COMMON SOCCER INJURIES
As with many winter sports, the soccer pre-season is well underway. The demands of pre-season training often increase along with work & school commitments at the start of a year. This results in an increase in load that can easily contribute to pre-season injuries.
So, before the soccer season is up and running we thought we’d give a run-down on the most common soccer injuries and why they may occur.
WHAT DO WE KNOW ABOUT SOCCER INJURIES?
A study of the players from 23 professional soccer teams over seven years has shown the following;
- 57% of injuries happen during games and 43% occur during training.
- Injuries resulting from trauma represented 81% of injuries that occur during games and 59% of injuries that occur during training.
- On average, a player will sustain 2.0 injuries per season. This equates to approximately 50 injuries per team.
- 87% of the injuries affected the lower limbs.
- The risk of anterior cruciate ligament (ACL) injury is 4-6 times higher in female players than in male players.
- On average, 12% of the season is lost to injury with each injury.
- Re-injuries constituted 12% of all injuries and they lasted significantly longer.
As a sport, soccer places unique demands on the body. The lower limb is a frequent site of injury as it is required to undergo the greatest amount of loading. Soccer injuries include (but are not limited to):
We also know that…
- Muscle strain, ligament sprain and contusion are the most common injury types.
- The thigh, knee, ankle and hip/groin are the most common injury locations.
- The single most common injury is thigh sprain, representing 17% of all injuries, with hamstrings being more commonly injured than the quadriceps. Hamstring are 2-3 times more likely to be injured during high-intensity games in the competitive season.
WHY DO THESE INJURIES HAPPEN?
As with many sports, there are a significant number of factors that contribute to soccer injuries. These factors can be both intrinsic (individual differences that make someone more susceptible to injuries) and extrinsic (environmental factors that influence injuries).
The biomechanics of the lower limb is one of the most significant factors that makes a soccer player more (or less) susceptible to injury. As most soccer players have a dominant and non-dominant side, the loading of the left vs right will be different.
One side will predominantly be the stance leg, whilst the other will predominantly be the swing/kicking leg. This is significant as it means the tissues in each leg are being loaded in a completely different manner, which often contributes to the development of injuries.
WHAT HAVE WE FOUND?
From our involvement with local soccer players, The Injury Clinic has found the following:
- 67% of players are unable to do a single leg squat
This information is most interesting as soccer players spend a significant proportion of their time at training and games standing on one leg (with either kicking or running). This means if the players are unable to do a single leg squat they have a high risk of hip, knee and ankle injuries as they do not have the strength required to stand on one leg and control movements.
- 35% have a poor side plank combined with poor glute activation
- 53% have positive anterior hip signs and 40% of these players have poor glute activation
The side plank is a significant measure of lateral strength. This is important to prevent the overload of anterior and posterior structures. These structures include the quadriceps, hamstrings, hip and knee; which are all structures commonly injured in soccer players. Hip impingement is one injury commonly seen and is often secondary to poor glute activation and poor lateral strength. Positive anterior hip signs indicate a pattern of hip impingement. As hip impingement has been associated with early degeneration and accelerated onset of osteoarthritis in the hip, it is concerning more than half of those seen at The Injury Clinic had positive testing for hip impingement.
WHAT CAN WE DO TO MINIMISE SOCCER INJURIES?
Due to the repetitive and uneven loading through the lower limbs, soccer players are quite susceptible to injury. To minimise the risk of injury the following should be considered:
- Strength and Conditioning – A program that focuses on core, lateral stability and single leg loading is vital in the prevention of injuries. A strength and conditioning program will also improve the tissues ability to cope with the demands placed on them while playing soccer, therefore reducing common injuries ie. patellofemoral pain and stress fractures.
- Warm-up – Extensive research has shown a comprehensive warm-up can reduce the risk of injury by 30-50% when it is performed a minimum of two times per week.
- Landing mechanics – The biomechanics of a landing after a jump can make a person significantly more (or less) susceptible to an injury. For example, if we consider ACL ruptures (which are extremely common in soccer players, in particular female athletes), research has shown 73% of ACL ruptures in female athletes occur while landing from a jump. By improving landing mechanics the risk of many injuries (including ACL ruptures) has been shown to decrease.
- Balance – Evidence demonstrates sport-specific balance training reduces the likelihood of injury, especially injuries to the knee and ankle.
- Plyometrics and agility -Evidence has demonstrated plyometric exercises encourages the body to move in a biomechanically correct way. This means in the body will move and respond to change in direction efficiently, which reduces the risk of injury.
In isolation, each of these factors will assist in the reducing the risk of injury. It is important, however, to include components of each of these factors into weekly training sessions throughout the pre- and competitive seasons. It is also important to note that these factors do not completely eliminate the risk of injury and this is not an extensive list of prevention measures. Lastly, it is important that any program implemented is constructed and overseen by a qualified professional (ie. Physiotherapist).
As a sport, soccer places varied and uneven loads through the tissues in our bodies, predominantly the lower limbs. Consequently, there are many common injuries and many factors that lead to the development of these injuries. At The Injury Clinic, we have had the privilege of working closely with many soccer players. This has given us an insight into the strengths and weaknesses that are commonly seen amongst soccer players. To minimise the risk of injury, the tissues (especially those of the lower limb) must be able to cope with the specific loads and demands that will be placed on them. This often means a specialised strength and conditioning program is necessary to improve the tissues ability to adapt and manage the loads.