Football is a great way to build endurance, improve speed, and stay fit, all while enjoying the team's camaraderie. And football is a relatively safe activity, with an injury rate of one-fifth to one-half of that in American football. But football does involve quick start-and-stop motions and physical contact, which can lead to injury.
Risk of injury is no reason not to play football, though. Football players just need to be aware of the risks and know what steps they can take to play as safely as possible.
Injuries to the ankle, lower leg, and knee—usually sprains—are the football injuries that occur most often. After ankle sprains , medial collateral ligament sprains of the knee are most common. The pivoting and lateral movements of football contribute to these injuries.
A good warm-up and careful stretching may help prevent some sprains. To avoid unnecessary risk, always check the condition of the field before you play. Don't play on fields with holes, glass, or rocks.
Muscle strains can be caused by:
• Pulling a muscle too far in a direction it doesn't want to go
• Contracting a muscle hard against resistance
• Contracting a muscle hard when the muscle is not ready
The most common muscle strains in football occur with groin muscles, hamstrings, and quadriceps. A muscle strain won't send you to the emergency room, but it can be painful and can keep you off the field for a few days or weeks. Strains occur frequently in football due to constant stop and go movement, or taking a longer stride than muscles can handle.
Good flexibility can lower your chances of muscle strain. Always stretch well after warming up. Focus on stretching the areas most susceptible to strain, but don't neglect other areas. The more flexible you are, the less likely you are to stretch beyond your capacity and pull or tear a muscle.
Wearing well-fitted cleats with appropriate spikes (longer spikes in softer turf and shorter spikes on dry, hard turf) may also help prevent strains. On especially hard surfaces, she says you may want to wear a turf shoe with no spikes.
The majority of football-related fractures are also in the lower extremities. Fractures often occur as a result of contact, so wearing protective gear like shin guards is extremely important.
4. Knee Injuries
Knee injuries constitute the most common type of major injury in football. It is estimated that the medial collateral ligament, the meniscus, and the anterior cruciate ligament (ACL) are the parts of the knee most often injured in football.
Many knee injuries, especially ACL ruptures, occur away from contact. They are often the result of putting too much of a load on the knee joint during the sudden stops and starts of football. Therefore, proper footwear, good field conditions, and appropriate strength training are the keys to prevention. Working on hamstring, quadriceps, and hip flexor strength in the weight room is suggested.
5. Head Injury
Head injuries, including dental, eye, and brain injuries, constitute about 5% of football trauma. They explain that closed-head injury is most often the result of a collision between players. Concussion occurs often when players try to head the ball and miss and collide with another player or a goal post.
While there has been some concern that repeated heading of the football ball leads to chronic brain injury, the most comprehensive study to date—does not suggest that repetitive heading alone causes long-term neurologic impairment.
It is important to head the ball with proper form. A study of elite football players at the 1993 Olympic Festival showed that properly executed heading was not found to result in any concussive episodes. Correct heading involves use of the frontal bone of the skull to contact the ball, the neck muscles to restrict head motion, and the muscles of the lower body to position the torso in line with the head and neck…"
And always make sure you hit the ball; don't let the ball hit you. Working to strengthen your neck muscles using isometric exercises is recommended. For example, use your hand to provide resistance against your head. Then use your neck muscles to turn your head right, left, forward, and backward. To protect your mouth and teeth, wear a fitted mouth guard. You may also want to consider protective eyewear.
As with a ny sport, a good warm-up is important to an injury-free football experience. The following routine is recommended:
• Cardio: Start with a few laps to get your heart rate up.
• Stretching: Focus particularly on the lower body and hips, and don't forget to stretch your neck gently.
• Passing: Begin with short distance passing, then move gradually into longer distance drives.
• Shooting: Work up from lighter, shorter shots on net to harder shots.
• Sprinting: Include a few short distance sprints.
Finally, don't play if you are tired and therefore more prone to injury. Hydration and good nutrition will help stave off early fatigue.
Football is a growing sport today. Notably, more female athletes are choosing to play football. With this added participation, it is inevitable that more injuries will occur. Many of these injuries are linked to physical training and conditioning.
The most common injuries in football typically involve the ankle, knee and hip region. Such injuries include ankle sprains, knee ligament sprains, meniscus tears, and muscular strains (hip and groin). ACL injuries are now reaching epidemic proportions, especially in the female football athlete.
Research has indicated that proper training programs can and do reduce ACL injuries and will help prevent other sports related injuries. Much of the research has indicated that strengthening, jump landing technique and agility training affect the risk for this type of injury.
The following list will outline how to effectively reduce common football injuries.
1. Perform a year round strength training program with special emphasis on balancing the muscles of the leg and targeting the core muscles (low back, abdominals and hip).
2. Understand the energy systems utilized in football and train them according to performance demands. This involves the proper blend of training aerobic endurance and anaerobic power to ensure explosive performance over the entire course of a match. Fatigue late in the match can lead to injury.
3. Perform routine stretching to prevent muscular imbalance and tightness. This refers to static stretching that should be done after a suitable warm-up or at the end of practice.
4. Perform supervised, carefully planned plyometric (jump) training to teach proper landing form and develop power.
5. Incorporate dynamic balance training to teach body control and reduce ankle sprains and knee injuries.
6. Take planned periodic rests from practice and play to avoid overtraining.
7. Perform routine agility and quickness drills to improve footwork and cutting ability. Many ACL injuries occur with non-contact cutting movements and it is critical for athletes to cut on a bent knee and be able to control their momentum during change of direction.
8. Perform a dynamic warm-up prior to practice and games that effectively simulates sport specific movement. These activities will better prepare the body for the demands placed upon it during competition. This can be further broken down into general and specific functional warm-ups.
9. Perform yearly pre-season physical screening evaluations with an athletic trainer or physical therapist to assess any musculoskeletal areas of weakness.
10. Perform pre-season, in-season and post-season fitness testing to assess training methods, performance and conditioning. This protocol will allow the coaches to adjust training volume, intensity and modalities to ensure that their athletes are peaking at the right time and not training improperly.
All of these suggestions are important in developing complete athletes and preventing common injuries. They will not prevent all football injuries, however, they will greatly reduce the risk potential and enhance athletic performance. The ultimate key to injury prevention is understanding the sport of football and developing a program designed to address its demands on the body.
Prevent Common Knee Injuries in Football
The top four time loss injuries in football are ligament injuries (to the ankle and knee) and muscle strains (to the hamstrings and groin). The top injury depends on the level of play. In highly intense, competitive football, hamstring strains are being reported as the top time loss injury. In lower levels of play, the lateral ankle sprain is the most common time loss injury. But the injury that leads to the most concern, especially amongst middle and high school aged females, their families and coaches, is an injury to the knee, specifically to the anterior cruciate ligament.
While an injury to the ankle is usually isolated to the lateral ankle ligaments, injury to the knee is far more complex and varied. Injuries can happen to the ligaments, tendons, meniscus, or articular cartilage. This all too brief description may stimulate your interest to learn more about any specific injury.
Ligaments: There are four primary (and a number of supporting) ligaments. The (medial and lateral) collateral ligaments are located on each side of the knee and prevent the knee from collapsing inward (valgus) or outward (varus). The MCL is injured during the classic ‘clip’ in American Football. An injured LCL is pretty rare. Injuries to the MCL and LCL rarely require surgery. The other two, the anterior and posterior cruciates, are located within the joint and restrict rotation and anterior and posterior movement of the tibia under the femur. These are usually injured during over rotation of the tibial alignment with the femur.
Tendon: The main tendon of the knee connects the quadriceps muscle to the patella and tibia. The most common injury is related to overuse, sometimes called a ‘jumper’s knee’. There are reports of the tendon tearing, but this is pretty rare and doesn’t happen to a normal tendon. The problem is no one knows they have a diseased tendon until it tears.
Meniscus: These two crescent moon shaped cups sit on top of the tibia, cushioning the femur. What these discs do is quite complex and injury to a meniscus leads to problems later. Rotation of the femur over the tibia is the usual cause of meniscus injury. If you read of an athlete having arthroscopic surgery and returning to play within a few brief weeks, it’s probably safe to assume an injured meniscus was the surgical target.
Cartilage: Covering the ends of long bones, including the femur and tibia, is a remarkable tissue that protects the underlying bone during movement. Left undamaged, this tissue can last a lifetime. Knee function is severely limited if the articular cartilage is damaged by injury or arthritis. Surgical repair techniques are still evolving. When you read of an athlete retiring because of some generalized knee issue, you could be safe is guessing that articular cartilage damage is at the root of their inability to continue playing.
While there are a number of potential injuries to the knee, most of the prevention programs are directed at preventing ACL injury. What is interesting is that the interest in the ACL is relatively new; the first paper on ACL surgery was published in 1972 and to date there has been nearly 9000 scientific papers published about the ACL. Googling ‘anterior cruciate ligament’ today resulted in nearly 1.1 million hits.
Just what is the rate of ACL injury in football?
An ACL rupture is certainly is one of the most serious knee injuries in sport, but with surgery and rehabilitation, most athletes return to play within 6-12 months. The actual rate of ACL injury varies according to sex, age, sport and more. More males are injured simply because more males than females play sports. Surgical records of physicians show that ACL injuries in sports are mostly non-existent before puberty. The numbers begin to climb beginning about the age of 14 and peak in high school, and then drop a bit to a plateau during college years before dropping again. Thus, one sees there are essentially three distinct injury rates based on age: 14-18 (middle/high school), college years, post college.
How do injuries occur?
ACL injuries can happen from direct contact to the knee, but most often the injury happens in the absence of any direct impact on the knee. The usual description is a rotation of the femur over a fixed tibia when the knee is near full extension. During play, this could be when a player plants their foot and changes direction. A specific and complex sequence of events has to happen to tear the ACL. Most feel that if the knee is near extension and then collapses inwards, the ACL is placed under considerable strain and can tear. When it does tear, the athlete feels immediate pain and instability of the knee. They many even hear an audible ‘pop’ when it ruptures.
Why women have more injuries than men is a matter of intense study. Most reports focus on differences in how women land and cut. Men tend to lower their center of gravity when landing or cutting while women do these in a more erect posture. Cutting or landing on an extended knee places the ACL at risk.
Devise prevention programs.
Many prevention programs have been attempted, but the most effective and successful programs combine core strength and neuromuscular control of the knee during landing and cutting.
Sample prevention program:
1. Warm-up: Back and forth across the field, jogs, then zigzag run, then jog backwards.
2. Stretch: calf, quads, figure four hamstrings, inner thigh, and hip flexor.
3. Strengthening: walking lunges, Nordic hamstrings (link that word to the hamstring article?), single toe raises.
4. Plyometrics: lateral hops over a cone, forward/backward hops over a cone, single leg hops over a cone, vertical jumps with headers, scissors jumps.
5. Agilities: shuttle run forward and back, diagonal runs, bounding run.
Alternative exercises are offered for variety. These include bridging with alternating hip flexion, abdominal crunches, sitting and double knee to chest, figure four piriformis stretch and seated butterfly stretch.
Re-assess injury rate to determine the program’s effectiveness.
Most injury prevention programs lead to overall reductions in injury rates of 30-40 percent. What is interesting about prevention programs is that they truly work. Look around at most training sessions and you will probably see well-designed practice plans for skills and tactics, but the weakest part of a training session is likely be the warm-up. So rather than just leave your fellow players to themselves for warm-up, consider a plan that follows some of these programs. You will have a healthier team with fewer injuries better prepared to fulfill your vision of how you want your team to play.