. If the anatomy connected to the ankle is not treated (for example by a physiotherapist or osteopath), the potential for decreased circulation, weakness of the ligaments and persistent tenderness will remain.

Even if there’s no tenderness in the area of the injury, an ankle sprain can make a player susceptible to other injuries.

Stress fractures
Stress fractures in the lower leg (tibia) and forefoot (metatarsals) are often the result of repeated impact on a hard surface or overuse. It’s important to wear protective shin pads and appropriate soccer boots!

AVOIDING INJURY

Use the right gear. Players should wear appropriate and properly fitted protective equipment such as shin pads. But don’t assume that protective gear will make you invulnerable if you perform dangerous or risky activities.
Strengthen your muscles. Conditioning exercises before games and during practice strengthen muscles used in play.
Increase your flexibility. Stretching exercises before and after games or practices can increase flexibility.
Use the proper technique. This principle should be reinforced constantly during the playing season.
Take breaks. Rest periods during practice and games can reduce injuries and prevent heat illness.
Play safe. No dangerous tackles!
Stop the activity if there is pain.
Avoid heat injury by drinking plenty of fluids before, during and after exercise or play, decrease or stop practices or competitions during periods of high heat or humidity, and wear light clothing.
Even with the above precautions, injury may occur. The key to a quick recovery is optimal management to speed up healing time. For serious injuries, consult an orthopaedic surgeon. A good natural alternative is osteopathy. Through specific diagnosis and treatment, the osteopath can improve rehabilitation and help prevent small discomforts from turning into severe damage. Even better, evaluation before playing soccer will identify potential problems before they arise. Many are preventable with the correct stretching and muscle-balancing exercises.

EMOTIONAL STRESS

The pressure to win can cause significant emotional stress, especially for a child. Sadly, many coaches and parents consider winning the most important aspect of sport. Young athletes should be judged on effort, sportsmanship and hard work. They should be rewarded for trying hard and for improving their skills rather than punished or criticised for losing a game or competition.