With the end of the amazing FIFA World Cup 2014, there is an exponential increase in acute soccer related injuries. As an orthopedic surgeon, it is amazing to see such an intrinsic rise in sports related injuries that correlate to the “sport dejour”. During Wimbledon or the Super Bowel. I see an increase in tennis and or football related injuries. Often these injuries occur in the weekend warrior or warrior princess, who has not been very active for an extended period of time. The current trending sport inspires these individuals, which is ultimately a good thing, however sometimes their enthusiasm and lack of overall fitness puts them at a higher risk for acute injury. I often remind them that it is imperative to have a focused fitness program to avoid injury and for appropriate rehab after an injury.
Here are most common acute soccer injuries that I have seen since the FIFA World Cup. This is a list of the 5 most common acute injuries that I diagnose in adults from playing soccer.
1. Ankle Sprains
Ankle sprains can occur from a misstep, a fall, from running or from an on-field collision. An ankle sprain is an injury to the ankle ligaments or ligaments complex surrounding the ankle. The patient often presents with an inability to bear weight on the ankle, swelling bruising and, of course, pain. The injured athlete can use the basics of R.I.C.E.- Rest, Ice, Compression and Elevation- during the initial triage treatment before and evaluation by their preferred healthcare practitioner. Depending on the severity of the sprain, treatment can involve the following over-the-counter anti-inflammatory medications (like naproxen or ibuprofen), splinting, the use of on air cast walking boot, short leg casting, or even surgery. Sometimes an x-ray or radiograph of the ankle and leg are needed if certain protocols are met.
I highly recommend a proprioception re-training program after an ankle injury. A balance disc and wobble boards are effective tools which can assist in strengthening the ligaments of the ankle and intrinsic muscles of the foot.
2. Low Back Pain
Low back pain is an extremely common problem that I see in patients who are injured while playing soccer. This strain over the lower back muscles can occur from excessive strain, torque, pulling, and direct contact on the soccer field or from a fall. Low back pain may occur from a lack of training or under developed core muscles strength. Most low back pain can be treated with rest, gentle stretching and OTC anti-inflammatory meds like ibuprofen or a prescribed muscle relaxer. I highly recommend acupuncture for this injury also. After 2 or 3 days of rest but not immobilization, most low back pain improves significantly. X-ray/ radiographs are seldom needed in the initial evaluation and management of low back pain. The key here is to return to activity slowly and progressively but more importantly to start an uncompromising, sustainable fitness regimen, which is dedicated to core strengthening techniques for the abdominal, pelvic and lower back muscles. This is essential to avoid and minimize further episodes of low back pain while playing soccer or any other sport.
3. Muscle Strains
Muscle strains involving the hamstring and groin muscles (adductor muscles) are extremely common injuries that occur during soccer. These injuries appropriately treated with rest, NSAINS, taping, gentle massage and stretching. It is really important to make progressive return to sports activity. This type of injury can easily exacerbated if not well healed before returning to play.
4. Achilles Tendonitis
This form of tendonitis is often seen in soccer players from an acute issue with respect to overuse for that day or this can be a chronic overuse problem. Achilles tendonitis can commonly be treated with rest, stretching, NSAIDS and sometimes immobilization with a walking boot or a cast. This usually resolved well with rest; however, I often remind patients that it is imperative to stretch before, during and even after soccer play or any other sport. Rupture of the Achilles tendon can be a devastating injury, which may need surgical injury depending on the severity of the rupture. If completely ruptured and retracted, surgical intervention is the standard of care.
Fractures of the wrist and clavicle are also frequently seen injuries related to a fall or collision while playing soccer. After x-rays reviewed, most clavicle fractures are treated with a sling, rest and anti-inflammatory medications. Clavicle fractures rarely need surgical intervention but if there is significant displacement and comminution of the fracture, surgery may be indicated. Commonly non-displaced wrist fractures are treated with rest, anti-inflammatory medications and immobilization via a splint or cast. Displaced wrist fractures may need surgical reduction and stabilization.
Soccer continues to be an amazing sport, which will help individuals get into shape, lose weight and maintain an elevated level of fitness. The specific injuries discussed, which I see in patients due to soccer, are often preventable if we increase our intensity and level of play incrementally. Life is truly a marathon and not a dash so we must continue to strive to be more fit via a progressive and consistent fitness program and by eating a balanced diet.
If you are injured while playing soccer be sure to get an evaluation by a medical practitioner as soon as possible. Be sure to avoid any weight bearing on the injured area and minimize movement of the painful area, until cleared by your health care provider.
Keep on Exercising! Exercise is Life!
D. Levi Harrison, MD