A Guide To Treating Common Soccer Injuries

Jenny Sanders, DPM

Given the popularity of soccer and the fact that most soccer injuries involve the lower extremity, this author offers pertinent treatment tips on ankle sprains and strains, pearls on proper shoe fit and keys to orthotic modifications.

A large-scale 2006 Federation Internationale de Football Association (FIFA) survey shows that soccer is the world’s number one sport. There are 265 million male and female players, and 5 million referees and officials. A grand total of 270 million people — or 4 percent of the world’s population — are actively involved in the game of soccer.1

   Of the 18 million Americans who play soccer, 78 percent are under the age of 18. In the 1990s, soccer was recognized as the fastest growing college and high school sport in the United States.2 The popularity of soccer has grown, especially among women, since the U.S. women’s soccer team won the World Cup in 1991 and 1999. In the United States, 35 percent of soccer players are women, one of the highest percentages of female participation in soccer in the world. Female participation in high school soccer has risen by more than 177 percent since 1990.3

   Previous studies have shown that soccer has a high injury rate and injury percentage. More injuries occur in soccer than field hockey, volleyball, handball, basketball, rugby, cricket, badminton, fencing, cycling, judo, boxing and swimming. Most soccer injuries occur to the lower extremities, especially the ankle.4

   Player to player contact is reportedly a contributing factor in 44 to 74 percent of soccer injuries. Most ankle sprains occur during running, cutting and tackling activities. Sixty-seven percent of foot and ankle injuries occur from direct contact. Significantly more injuries involve a force from the lateral or medial direction in comparison to an anterior or posterior direction. Researchers have noted that the weightbearing status of the injured limb is a significant risk factor.5

   High school soccer participation in the United States increased fivefold over the last 30 years. With increased participation comes increased injury incidence. Overall, the most frequent diagnoses were incomplete ligament sprains (26.8 percent), incomplete muscle strains (17.9 percent), contusions (13.8 percent) and concussions (10.8 percent). The most commonly injured body sites were the ankle (23.4 percent), knee (18.7 percent), head/face (13.7 percent) and thigh/upper leg (13.1 percent).6 Sprains, contusions and strains of the lower extremities were the most common injuries in men’s collegiate soccer with player-to-player contact the primary injury mechanism during games.7 Ankle ligament sprains, internal derangements of the knee and concussions were the most common injuries in women’s collegiate soccer.8

   Based on the prevalence of soccer injuries, it is important for podiatrists to be aware of common treatments for soccer injuries as well as recommended rehabilitation after injury.

How To Address Ankle Sprains

The single most common injury in soccer is the ankle sprain. Most ankle sprains are inversion sprains (85 percent), mainly involving the lateral ligament complex.9

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