Are Soccer Injuries Inevitable?: With the Right Treatment Plan, Maybe Not!
Lower body injuries are a devastating yet realistic component of most competitive sports, especially for soccer athletes. Soccer is a very physically demanding sport which requires agility, cutting, and quick stopping motions. These high-speed, reactionary motions put soccer athletes at a much higher risk of lower-body injuries to the knee, ankle, and hip/groin. About 48%-70% of soccer athletes sustain one or more injuries per season (Del Coso, Herrero & Salinero, 2016). Injuries during sports are somewhat inevitable but with proper pre-rehabilitation (pre-hab), the risk of injury or severity of an injury can be reduced!
ACL Injuries in Soccer
One of the most severe injuries commonly experienced in soccer is anterior cruciate ligament (ACL) injuries. The ACL is one of the stabilizing ligaments in the knee and connects the tibia to the femur (Mayo Clinic, 2021). The sudden stopping and starting, quick changes of direction, and general unpredictability of soccer put the ACL at a greater risk of sprains and tears. Soccer athletes also tend to have a weak hamstring-to-quadriceps ratio (Brophy, Silvers & Gonzales, 2010). This imbalance of leg musculature and power puts a greater strain on the ACL. Another aspect of soccer that puts athletes at a higher risk of ACL injury is improper neuromuscular patterns such as kicking and planting (Brophy, Silvers & Gonzales, 2010). If these neuromuscular patterns are performed incorrectly it can put the ACL at a greater risk of injury or tear. Female soccer players are at an even higher risk of ACL injury than men (Horwitz, 2014). This is because female soccer athletes generally have a narrower intercondylar notch, smaller ACL, more ligament laxity, and increased flexibility, which altogether create a more unstable joint, leaving the ACL exposed to a greater risk of rupture (Brophy, Silvers & Gonzales, 2010).
How to Decrease the Chances of ACL Injuries in Soccer Athletes?
Increasing the stability of the joint is a key aspect to help prevent ACL injuries from occurring in soccer athletes. An increase in stability can be achieved in a variety of ways. The first way is to increase the strength of the muscles surrounding the knee. Increasing muscle strength helps to support the knee externally by creating more joint stability. As stated previously, soccer athletes tend to have stronger quadriceps when compared to hamstrings (Brophy, Silvers & Gonzales, 2010). Strengthening the hamstrings specifically will help to reduce the quadricep-to-hamstring ratio imbalance, and decrease the risk of injury to the ACL. Neuromuscular balance training is also important to help correct poor neuromuscular patterns learned earlier in life. Finally, improving core strength is crucial to creating a more stable center of mass, which ultimately leads to more stable joints (Brophy, Silvers & Gonzales, 2010). Making these few corrections will greatly reduce the athlete’s risk of ACL injury.
Lateral Ankle Sprains in Soccer
Soccer requires athletes to be constantly making quick stopping and cutting motions. These movements commonly result in lateral ankle sprains, especially when these actions are reactionary (Thompson et al., 2016). The unanticipated quick actions required of soccer, in conjunction with soccer being a high-contact sport, increase the chances of sprain even more. The lack of warning from planting, cutting, switches of direction, or even an incoming tackle may result in the ankle rolling onto the outside edge. Similar to the ACL, the risk of ankle injuries increases from poor neuromuscular control. Some other factors that increase this risk are weak muscles surrounding the ankle, poor joint mobility and inadequate physical fitness (Kofotolis, Kellis & Vlachopoulos, 2007).
How to Decrease the Chances of a Lateral Ankle Sprain in Soccer Athletes?
Some of the main goals to prevent lateral ankle sprains are to increase joint stability while also maintaining mobility. Muscles surrounding the ankle such as the tibialis anterior, tibialis posterior, fibularis longus, and fibularis brevis should be targeted when strengthening the ankle. Ankle range of motion exercises are important to implement to maintain normal ankle mobility.
Hip and Groin Injuries in Soccer
Hip and groin injuries are very common in soccer athletes. These injuries generally arise from sudden changes of direction and speed rather than contact with the opposition (Kerbel, Smith, Prodromo, Nzeogu & Mulchahey, 2018). Usually, these types of injuries are less severe than the other injuries already covered, however, they can still result in time lost on the field. Tight muscles around the hip and limited range of motion at the joint together greatly increases the chances of hip and groin injuries, the most common being muscle strains (Tak et al., 2017).
How to Decrease the Chances of Hip and Groin Injuries in Soccer Athletes?
The most effective way to prevent hip and groin injuries in soccer is to strengthen the muscles around the hip as well as increase hip mobility. Strengthening the muscles around the hip such as the quadriceps, hamstrings, adductors, and glutes will be important to increase stability and improve muscle imbalances. Including hip range of motion exercises will help to improve hip mobility. Implementing both these preventative treatments will reduce the risk of injury to the hip and groin caused by quick changes of speed and direction.
Be proactive! If you are feeling lost on how to get started on pre-hab work, contact Acumen Performance! Here at Acumen Performance you would have access to a variety of assessments that can help determine if you are at a greater risk for injury. Our Strength and Conditioning coaches, Athletic Therapists, and Kinesiologists work together to provide you with the information you need on how to decrease your risk injury! Our team of experts uses Performance Testing and Movement Screens to determine possible areas of risk and the information gathered is used to create programs that will decrease the chances of injury altogether. This can be done with personalized mobility programs, strength programs, and neuromuscular balance programs. Learn how Acumen Performance can help you prevent time lost on the pitch due to injury! Reach out to us for more details!
Brophy R., Silvers HJ., Gonzales T. (2010). Gender influences: the role of leg dominance in ACL injury among soccer players. British Journal of Sports Medicine 2010;44:694-697.
Del Coso, J., Herrero, H., & Salinero, J. J. (2016). Injuries in Spanish female soccer players. Journal of sport and health science, 7(2), 183-190.
Horwitz, D. S. (2014, August 7). ACL Injuries: Female Athletes At Increased Risk. Retrieved November 08, 2017, from http://www.momsteam.com/health-safety/muscles-joints-bones/knee/acl-injuries-in-female-athletes
Kerbel, Y. E., Smith, C. M., Prodromo, J. P., Nzeogu, M. I., & Mulcahey, M. K. (2018). Epidemiology of Hip and Groin Injuries in Collegiate Athletes in the United States. Orthopaedic journal of sports medicine, 6(5), 2325967118771676. doi:10.1177/2325967118771676
Kofotolis, N. D., Kellis, E., & Vlachopoulos, S. P. (2007). Ankle Sprain Injuries and Risk Factors in Amateur Soccer Players during a 2-Year Period. The American Journal of Sports Medicine, 35(3), 458–466. https://doi.org/10.1177/0363546506294857
Mayo Clinic. (2021, March 10th). ACL injury. https://www.mayoclinic.org/diseases-conditions/acl-injury/symptoms-causes/syc-20350738#:~:text=The%20anterior%20cruciate%20ligament%20
Tak, I., Engelaar, L., Gouttebarge, V., Barendrecht, M., Van den Heuvel, S., Kerkhoffs, G., Langhout, R., Stubbe, J., … Weir, A. (2017). Is lower hip range of motion a risk factor for groin pain in athletes? A systematic review with clinical applications. British journal of sports medicine, 51(22), 1611-1621.
Thompson, J. A., Tran, A. A., Gatewood, C. T., Shultz, R., Silder, A., Delp, S. L., & Dragoo, J. L. (2016). Biomechanical Effects of an Injury Prevention Program in Preadolescent Female Soccer Athletes. The American journal of sports medicine, 45(2), 294-301.