From Head To Toe

From Head To Toe
***This article is part of an educational series for soccer parents and youth players new to soccer***

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Soccer has gotten lots of bad press for being “soft” due to professional players who dive and fake injuries to get calls. After all, “diving” after minimal contact with a player can earn a team the opportunity to take a game-winning penalty.

But the reality is this: soccer is rapidly becoming one of the toughest sports out there as the style of modern play gets more aggressive.

From youth house leagues all the way up to the World Cup Stage, players need to protect themselves more than ever from the increasing rate of injuries.

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To put it plainly, the game isn’t as tame as it used to be.

What the Numbers Have to Say About Soccer Injuries
Soccer isn’t for the faint of heart. From a physical and mental perspective, it takes a tremendous amount of endurance, toughness and resilience to run up and down a court for 90 minutes. We don’t need to mention the other skills that are required for success (ie. coordination, speed, explosiveness, IQ).

But with an increasingly aggressive style of play, soccer players, especially younger ones, are either burning out or second-guessing whether they should play due to the severity of their injuries. Research conducted over the last several years also shows that these injuries have become more problematic.

Concussions Rival American Football
American Football has made headlines over the last few years due to fears over tackling and how they can cause traumatic brain injuries (TBIs) and concussions. However, soccer is next in line and the following numbers prove its risks:

* Concussions and mild traumatic brain injury (MTBI) among youth soccer players has risen 110% over the past 25 years
* Concussion rates in women’s soccer are almost 3 times higher than men’s soccer, and now outpaces those in American football
* The rate of concussions/MBTIs in high school and college players is second only to football

Part of the reason why concussions may be recognizable is due to our increased awareness of their symptoms and how they occur. But there is no doubt that there is an increase in these injuries because the sport contains far more contact than it has in previous years (more on this later).

Musculoskeletal Injuries
As much as concussions and head injuries attract significant attention in soccer safety discussions, muscle and joint injuries are even more problematic. Soccer players are prone to overuse injuries, which usually manifest as strains, sprains and fractures. From the youngest upstarts to seasoned vets, players spend more time on the pitch than ever, increasing their risk of sustaining these injuries. It comes as no surprise that the rates of these injuries are also on the rise, as the following numbers show:

* Lower limb injuries account for 65.6% of all soccer injuries; torso/pelvic injuries make up 14.7% injuries, upper limb injuries make up 4.5%, head/face/neck injuries account for 4.3% soccer injuries, while the remaining 3.7% occur elsewhere
* For men, muscle strains are the most common injuries (25.8% involve hamstring and adductor groin strains)
* An additional 25.3% of injuries in men are ligament sprains, while contusions account for 20.3% of injuries (concussions for the remaining 5.5%)
* For women, ligament sprains comprise 25.7% of their injuries, while muscle strains account for 21.5%, contusions at 15.9% (concussions for the remaining 9.2%)

You don’t need to look at numbers alone to see that these injuries are getting more severe. For example, in a NYTimes article, “Broken Bones and Bruises Rise as Youth Soccer Gets Aggressive”, there was mention of an 11-year-old soccer player who took an elbow to the head and was then sidelined due to a concussion for six weeks. As for professional players, it’s becoming more common to hear that former players now suffer from Chronic traumatic encephalopathy (CTE), a condition caused by repeated head trauma.

It’s clear that the coaches, league organizers and parents of soccer players, as well as players themselves, need to invest in injury prevention.

Common Soccer Injuries From Head to Toe
The first step to prevent and reduce the risk of sustaining soccer injuries is to develop an awareness of what injuries players face. They are numerous, but largely preventable once understood. As was mentioned above, the majority of injuries occur in the lower body (not the head as one may believe).

Head & Neck

Concussions - Mild traumatic brain injury caused by a sudden impact to the head.

Torso

Groin strain (groin pull) - A type of strain that occurs when the inner thigh muscles are stretched beyond their limits.

Legs

Ankle sprains - Occurs when ligaments surrounding the ankle joint are stretched and torn.Achilles tendonitis - A chronic injury that occurs due to overuse, appearing as pain in the back of the ankle.Achilles tendon rupture - A partial or complete tear of the Achilles tendon that will produce an audible “pop” sound.Hamstring injuries - Any injury ranging from a minor strain to a total rupture of the hamstring muscles.Iliotibial band syndrome - Overuse of a tendon called the IT band along the outside of the thigh.Patellofemoral pain syndrome - A condition in which the cartilage under the kneecap is damaged due to injury or overuse.Plantar fasciitis - Inflammation of the band of tissue that runs from the heel to the toes, often present as foot pain.Pulled calf muscle - Occurs when either the gastrocnemius or soleus muscles are pulled from the Achilles tendon.Shin splints - A variety of painful symptoms that occur in the front of the leg, usually occurring due to intensive or sudden changes in training.Stress fractures - Overuse or repeated impacts on a bone.

Prevention Over Cure
Ultimately, the key to longevity and resilience in one’s soccer career is learning how to prevent injuries from occurring in the first place. It’s not possible to avoid all injuries and over the course of a player’s career, the occasional injury will likely occur. However, the key is to reduce the risk of sustaining more serious ones that can have long-term consequences.

Conditioning
The first step to preventing soccer injuries is by means of sound conditioning. A body part that’s ill-prepared for an unfamiliar motion will likely be too weak to sustain the forces unleashed upon it. That’s why coaches need to put their players through routine conditioning to strengthen the muscles, joints and bones to withstand unfamiliar movements.

Consider what happens to players coming out of the off-season - they’re out of shape. For several weeks, they haven’t played at the intensity they normally do during the regular season. This may appear in the form of diminished coordination and reduced endurance (both muscular and cardiovascular). Expecting them to play at the same efficiency as they do in the regular season is unrealistic (unless you want them to injure themselves).

Additionally, you need to take into account other factors such as players who are already injury-prone as well as their gender. Regarding gender, female players are more susceptible to certain injuries such as ACL tears and kneecap pain.

With all of this in mind, young players need conditioning exercises that strengthen vulnerable muscles and protect surrounding joints.

Dynamic Stretches
Dynamic stretches are ideal for soccer because they warm up the muscles without overstretching them, which in itself can lead to muscle injuries. Here’s a list of dynamic stretches that can be performed for conditioning purposes.

FrankensteinsButt-KicksHigh-Knees/Knee HugsFront-to-Back Hip/Leg SwingLateral Hip SwingsForward, Backward Arm CirclesRotational WindmillAnkle RotationsResistance Training
Stretching alone doesn’t prepare muscles and joints for high-impact movements. Muscle strength and bone density also matter. This is important to consider because research has shown that weaker neck muscles (especially problematic for female players) increase the risk of concussions. In other words, strong muscles and bones are like shock absorbers against high-impact forces.

For older youth, carefully-monitored resistance training allows them to build more “shock-resistant&rdquo