Let's Break to Educate: Common Soccer Injuries with Anthony Howell

Video Transcription

Good afternoon. My name is Anthony Howell. I'm a physical therapist at CHI Saint Joseph Health – Outpatient Rehabilitation. Thanks for joining us today for Let's Break to Educate. Today's topic is going to be common soccer injuries.

Types and Treatments of Common Soccer Injuries

So, what I'm doing today, we'll just break it up into four common types. We'll talk about: 

• Contusions
• Fractures
• Sprains 
• Strains. 

Contusions

The first two are pretty straightforward. Contusion is just another name for a bruise. 

Bruises are very common in soccer. You get it from running into another player, getting knocked down or falling to the ground. Typically, contusions aren't any type of injury that's going to have you losing any playing time. They usually heal on their own without much treatment. They can be painful or a nuisance, but typically they don't really set you back any, and they'll heal on their own. 

Fractures

Second, we'll talk about fractures. Fractures are obviously much more significant than a contusion. A fracture is just a broken bone. There are three areas, really, in soccer that you'll see some of the most common fractures – one's an ankle fracture. You'll have a player that's running. They'll plant their foot and try to cut or turn real quickly, and roll that ankle over.hey can experience a fracture there or just collide with another player and step on their foot. They can roll it over, and you'll have that fracture.

A couple of other areas – one is a wrist fracture. Even though the soccer players don't really use their upper bodies that much to actually touch the ball, what will happen is the player will fall and as the player falls, they'll stick their hand out. They'll fall on their outstretched hand, and it can cause a wrist fracture.

And then, also along the same lines, the falls can cause another kind of common fracture in soccer, and that's the collarbone. When a player falls and they land on their shoulder, sometimes you'll get that collarbone fracture, and those injuries are a much more significant loss of time. You're looking at least six or eight weeks just for that area to heal and then just the rehab to get back. So, you're definitely losing a lot of time with those types of injuries.

Sprains

So, then we move along to sprains. A sprain is just an injury to a ligament. A ligament is a thick band of tissue that connects bones together and provides stability, and so a sprain is just when you overstretch that ligament. Once you get that body into a position that really stretches that ligament, it can be a mild injury that only takes you a day or two to recover from, or it can be a fairly significant sprain, where you actually tear or rupture that ligament when that happens.

Some common areas in soccer, again, what you'd probably think of, you're looking at knee sprains and ankle sprains. The knee sprain – two pretty common ligaments that get injured are the MCL ligament, which is the medial collateral ligament, and that's located on the inner portion of the knee, and then you have the ACL, or the anterior cruciate ligament, which is one of the ligaments located inside the knee joint itself. The ACL, I'm sure you've heard many times, that's the injury that a lot of people don't want, that you hear about when they tear an ACL.

Once you tear that ligament, it's not going to heal on its own. You're going to end up in surgery, and then you've lost your year of playing with that. Rehab, you're typically looking at 9 to 12 months to get back from that type of injury. A lot of times those are even non-contact injuries. Someone will plant and turn, and they'll twist their knee. And there's that pop that you'll hear athletes always describe that they feel, or that they hear, when they tear their ACL, and a lot of people know right when it happens that something bad has happened, and it ends up being that ACL that's torn.

And then we'll sort of move on to the, actually, it's the most common injury overall in soccer, is an ankle sprain. The ankle sprain is, it affects the ligament most commonly that's located along the outside portion of the ankle. Same thing when I was talking about the fractures of the ankle, the sprains happen a lot of times the same way. The player will plant their foot and they'll just roll that ankle over, or they'll step on another player's foot, and they'll roll that ankle over. And that just really over-stretches those ligaments on the outside of that ankle. It can be from a day or two you miss to several months, depending on the severity of that sprain.

The tricky thing with ankle sprains is a lot of people will just put a brace on and think they're fine to go back and they'll try to rush that rehab back too soon. And then one of the primary things that you'll see are actually 24% of all soccer ankle sprains reinjure or resprain that injury. So, it's something you really need to watch for and do the proper rehab and heal correctly before you try to jump back into playing, because you're just going to end up setting yourself back a long time if you try to jump back in too quickly. That's a very common thing that you'll see and that we end up getting in here in physical therapy are people that have recurrent ankle sprains. That just prolongs that rehab and that prolongs that missed playing time. So, then we'll move on to strains.

Strains

So, a strain, as you know, is just injury to a muscle or a tendon. So, a sprain is a ligament, a strain is a muscle and tendon. And same type of thing, you overstretch that tissue in there, and that's how you get that strain. And it can be anywhere from a mild injury to a pretty significant strain, which is an actual tearing, a complete rupture of a tendon or a muscle. And those will set you back. Same as what the other significant injuries, several months missing a whole year of playing time with that.

The common areas in soccer that you'll notice, most of the strains are the quadricep muscle, which is the muscle in the front of the thigh, hamstring muscles, which are the muscles in the back of the thigh, and then the calf muscles. And you'll see a lot of strains there, and all of them vary in degrees of severity, but typically we see that the quadricep strains are the ones that will cause someone to miss the most amount of playing time. Those muscles take a lot of abuse. They produce a lot of power when you're running, and so those will really sets you back quite a bit if you injure that area.

Looking at sprains and strains both, typically when that happens, when someone is affected by one of those injuries, they'll have pretty immediate pain. You can have swelling, you can have bruising, and all of that depends on how bad the injury is. Typically, with sprains and strains, if you end up seeing bruising, that's a fairly significant injury. That's just showing that you've torn something enough that you've caused some bleeding underneath the skin, and that's what produces that bruising color, the purple, green, black color that you'll see. And that again, just kind of prolongs that healing time. 

The RICE Method

The best course of action, if you have any injury like that, is just to focus on that RICE method. You may have heard of that before, but the RICE is – the R is just for rest. So, quit playing. Take the weight off that area. Just let that area rest for a bit. 

The I is for ice. Put some ice on it, whether it's around the ankle, around the knee, wherever, just wrap you an ice pack around it for about 15 or 20 minutes at a time. 

C is for compression. So, compression is to take an Ace wrap, you wrap that Ace wrap around that area, and it doesn't need to be real tight, but you want just a little bit of compression on that, around that joint, just to keep the swelling down. 

And then the E is for elevation. The elevation is to raise that body part up. You want it to get it above your heart to try to decrease some of that swelling in the area. So, again, if it happens to be your ankle, typically you're going to need to lay down. You can prop that leg up so you can get the ankle above the heart so you can get that swelling to decrease with that. 

And then, depending on the severity of it, if it's more of a significant injury, then you should probably go ahead and follow up with your physician or your physical therapist, or if you have a trainer on staff, someone to further assess it to see really does this need further treatments or further diagnostic testing or imaging. Whether it be x-rays or MRIs, as I said before, you don't want to jump back into playing on an injured body part and then just reinjure it again. And then you're just, you're setting yourself back too much.

Preventing Common Soccer Injuries

Looking at injuries and what helps us solve the injuries, and you think, "So, what do we do about that?" You really have to start talking about prevention. 

So, prevention starts in the off-season. You want to be working in the off-season on getting those muscles stronger, working on your agility, your quickness and working on your speed. For soccer, you really think about working on your hip muscles, your knee muscles, your ankle muscles, all of those areas where they take a lot of the abuse and a lot of the power when you're trying to run and stop and kick and plant. 

And, hopefully, you'll have someone that can set up a decent program for you to do that, whether it be your coach or again, a trainer or a therapist or someone that can set up a decent program for you in the off-season, that you can work on those types of things to help to prevent injury down the road. The stronger and more flexible you are going into the season, the much less risk you have of injury when you go at it that way.

Also, think about before games and before practice that you also warm up. You'll see a lot of warmups in organized sports where they’re, it's a team sport, if it's high school or whatever. But, sometimes what we don't see is the weekend warriors who decide to run out and jump into a soccer game and then when they end up in here in therapy the next week, because they've strained something just because they didn't warm up.

So, warmups before practice or before a game doesn't have to be anything fancy. I'd start off with just a little light jog, just to warm the muscles up. After you're jogging, add a little bit of stretching into it. You can do some dynamic stretching, which is stretching where you're moving the limb or the body part through a full range of motion, where you're doing some extra long strides when you're running or some lunge walking, things like that. And if you have a particular area that's significantly tight on you, that's troublesome, you can throw some static stretches in, too, where you're just, that's the common stretch you'll see people do where they just lean and hold a stretch for an extended period of time. So, you can do both of those stretches, but don't forget the dynamic stretching when you're warming up.

And then start off after you do get a little warmed up with your jogging and your stretches, then I would just start doing some passing drills, some short kicks, and then slowly with your partner back up, starting to do some longer drives with your kicking. Progress to doing some shots on that. Again, backing up, doing some longer shots with that. Then I would finish up with just doing some quick sprints, up and down the field, nothing real long, but just making sure that the muscles are flexible and that they're stretched out. The muscles are warmed up and ready for the activity of the game.

Conclusion

So, the take-home message, I think, is injuries are part of the game. Most people deal with some sort of injury during their playing career. But, if you prepare for the season by doing your pre-season, your off-season workouts and getting stronger, warming up before the game, you can really decrease that risk of injury. And then also thinking about if you do get injured, making sure that you really rehab that injury before trying to get back in too soon. You end up setting yourself back if you try to jump back in too soon, and just prolonging that rehab time and missed game time.

I hope this was educational for you guys. If you have any questions, always feel free to call us here. I'm actually based at the office park here at Saint Joseph Office Park on Harrodsburg Road. You can call us at 859.313.1699. Thank you for joining me for Let's Break to Educate, and you guys have a good afternoon.