Soccer Injury Prevention
Approximately 231,447 athletes were treated in hospital emergency rooms for soccer-related injuries in 2012, according to the US Consumer Product Safety Commission.
Common Soccer Injuries
Already the most popular international team sport, soccer continues to gain popularity in the United States. With more people playing soccer, it is not surprising that the number of soccer-related injuries is increasing — particularly as children get older and their level of play intensifies.
Sprains and strains, often around the knee and ankle, are very common in soccer. Player collisions — either full body or kick collisions — can cause a wide range of injuries, including cuts, bruises, and concussions. Overuse injuries, such as Achilles tendinitis and shin splints, frequently occur, as well.
Several strategies can help prevent soccer injuries — from careful inspection of the field to wearing proper shin guards.
Proper Preparation for Play
- Maintain fitness. Be sure you are in good physical condition at the start of soccer season. During the off-season, stick to a balanced fitness program that incorporates aerobic exercise, strength training, and flexibility. If you are out of shape at the start of the season, gradually increase your activity level and slowly build back up to a higher fitness level.
- Warm up and stretch. Always take time to warm up and stretch, especially your hips, knees, thighs and calves. Research studies have shown that cold muscles are more prone to injury. Warm up with jumping jacks, stationary cycling or running or walking in place for 3 to 5 minutes. Then slowly and gently stretch, holding each stretch for 30 seconds.
- Cool down and stretch. Stretching at the end of practice is too often neglected because of busy schedules. Stretching can help reduce muscle soreness and keep muscles long and flexible. Be sure to stretch after each training practice to reduce your risk for injury.
- Hydrate. Even mild levels of dehydration can hurt athletic performance. If you have not had enough fluids, your body will not be able to effectively cool itself through sweat and evaporation. A general recommendation is to drink 24 ounces of non-caffeinated fluid 2 hours before exercise. Drinking an additional 8 ounces of water or sports drink right before exercise is also helpful. While you are exercising, break for an 8 oz. cup of water every 20 minutes.
Ensure Appropriate Equipment
- Wear shin guards to help protect your lower legs. Soccer tournament records show that lower leg injuries are most often caused by inadequate shin guards.
- Wear shoes with molded cleats or ribbed soles. Shoes with screw-in cleats often are associated with a higher risk of injury. However, shoes with screw-in cleats should be worn when more traction is needed, such as on a wet field with high grass.
- Use synthetic, nonabsorbent balls on wet playing fields. Leather balls can become water-logged and very heavy when wet, putting players at high risk for injury.
Ensure a Safe Environment
- Soccer goals should be well padded and properly secured. Padding the goal decreases the incidence of head injuries when the goalie and other team members collide with the posts.
- The playing surface must be kept in good condition. Holes on the playing field should be filled, bare spots reseeded, and debris removed.
- Secure the goals at the end of play. A simple bicycle lock can chain the goals together and prevent them from tipping over. Unsecured, unsupervised soccer goals can fall onto children and result in severe injuries.
- Pay attention to the weather conditions: In a thunderstorm, leave the field and get inside immediately. In hot weather, take sufficient water breaks. In cold weather, wear appropriate clothing, including gloves and hats. Consider shortening practices in severe temperature extremes.
- Do not crawl under or sit on the goal, or hang from the net. Injuries and deaths have occurred when goals have fallen onto players.
Prepare for Injuries
- Coaches should be knowledgeable about first aid and be able to administer it for minor injuries, such as facial cuts, bruises, or minor strains and sprains.
- If playing on artificial grass fields, make sure to adequately clean any skin scrapes or abrasions to reduce the chance of them getting infected.
- Be prepared for emergencies. All coaches should have a plan to reach medical personnel for help with more significant injuries such as concussions, dislocations, contusions, sprains, abrasions, and fractures.
Safe Return to Play
An injured player’s symptoms must be completely gone before returning to play. For example:
- In case of a joint problem, the player must have no pain, no swelling, full range of motion, and normal strength.
- In case of concussion, the player must have no symptoms at rest or with exercise, and should be cleared by the appropriate medical provider.
Prevent Overuse Injuries
Because many young athletes are focusing on just one sport and are training year-round, doctors are seeing an increase in overuse injuries. The American Academy of Orthopaedic Surgeons has partnered with STOP Sports Injuries to help educate parents, coaches, and athletes about how to prevent overuse injuries. Specific tips to prevent overuse injuries include:
- Limit the number of teams in which your child is playing in one season. Kids who play on more than one team are especially at risk for overuse injuries.
- Do not allow your child to play one sport year round — taking regular breaks and playing other sports is essential to skill development and injury prevention.
Source: US Consumer Product Safety Commission (CPSC), 2012
Ten Ways to Reduce or Prevent Soccer Injuries
By Lindsey Barton Straus, JD
According to a study reported in the February 2007 issue of the American Journal of Sports Medicine, youth soccer players (ages 2 to 18) suffer around 120,000 injuries each year sufficiently serious to require a trip to a hospital emergency room. The total number of soccer-related injuries, including those treated outside of a hospital ER, is estimated to be nearly 500,000 per year.
A significant number of these injuries could be prevented if parents, athletes and soccer organizations employed the following safety measures:
1.Reduce injuries through proper conditioning. Conditioning-related injuries, such as strains and sprains occur most often at the beginning of a season when kids are most likely to be out of shape. Such injuries are preventable if, before the start of a season, a child follows a conditioning program designed specifically for soccer. Proper conditioning is particularly important for girls. Not only are girls predisposed to instability or dislocation of the kneecap (patella), pain and problems under the kneecap, but the twisting and cutting in soccer make them particularly vulnerable to non-contact injuries of the anterior cruciate ligament (ACL), which they suffer at a rate two to ten times higher than boys. Proper conditioning (especially building up hamstrings and inner quadriceps muscles) and teaching girls to pivot, jump, and land with flexed knees and employ a three-step with the knee flexed instead of a one-step stop with the knee extended have been shown to prevent some of these injuries.
2.Reduce injuries through proper stretching, warm-ups and cool-downs. Research shows that cold muscles are more injury prone and athletes with poor muscle flexibility experience more soreness, tenderness and pain after exercise. Unlike sports like gymnastics or swimming, soccer does not develop natural flexibility. As a result, stretching, particularly of the groin, hip, hamstrings, Achilles tendon, and quadriceps, during warm-ups before practices and games and during the cool-down after playing, is particularly vital in reducing the risk of strains and sprains. Stretching is particularly critical for soccer players between the ages of 10 and 13 who have less natural flexibility because their bones are growing faster than their muscles. It is also critically important for girls, who need to strengthen and stretch leg muscles to reduce the risk of ACL injuries.
3.Reduce injuries by properly maintaining the field. By some estimates, fully 25% of all soccer injuries result from poor field conditions. Don’t leave it to the referee to check the field for holes, puddles, broken glass, or stones or other debris. Be proactive by setting up a field detail.
4.Reduce injuries by wearing proper shin guards. One recent study revealed that among one league of youth soccer players, the shins were the third most likely area to be injured. Of the seventeen fractures, four were to the tibia (shinbone). The study confirmed that shin guards significantly decreased the force to the tibia compared to impacts without shin guards. Make sure the shin guards meet appropriate safety (i.e. ASTM) standards.
5.Reduce injuries from goal post collisions. Soccer goalies suffer a disproportionate number of injuries, many from absorbing the impact of colliding with the post of a heavy, stationary, unpadded goal post. A study by the Consumer Product Safety Commission (CPSC) concluded that padded goal posts significantly reduced the number and severity of such injuries, and were especially effective in reducing head injuries. In another study of 471 soccer games using a goal post padding system developed by Dr. David Janda, an orthopedic surgeon and director of the Institute for Preventive Sports Medicine in Ann Arbor, Michigan, there were seven major collisions between a goalie and the post, but no injuries.
- Anchor the goal posts. According to the CPSC, at least 29 fatalities and 49 major injuries during the period 1979 to 2004 have been linked to unanchored or portable soccer goals. The CPSC recommends that allhere movable soccer goals be anchored firmly in place at all times. For more information on anchoring goal posts, click
- Reduce orofacial injuries by using mouth guards. As many as 30% of all soccer injuries are to the orofacial region, including tooth avulsions, tooth fractures, concussions, and oral lacerations. Many of such injuries could have been prevented had the player worn a mouth guard. Yet only about 7% of youth soccer players wear mouth guards all or most of the time, and few state interscholastic athletic associations mandate their use. Both the American Academy of Pediatric Dentistry and American Dental Association recommend a sports mouth guard for soccer.
- Take steps to reduce the risk of concussions and other traumatic brain injuries. Two recent studies suggest that years of heading a soccer ball may result in the short term in weaker mental performance, including a decline in cognitive function, difficulty in verbal learning, planning, and maintaining attention; and reduced information processing speed. The long-term effects of heading, however, are less clear. The studies have led some groups, including the National Soccer Coaches Association of America to recommend that its members not stress heading drills among children 10 or younger. Players, coaches, parents, referees, and health professionals need to be educated about the injury potential from heading a soccer ball; rules on the distance of players from the ball on restarts (such as free and corner kicks) need to be strictly enforced; and balls should be of the size and weight appropriate for the players’ age and be made of synthetic, nonabsorbent materials when games are played on wet fields (because leather balls, when wet, become heavy and water-logged, increasing the risk of injury).
- Reducing overuse injuries by setting participation limits. Nearly half of all of the sports injuries children suffer each year are overuse injuries. There are a number of commonsense steps parents can take to reduce the risk of overuse injuries. First, before letting a child play on two or three soccer teams at the same time, consider that all the extra wear and tear on her body may lead to overuse injuries years later. Second, set limits. A child is far less likely to suffer an overuse injury if he takes off at least three months a year from sports, and practices and plays soccer no more than twelve hours per week.
- Be prepared for medical emergencies. A properly stocked first-aid kit should be available at all soccer practices and games, youth sports coaches should receive training in first-aid and an emergency medical plan should be in place.
Soccer Injuries: Prevention & Care
US Youth Soccer strongly recommends that parents and coaches consider attending a Red Cross First Aid course and CPR (Cardiopulmonary Resuscitation) course.
The first line of defense in the treatment of athletic injuries is to prevent them. This is accomplished by a well-planned program, competition among athletes with equal ability and size, proper warmup and adherence to the Laws of The Game. Other factors that can lead to the prevention of injures:
- Proper use of equipment (shin-guards, no jewelry, uniforms designed for climate)
- Continuous upkeep of the playing surfaces.
- Proper fitting shoes, proper type of shoe for surface.
- Ample water supply and breaks to rest players.
- Avoid scheduling training during the hottest periods of the day and when there is intense humidity.
- Full rehabilitation of initial injury prior to returning to play.
- Use proper preseason screening program by qualified personnel:
- Will insure that players are not entering the season with preexisting injury.
- Insures that rehabilitation is complete.
- Determines the general health of the player
- May need some suggestions for rehabilitation or conditioning.
It is suggested that the coach or someone from the team be responsible for assisting with injuries, which may include attending a certified Red Cross First Aid course.
It is recommended that the coach should follow up with a phone call immediately after the game to the parents regarding any type of injury, should the parents not be in attendance at the game.
The care of the injured athlete will begin the moment that an injury occurs. Immediate care will reduce the severity of the injury and the possibility of long-term disability. The coach, upon seeing an injured player should:
- Determine if the player is conscious and breathing. If unconscious and not breathing, begin CPR and call for medical assistance.
- Ask how the injury occurred: “Where did you get hit?”, “did you twist you leg?” etc.
- Ask the player where it hurts.
- If the player is unable to continue, he should be checked to determine extent of the injury.
After determining that the injury IS NOT life threatening, the nature of the injury can be further determined:
- Note the position of the injured part.
- Look for swelling and deformity.
- Compare with opposite side.
- Ask the player and or teammates what happened.
Treatment should be as follows: (RICE)
Rest- removes the player from the game.
Ice- applies ice to the injured part.
Compression– apply compression bandages
Elevation– elevates injured body part above heart if possible.
The RICE treatment is the only first aid treatment that is safe for a sports injury without professional advice.
The RICE treatment helps in three different ways:
- Applying ice chills the injured area causing the blood vessels to contract, reducing circulation to the injured area.
- Applying pressure with an elastic bandage inhibits the accumulation of blood and fluids in the area, thereby minimizing pain and swelling.
- Elevating the injured area decreases fluid accumulation to the injured area, puts the area to rest and helps reduce painful muscle spasms.
RICE treatments can do no harm to any type of injury. Almost anything else- including heat applications can cause harm in some instances.
After evaluation of the injured athlete, follow-up should be considered if:
- Gross swelling or deformity is present.
- The player is unable to bear weight on the injured part.
- Severe pain or discomfort is present.
Some common terms that you should know in dealing with soccer injuries:
- Sprain– An injury to one or more ligaments. Ligaments are bands of tissue that attach bone to bone and stabilize joints. CARE: RICE
- Strain- A tearing injury to a muscle or tendon (tendons attach muscle to bone, except the Achilles tendon). CARE: RICE
- Contusion– A crushing injury to a muscle or tendon caused by an outside force, which causes hemorrhaging to surrounding tissue. CARE: RICE
- Abrasion– A loss of surface area of the skin caused by sliding on the field surface. CARE: Clean area with antiseptic to prevent infection. An antibiotic ointment may be used to keep wound moist and prevent infection.
- Blister- The collection of fluid under the skin usually caused by friction between the shoe and the skin. CARE: If open, treat as an abrasion. If closed, it should be drained only by a qualified person.
- Heat Exhaustion- A heat illness characterized by pale, clammy skin and profuse perspiration. Person may complain of being tired and weak with headache. Possibilities of cramps, nausea, dizziness, vomiting or fainting. CARE: Move to cool area, have player lie down with feet elevated. Remove restrictive apparel. Cool with wet towels. If player is alert, water may be given. If player vomits- take top hospital immediately. Always refer to a physician for further diagnosis and treatment.
- Heat Stroke- A heat illness characterized by high body temperature, skin is dry and hot to the touch, rapid pulse, player may lose consciousness. CARE: Seek immediate medical attention (Call 911), while waiting, treat as above for heat exhaustion.
- Cramps– An involuntary contraction of a muscle or muscle group that is repetitive and rapid in nature. CARE: Hydrate with water and stretching.
- Concussion– An injury to the brain. May complain of headache, ringing of the ears, dizziness, and blurred vision. CARE: Seek immediate medical attention.
Rules of thumb when handling an injured player:
- Avoid panic.
- Check for consciousness, bleeding, deformation, discoloration, breathing, shock.
- Depending on nature of injury avoid moving the injured player.
- Inspire confidence and reassure player.
- Use common sense.
- Seek professional help.
- Always err on the side of caution.
Use certified athletic trainers when available.
It is recommended that if a player has had medical attention, he/she must have written permission from a MD to return to activity.
Resumption of Activity Following an Injury
The player must not be able to return to play in practice or game conditions until the following criteria have been met:
- The player should be able to run straight without pain; run and turn in a figure eight without a sign of a limp.
- Should be able to support weight with the injured part. If the injury is an ankle or knee, he should be able to do a toe raise on the injured side without being supported.
- The player should have practiced with the team prior to competition.
- There should be no pain or swelling or disability following activity.