By Elise Hiza, MD, Orthopedic Surgeon
Billions of people around the world are tuning in for the 2019 Women’s FIFA World Cup, which is in full play. You can’t help but be amazed at the level of athleticism, power and strength that’s required of soccer players – especially at the professional level. As you watch in awe on the edge of your seat and find yourself flinching at some of the tackles, you may be surprised when they come out unharmed – but not everyone is as lucky. Soccer is a high-contact and physical sport at any age – but professional athletes don’t take the “physical” part lightly, especially when there is a World Cup on the other end of the fight.
This summer, you may find yourself on the sidelines while Asheville City Soccer Club men’s and women’s teams take the field at Memorial Stadium. Or, you may spend a lot of time being a soccer mom or dad at your child’s games. Or, with plenty of adult leagues here in town, you may even find yourself kicking the ball around! Whether you’re watching or playing the beloved game of soccer, here are some common soccer injuries to be mindful of so you know how to prevent them, when to seek care from a medical professional and when to listen to your body and rest!
Common Soccer Injuries
On top of being a physical sport, soccer requires a lot of running – players average about 8-12 miles of running per game! That doesn’t include the running players do outside of games in preparation for competition. The fast changes of pace and direction, and contact with other players can take a toll on players’ bodies if not properly cared for.
Injuries can be acute or chronic. Common acute injuries (injuries that are more immediate) that can often occur on the soccer field are:
- Concussion
- Groin/hip injuries
- Hamstring injuries
- Ankle sprains
- Foot and toe injuries
- Contusions
- Knee injuries (including ACL and MCL tears)
Chronic, overuse injuries are common in players, such as tendinitis, bursitis and inflammation, which develop over time. When we are training, we are trying to develop stronger, faster, more functional muscles. To do this, you must stress the muscles, which causes “microtrauma” to them and creates tiny muscle rips and tears. Your body comes along and builds things back up stronger than before so that the next time it experiences that weight or load, it can withstand it. The “building back up” takes time, and if you continue to stress those tissues before they have a chance to build back up, you develop chronic injury to those tissues known as “overuse injuries.”
You may have heard of athletes suffering from a torn ACL (anterior cruciate ligament) or MCL (medial collateral ligament), which is not uncommon in soccer players – and is an event that an athlete remembers! ACL and MCL injuries can occur during a quick intense collision between two players, or a player can simply plant their foot oddly or uncomfortably causing the knee to twist, even slightly. Athletes with a torn-ligament injury often recall they hear a “pop,” experience immediate pain, swelling and difficulty with range of motion, and also a feeling of instability or “giving way” of their knee. Inability to bear weight, extreme pain, swelling or instability of the knee should be signs to have athletic training staff or a doctor evaluate the knee. In the meantime, ice, elevation, compression and anti-inflammatory medications are important.
Medial tibial stress syndrome, better known as shin splints, is one type of overuse injury that occurs from excess running, jumping or lower extremity activity. Pain occurs over the inside of your shin bone, usually at the back part where the muscle meets the bone. Shin splints can range anywhere from tendinitis of the muscles that hook into your tibia (shin bone) to inflammation of the covering of the bone (periosteum) to an actual stress fracture. Ice and massage can usually help shin splints to feel better, but rest is what will ultimately help them heal.
Iliotibial syndrome impacts the iliotibial band – that awesome “stripe” you see on individuals with exceptionally strong or toned outer thighs. The iliotibial band is a long tendinous structure that hooks a muscle in your upper/outer hip, goes down your leg and hooks to your tibia bone below your knee. The tendon moves over bones in different areas and that friction can cause inflammation at the hip or at the knee. Athletes can often experience overuse injuries to this part of the body.
Finding a Balance between Rest and Play
While injuries are common and often unpredictable, they can be prevented. My top two tips to prevent injury at any age is to rest when you need it and add variety into your workout and training regimen.
Rest: The best way for athletes to protect themselves against chronic, overuse type injuries is… REST! Elite-level soccer players do not play every minute of every game. In fact, rest and days off are part of what keeps them playing at an elite level! It is very important to take 1-2 days off from activity every week to avoid chronic, overuse symptoms. Athletes are often required to push their bodies physically, which is necessary in competition. That’s why resting matters even more – listen to your body when you feel like you need rest.
Make sure younger athletes are not playing 2-3 full soccer games a day and that they have adequate rest (at least one full day off per week from heavy training). Many young athletes are playing for both their school and club teams now, which means double practices, double games – and that also means double the injuries. If they are playing for both teams, be selective about which practices and games they participate in.
Workout and training: When you aren’t resting, you’re likely training or competing. One thing athletes may not realize is the benefit of cross training, or adding in different types of exercise into your regimen. Incorporating activities like yoga, Pilates, cycling, core strengthening and balance into their regimen can help prevent acute and chronic injuries on the field – especially in younger athletes. Early subspecialization in a single sport is linked to chronic, overuse injuries. In fact, we are learning that multisport athletes are better athletes with fewer injuries! In regard to preventing injuries in soccer (and other sports), an athlete cannot do enough balance and “core” type exercises such as yoga, balance exercises, Pilates or barre.
The adult soccer league is really prominent here in Asheville, and while it may be recreational and for fun, adults are still at risk of injury. Before you dive in to a soccer game, particularly if it’s been a while, be sure you maintain your strength off the field and properly warm up and stretch. If you’ve been out of the game for a while, it’s important to prepare your body for the sport you are playing to prevent chronic or acute injuries.
Seeking Medical Care
If someone is significantly injured, they should discuss their injury with a coach or athletic trainer – athletic trainers are great liaisons who are trained to manage on-field injuries. If this is not an available option and the player cannot continue the game, then they should stop playing and seek medical care. If you feel it’s an emergency, then urgent care or the emergency department may be your best option; most injuries are okay to be seen the next day or on an outpatient basis.
Work hard, rest hard and have fun!
The Mission Orthopedics and Sports Medicine team strives to help patients heal in the least invasive manners possible. When it comes to rehabilitation, our orthopedics and sports medicine teams provide innovative and personalized care, treating you as we would treat our own family. We offer a multitude of treatments, including:
- physical therapy
- bracing
- injections
- PRP (platelet-rich plasma)
- stem cell therapy
- surgery
Elise Hiza, MD, is an orthopedic surgeon and the director of Mission Sports Medicine.
