• Prevention & Treatment of 5 Most Common Football Injuries

    Common Football Injuries

    Photo Credit: Marcel Strauss

    Football or ‘Soccer’ is the world’s most popular sport. There are over 240 million registered players worldwide and many more recreational football players.

    Most football injuries affect the lower extremities, which are defined as the groin and pelvis, hip and thigh, knee, calf, foot and ankle. Research shows that most football injuries are caused by trauma, such as a collision with an opponent or landing awkwardly from a jump. Approximately one quarter to one third of all football injuries are due to overuse and develop over a period of time.

    When reviewing the published literature on football injuries, the overall incidence of injury in football is between 9 and 35 injuries per 1000 hours of football in adults, and between 0.5 and 13 injuries per 1000 hours of football in adolescents. It is clear that the older the player, the more likely they are to get injured. The research also shows that more injuries occur during competitive matches than occur during training. There is also a sex difference in football injuries with female players having a higher injury rate than males.

    Football is popular despite its higher incidence of injury in comparison to other sports. Footballers suffer more injuries than those involved in field hockey, basketball, rugby, cricket, badminton, cycling, judo, boxing and swimming. However, it should be said that many of the injuries sustained in football are not particularly severe. Having more knowledge of common football injuries is a great way to help you prevent getting injured.

    1. Hamstring Strain

    During sprinting activities in football the hamstring muscles can be forcibly stretched beyond their limits and the muscle tissue can be torn. A tear in a muscle is referred to as a strain and, depending on its severity, it is classified as a first, second or third degree strain.

    Hamstring muscle strains accounted for almost 40% of Premiership injuries in the 2004/2005 PhysioRoom Analysis of Injuries. The hamstring muscles work over both the hip and knee joint and can become susceptible to injury due to fatigue.

    What can you do to prevent a hamstring strain?

    A warm up, prior to matches and training, is thought to decrease muscle injuries because the muscle is more extensible when the tissue temperature has been increased by one or two degrees. A good warm up should last at least 20 minutes – starting gently and finishing at full pace activity. Practising sport specific activities helps tune coordination and prepare mentally for football. We recommend compression shorts for providing extra warmth around the hamstring region.

    What should you do if you suffer a hamstring strain injury?

    The immediate treatment of any muscle injury consists of the RICE protocol – rest, ice and compression and elevation. If you have to apply ice at home, the use of an ice bag is recommended. This is a safe method of ice application to avoid the risk of an ice burn.

    All injuries should be reviewed by a doctor or chartered physiotherapist. Depending upon the severity of the hamstring injury, the leg must be rested from sporting activity for between a couple of weeks and 3 months.

    2. Sprained Ankle

    sprained ankle is one of the most common injuries in football. It refers to soft tissue damage (mainly ligaments) around the ankle, usually caused when the ankle is twisted inwards. As well as damage to the ligaments, the capsule which surrounds the ankle joint can also be damaged. The damage causes bleeding within the tissues, which produces a swollen ankle and ankle pain.

    What can you do to prevent a sprained ankle?

    Taping and bracing the ankle can help to reduce the risk of ankle sprains. Previous research has shown the injury incidence in people with taped ankles was 4.9 ankle sprains per 1000 participant games, compared with 2.6 ankle sprains per 1000 participant games in subjects wearing ankle braces. This compared with 32.8 ankle sprains per 1000 participant games in subjects that had no taping or bracing. The use of an ankle brace is a convenient alternative to taping the ankle.

    Rehabilitation with a chartered physiotherapist significantly improves the level of ankle function. Wobble board training is designed to assist the re-education of balance and proprioception. Previous research has suggested that patients with ankle instability who underwent wobble board training experienced significantly fewer recurrent sprains during a follow-up period than those who did not follow the training programme. 

    What should you do if you suffer a Sprained Ankle?

    In the first few days following an ankle sprain it is important to follow the PRICE protocol. protection, rest, ice, compression and elevation (never apply ice directly to the skin). An ankle cryotherapy cuff is the most effective method of providing ice therapy and is the professional’s choice. It can provide continuous ice cold water and compression for 6 hours and significantly reduce ankle pain and swelling. Alternatively if you have to apply ice at home, the use of an ice bag is recommended to avoid the risk of an ice burn.

    3. Knee Cartilage Tear

    A torn cartilage occurs fairly frequently in football. Cartilage tears accounted for 12% of all Premiership injuries in the PhysioRoom 2004/2005 Analysis of Injuries. The term cartilage tear is slightly misleading, since it is the meniscus within the knee that is actually damaged. There are two menisci within each knee joint that are made from tough fibrocartilage – hence the use of the term cartilage for this injury.

    As the knee joint bends the thigh bone usually rolls, spins and glides on the top surface of the shin bone. However, if there is rotation caused by a twist whilst the joint is bearing weight, the menisci can get jammed and nipped in between the two bones. If the force is sufficient, a tear of the meniscus will occur.

    Cartilage tears are usually accompanied by pain and knee swelling. If it is a small tear if may simply settle down. However, with larger cartilage tears, the flap of torn cartilage may interfere with joint movement and cause the knee point to lock or give way.

    What can you do to prevent a knee cartilage tear?

    There isn’t a great deal that you can do to prevent a cartilage tear. These injuries occur due to the positioning of the knee in a semi bent position while it is bearing weight. Having strong quadriceps and hamstring muscles that can deal with the strain on the knee joint may be helpful.

    What should you do if you suffer a torn knee cartilage?

    Surgical removal of the torn fibrocartilage is known as a meniscectomy. This knee surgery is usually undertaken using an arthroscope (a small camera that allows the surgeon to visualise the inside of the knee). The surgeon then uses a small burring device to trim away the torn cartilage. Following surgery, a period of 4 to 6 weeks physiotherapy is usually required.

    4. Hernia

    Hernia and groin problems are common in sports, particularly in football where the pelvic region is subject to large stresses during kicking, sprinting and turning. Two common conditions that affect footballers are an inguinal hernia and Gilmore’s Groin (also known as a sports hernia).

    Following sporting activity the person with a sports hernia will be stiff and sore in the groin region. The day after a football match, getting out of bed or a car will be difficult. In the early stages, the person may be able to continue playing their sport, but the problem usually gets progressively worse.

    What can you do to prevent a hernia?

    Core strength and stability exercises can improve muscle function across the trunk and pelvis. This improved muscular strength and stability can help to counteract the large forces that are applied to the lower abdomen and pelvis. This can reduce the risk of developing a hernia.

    What should you do if you suffer a hernia?

    Anyone with the signs and symptoms of a hernia should consult a hernia specialist. Because it requires an expert to diagnose a hernia it is not unusual for many weeks or months to pass before the correct diagnosis is made. In those people who have typical hernia symptoms an expert can confirm the diagnosis with physical tests and an ultrasound scan.

    In most cases it is usually possible to continue playing football while wearing compression shorts, until an opportune time can be arranged for surgery. The surgical treatment of hernias has been revolutionised over the past ten years. The world’s top hernia surgeons now perform hernia surgery under local anaesthetic. This has greatly accelerated the rehabilitation period.

    5. Anterior Cruciate Ligament (ACL) Injury

    The anterior cruciate ligament (ACL) lies deep within the knee joint, connecting the thigh bone with the shin bone. Its function is to prevent excessive forward movement of the shin in relation to the thigh and also to prevent excessive rotation at the knee joint. The ACL can be injured in several different ways during football, most notably by landing from a jump onto a bent knee then twisting, or landing on a knee that is over-extended. Direct contact on the knee from opponents can also cause damage to the ACL.

    What can you do to prevent a anterior cruciate ligament injury?

    Proprioception training using a wobble board is thought to be very effective in the prevention of knee ligament injuries, as well as during rehabilitation.

    Wobble boards are designed to assist the re-education of the proprioceptive system by improving sensory function around the knee. Previous research has also shown that wobble board training improves single leg stance ability and balance, while other studies have suggested that patients who underwent wobble board training experienced significantly fewer knee ligament injuries.

    What should you do if you suffer an ACL injury?

    All ACL injuries require the opinion of an orthopaedic consultant. During the immediate aftermath of an ACL injury the PRICE treatment protocol is most effective. This is an acronym for Protection, Rest, Ice, Compression and Elevation.

    Protection: The injured tissues should be protected from further damage by using a knee brace.

    Rest: Rest from sports is essential, but even excessive walking should be avoided.

    Ice: Cryotherapy is the most effective method of providing ice therapy and is the professional’s choice. It can provide continuous ice cold water and compression for 6 hours and significantly reduce knee pain and swelling. If using ice, the use of an ice bag is recommended for it’s safe application to avoid the risk of cold burns.

    Compression: Compression can be provided by the intermittent use of an Cryocuff or compression sleeve to reduce knee swelling and relieve pain.

    Elevation: To relieve knee pain and prevent knee swelling, the knee is elevated above waist height

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