Acute and Cumulative Soccer Injuries

Although many soccer injuries involve the legs and lower extremities, other body areas are susceptible to injury/s as well. Acute or cumulative is how soccer injuries are generally described. Acute injuries are traumatic. They are usually caused by a slip, trip, and fall, getting hit, and crashing into other players. Cumulative injuries involve repetitive stress on a muscle, joint, or connective tissue. This triggers progressive aches, pain, and physical impairment that gets worse with time. Understanding how and why they happen is the first step in injury prevention. The more common injuries experienced among soccer athletes include.

Concussion

This is a form of mild traumatic brain injury mTBI caused by a sudden hit/impact to the head. Players are trained to head the ball; however, concussions can happen if not ready for impact or heading at an awkward position.

Ankle Sprains

Ankle sprains are when there is stretching and tearing of ligament/s that surround the ankle joint.

• Lateral ankle sprains or outside of the ankle can happen when a player kicks the ball with the top of the foot.
• A medial ankle sprain or inside of the ankle can happen when the toes are turned out when the foot is flexed up.

Achilles Tendonitis

This is a chronic injury that occurs from overuse with pain in the back of the ankle. Players are constantly performing repetitive and sudden movements that, over time, can cause this type of injury.

Achilles Tendon Rupture

A rupture involves a partial or complete tear of the Achilles tendon. Often players say with a popping sound. This happens when players perform fast, explosive movements. Rapid stopping, starting, shifting, jumping can all contribute.

Groin Pull/Strain

This is a type of strain that happens when the inner thigh muscles are stretched beyond their limit. As a result, a player can pull the groin when kicking and/or resistance from an opponent trying to take the ball or kick in the opposite direction.

Hamstring Injury

These injuries involve the three back muscles of the thigh and can vary from minor strains to complete ruptures/tears. This comes from running, sprinting, jumping, and stopping, leading to these types of injuries.

Iliotibial Band Syndrome

This is an overuse/repetitive injury that involves a tendon known as the IT band. This is the connective tissue that runs along the outside of the thigh. Constant running can create friction as the band gets pulled along the outside of the knee, which can cause tendonitis.

Plantar Fasciitis

This causes foot pain caused by inflammation of the tissue bands that run from the heel to the toes. Several factors can cause the condition. This could be players using inappropriate or not correctly fitting shoes, shoes that do not provide proper arch support or playing on a hard surface.

Calf Muscle Pull

This is when one of the muscles of the lower leg gets pulled from the Achilles tendon. Again, quick and spontaneous sprinting, running, or jumping is usually the cause.

Knee Injuries

The most common soccer injuries are those that involve the knee. This is because of the stopping and shifting directions quickly and suddenly. The explosive, spontaneous movements place extreme stress on the knees and the supporting ligaments. When the stress goes beyond the ligament’s limits, it can cause a sprain or tear in the joint. When there is an injury to the knee/s, it is diagnosed using a grading scale.

• Grade 1 Mild sprain
• Grade 2 Partial tear
• Grade 3 Complete tear

Runner’s Knee

Patellofemoral pain syndrome, also known as runner’s knee, is a condition where the cartilage under the kneecap gets damaged from an injury or overuse. This happens when there is a misalignment in the knee and/or strained tendons.

ACL Injury

The anterior cruciate ligament or ACL is at the front of the knee. These are the most common knee injuries. This is because the ligaments are less retractable than muscles or tendons. And those in the knees are highly vulnerable to damage.

Cruciate Ligament Injury

This type of injury does not always cause pain but often causes a popping sound when it happens. Pain and swelling develop within 24 hours. This is followed by the loss of range of motion and tenderness around and along the joint.

Meniscus Injury

The Meniscus involves a C-shaped piece of cartilage that cushions the space between the femur and the shin bone. These tears are painful and are often the result of twisting, pivoting, decelerating, or quick/rapid impact.

Shin Splints

The term describes a variety of painful symptoms that develop in the front of the lower leg. This often happens from over/intense training, or the training gets changed. Players can also develop shin splints from training while not using appropriate shoes.

Stress Fractures

These types of fractures are usually the result of overuse or repeated impact on a bone. The result is severe bruising or a slight crack in the bone.

Tendonitis

When tendons get inflamed, it is referred to as tendonitis. This comes with repetitive overuse but can also develop from a traumatic injury that causes micro-tears in the muscle fibers.

Soccer Injuries Prevention

Many of these injuries result from overuse, overtraining, improper conditioning, and/or not warming up properly. Here are few tips to help reduce the risk.

Warm-up for at least 30 minutes before playing

Pay special attention to stretching the:

• Groin
• Hips
• Hamstrings
• Achilles’ tendons
• Quadriceps

Wear protective gear

This includes:

• Mouthguards
• Shin guards
• Kinesio tape
• Ankle supports
• Eye protection
• Ensure they are correctly sized and maintained.

Check the field

Check for anything that could cause injury/s. This includes:

• Holes
• Puddles
• Broken glass
• Stones
• Debris

Avoid playing in bad weather

Or immediately after heavy rain when the field is especially slick and muddy.

Allow enough time to heal after an injury.

This also goes for minor soccer injuries. Trying too fast to get back increases the risk of worsening the injury, re-injury, and/or creating new injuries.

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Body Composition

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Athletes and Carb Loading

Carb loading is a strategy that athletes use.

Endurance athletes

Utilize carb-loading to help them increase energy storage for long runs, bike rides, swims, etc. When timed effectively, carb-loading has been shown to increase muscle glycogen, leading to improved performance.

Bodybuilders and fitness athletes

Use carbo-loading to build size and mass before competitions. The timing and efficacy of carb-loading vary from person to person. Make sure to experiment before the next big competition.

References

Fairchild, Timothy J et al. “Rapid carbohydrate loading after a short bout of near maximal-intensity exercise.” Medicine and science in sports and exercise vol. 34,6 (2002): 980-6. doi:10.1097/00005768-200206000-00012

Kilic O, Kemler E, Gouttebarge V. The “sequence of prevention” for musculoskeletal injuries among adult recreational footballers: A systematic review of the scientific literature. Phys Ther Sport. 2018;32:308-322. doi:10.1016/j.ptsp.2018.01.007

Lingsma H, Maas A. Heading in soccer: More than a subconcussive event?. Neurology. 2017;88(9):822-823. doi:10.1212/WNL.0000000000003679

Pfirrmann D, Herbst M, Ingelfinger P, Simon P, Tug S. Analysis of Injury Incidences in Male Professional Adult and Elite Youth Soccer Players: A Systematic Review. J Athl Train. 2016;51(5):410–424. doi:10.4085/1062-6050-51.6.03