May 3rd, 2013

Health N

Staff Report

Health N
Trinity is playing soccer against South Oldham

As a part of the Louisville Orthopaedic Clinic, the Sports Rehab Team physical therapists are knowledgeable and trained in the latest advancements and techniques available in sports rehabilitation.

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Soccer is the most popular sport in the world and one of the fastest growing sports in the United States.  Thousands of youth, teens, and adults enjoy playing the sport in recreational, scholastic and professional leagues. The rising numbers of participation is resulting in rapidly growing rates of injuries.  These injury rates increase as children get older and the level of their play intensify.  This information should not deter participation, but should be used to educate and inform.

As expected, lower extremity injuries are the most common in soccer play.  Sprains, strains, and contusions of the knee, lower leg and ankle are frequent acute injuries.  The most serious acute injury is an ACL tear.  Soccer places numerous plant and twisting loads on the ACL is the most common mechanism for the injury.  Given the increasing rates, ACL injury prevention programs have exploded in popularity.  These programs feature strengthening of the quadriceps and hamstring muscles, balance exercises, and plyometric drills.

Reducing Overuse Injuries

Some overuse injuries include Achilles and patellar tendinitis, shin splints, and stress fractures.  These injuries occur more often as the result of overtraining and poor equipment.  Stretching, moderation, and simply listening to your body can reduce the likelihood of an overuse injury.


Surprisingly, soccer has some of the highest rates of concussions for contact sports, including football.  Head to head contact between players is probably the most common mechanism for concussions.  Studies within the last few years have also looked into the effects of heading the soccer ball.  Some have even suggested banning heading of the soccer ball, which can cause rapid stress to the head, neck and brain. 


No matter how much someone tries, injuries will occur in sports.  Yet there are ways to reduce the chances of injury.  Athletes, parents, and coaches all have a role in preventing injury in all sports.  The most important tool in injury prevention is education.


Conditioning is an important aspect in any sport, but especially in an endurance sport like soccer.  Preseason conditioning can improve athletes’ aerobic fitness, but also prepare them for the demands of soccer.  Fatigue can play a role in higher rates of injury.  Drills in the preseason also strengthen and improve muscle memory.  Finally, a dynamic warm up with stretching before and after all games and practices significantly reduces injury rates.

Field Conditions

Field conditions can also have an important role in reducing the rate of injury in soccer.  Whether it’s turf or grass, a quality field places less stress on the body and doesn’t place athletes at an unnecessary risk of injury.   Soccer is also played in all sorts of weather.  Athletes should adapt to poor playing conditions such as muddy fields and slick surfaces.


Finally, equipment can also play a role in reducing injuries in all sports, including soccer.  Simply wearing shin guards and wearing the right shin guard can aid in reducing lower leg injuries, such as contusions and lacerations.  When choosing shoes, molded cleats are preferable to screw-in cleats.  Screw-in cleats stick into the ground more than molded cleats and used when more traction is needed.

-Mike Mehring, ATC-

Comments and thoughts by Executive Director at Mockingbird Valley Sports Complex and Kentucky Fire Juniors, and Bellarmine University Women’s Assistant Coach Frank Peabody:

1) How do field conditions for soccer affect the players?

Field conditions play a massive role in soccer as a whole for players, specifically with regards to an overall development approach in youth soccer, and for overall quality of play for older age groups and higher levels of play (semi-professional, professional, etc.).  Specifically for early-mid teenage years youth soccer players, lack of quality field conditions pose injury concerns to players whose bodies are beginning to change/mature because the sport demands players to be agile, with constant acceleration quick stopping and/or change of direction. When field conditions are poor, the primary focus for players on the pitch that determines all necessary movements/reactions from players, which is the ball, has tendency to be less predictable, and places even more demand on the players' physical movements.  When play becomes less predictable due to lack of quality playing surfaces, the risk for injury for players is much higher; not only with regards to player reactions to the movement of the ball, but also because there is higher risk for ankle and/or knee injuries due to a miscalculated step in a new direction (typically causing knee injuries), or just higher risk for more common injuries like sprains in the ankles.  The lack of quality public playing surfaces in the City of Louisville is something that has become more than evident with the growth of soccer in the last 5 years.  Ownership at Mockingbird Valley Sports Complex (MVSC) and the Kentucky Fire Juniors (KFJ) have spent countless hours researching, budgeting and planning (on behalf of the City) for how to bring quality public soccer-specific surfaces to Louisville, and have even gone as far as making presentations to City Officials such as the Mayor of Louisville.  We have calculated and presented positive economic impact reports that would benefit the City of Louisville with construction of such a complex, but to date have not gained the support of any City Officials in this endeavor.  

2) What are common lower extremity injuries for soccer players?

The most common lower extremity injuries for soccer players are generally tendonitous (in any lower extremity joint group), ankle injuries (most commonly sprains, but also breaks from time to time) and knee injuries, such as MCL or ACL injuries, which are the most detrimental for soccer player.  Of course, there are common muscle-related injuries, such as a pulled hamstring, that come about due to improper body maintenance (such as not warming-up or cooling down properly).  Other lower extremity injuries I have witnessed are shin-splints, oshkin-slaughter-schloters, plantar-fasciitis, groin and/or hip-flexer injuries; most of these are muscle-related, but all of these types of injuries can be caused by the field conditions which players are participating on.

3) What exercises do you suggest to prevent injuries?

Proper warm-ups (prior to strenuous physical activity) and cool-downs (following strenuous physical activity) are vital for athletes of any type to avoid injury.  Specifically for soccer players, warm-ups should consist of activities that increase the heart-rate (jogging, for example) in little-no pressure settings with dynamic stretching built into the activity.  Cool-down activities should consist of activities that help the body recover from the strenuous physical activity performed, in a no-pressure setting (such as jogging, but should not be just walking), so that the heart rate can decrease incrementally, and there should always be some sort of static stretching involved as well.  Dynamic stretching consists of different movements that help exploit player muscle groups while continuing to be active, whereas static stretching involves players to stop their movement and stretch one specific muscle group for a set period of time (bending over to touch your toes with straight legs for 10 seconds, as an example).  Additionally, the fitness level of a player has a lot to do with the frequency in which injuries occur to that player.  Generally speaking, when players maintain a high level of cardiovascular fitness, combined with speed/agility training and/or appropriate weight training, injuries are much less frequent.


4) What are a few ways to condition for soccer?

There are many ways to condition for soccer, which is a game that places high physical demands on players with regards to overall quickness (speed) over short and long distances, as well as endurance over a longer period of time.  As I mentioned previously, speed and agility training is something that most all soccer players will experience at some point in their careers, provided they are participating at a competitive level.  Speed and agility training helps players to be as efficient as possible with regards to their overall explosiveness and quickness, and helps players to train their bodies to minimize the time spent or distance covered to get to where they need to be on the field.  Endurance fitness is something that most coaches do not have the time or ability to spend time on when training in a team setting, simply due to time constraints.  That said, coaches typically place the responsibility of keeping their individual endurance-fitness level at a maximum capacity on the players themselves, asking them to make sure they are going for longer distance/time runs on their own during off days or during the out of season periods of time.

5) Do certain soccer players at certain ages deal with specific injuries?

While I do not have much of a professional medical background, it is my opinion that the majority of the more serious injuries occur to players who are entering the pubescent/teenage years.  That said, it seems to be fairly well documented that the more serious knee injuries, such as ACL and MCL injuries are actually more gender-specific than age specific; it has been shown that, generally speaking, girls are more susceptible to such knee injuries than boys, during their teenage years.  

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