Preventing Injuries in Football

Understanding injury prevention in football has never been more important, with the demands on players increasing. More fixtures, less rest

Written By: Dr. Raphael Villatore MD

In the dynamic world of soccer, the allure of success at the highest levels has never been greater. The lure of substantial financial gains for those who conquer the elite echelons of the sport is undeniable, creating a magnetic pull that resonates throughout the entire soccer ecosystem.

From grassroots enthusiasts to amateur hopefuls, the ripples of this pursuit touch everyone involved, shaping the sport’s fabric in remarkable ways. As the pursuit of glory intensifies, athletes find themselves navigating a landscape of escalating expectations. The spotlight burns brighter, the demands grow greater, and the stakes become ever higher.

This phenomenon isn’t confined to the upper echelons alone; it trickles down, infusing every level of the game with an undeniable energy. The passion that fuels a child’s first kick, the camaraderie that ignites on amateur fields – all are connected by the shared dream of soccer excellence.

Yet, with every step toward the pinnacle of achievement, the challenges that athletes face also evolve. One of the most pressing is the relentless pace of the modern game.

Fixture schedules have expanded, weaving a dense web of matches that demand peak performance. In this unyielding rhythm, time for recovery becomes a precious commodity, stretching thin the line between pushing limits and risking injury. The exhilarating highs of competitive match play are met with the need for strategic rest and recuperation.

Soccer player of Botafogo team (Igor Rabello) during a Brazilian Championship Soccer match. Botafogo team versus Vasco da Gama team.

This paradigm shift is most vividly illustrated when looking at the grassroots and amateur levels. Here, the influence of professional soccer reverberates powerfully. The once-simple joys of playing with friends on a local field now dance in step with the demands of the highest stages.

The dream of making it big means that health and well-being must be approached with a newfound seriousness. The pathway to success, while exhilarating, necessitates a balanced approach to training, nutrition, and self-care.

Amidst these challenges, the ongoing professionalization of soccer has cast a steady light on the holistic welfare of players. The beautiful game is embracing a more comprehensive understanding of what it takes to excel, recognizing that success cannot be solely measured in trophies. The player’s well-being, both physical and mental, has emerged as a priority, reminding us that the pursuit of greatness should never come at the expense of personal welfare.

In this era of shifting dynamics, soccer stands at a crossroads of innovation and tradition. The glittering rewards of success beckon, but they are accompanied by heightened demands and evolving considerations.

As we marvel at the breath-taking goals and heart-stopping saves, let us also remember the dedication, sacrifice, and resilience that underscore each moment on the pitch. The story of soccer is not just one of goals and victories; it’s a narrative of dreams, challenges, and the unbreakable spirit that propels the game forward.

A deeper dive into this area has revealed how elite level players competing at the higher echelons of world soccer such as Lionel Messi, had accumulated between 64 to 69 official competitive games through seasons 2011-2012, 2010-2011, & 2009-2010.

This in itself highlights not only the physical demands imposed on top players and explained within the ISSPF accredited online sport science course ‘Physical Training & Soccer Methodology Course’ but the need to have a physical & psychological robustness to remain injury free.

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Injuries in Football

Delving into the realm of injury prevention strategies and exercises requires a foundational understanding of the nature of injuries themselves. An injury is marked by an abnormal alteration in bodily structure, arising from either external or internal factors, wherein energy transfer surpasses the capacity of a football player or soccer athlete to sustain functionality. Within the context of sports, a sports injury is characterized by tissue damage resulting from engagement in athletic activities or physical exercises.

According to FIFA, the governing body of football, an injury pertains to any physical ailment experienced by a football or soccer player during a match or training, irrespective of the need for medical attention or the duration required for recovery.

Cristiano Ronaldo 7 is injured on the grass. AC Milan - Juventus. Italian Serie A TIM. Giuseppe Meazza Stadium

Given the inherent dynamics of the sport, with its predominant reliance on the lower extremities for ball control, manipulation, and movement, injuries are most commonly concentrated within this anatomical region. As previously emphasized, approximately 60% of all soccer injuries manifest in the lower body, with the knee accounting for 25% of these cases, closely followed by the ankle.

Central to our discussion are muscle strains, constituting 35% of reported diagnoses and leading to extensive training downtime across all levels of the adult game. This not only impacts the athlete’s progress but also results in financial losses due to missed game opportunities. Sprains, contributing to 20% of injuries, and contusions, spanning between 16% to 24% of cases, further compound the injury landscape.

It is noteworthy that contusions, commonly associated with physical contact, seldom translate into lost training or competition days, as evident from injury audits conducted globally. Accumulated studies within this domain consistently underline a select group of injuries responsible for substantial participation disruption. These injuries transcend competition levels and gender, with ankle sprains, knee sprains, hamstring muscle injuries, and adductor tears taking the forefront. Collectively, these injuries contribute to nearly half to two-thirds of the total soccer-related injuries.

As we delve into the realm of soccer coaching, armed with this comprehensive understanding of injury profiles, we are poised to explore effective strategies and exercises that can safeguard players and ensure their sustained engagement in the beautiful game.

What are the Most Common Injuries in Football?

  • Ankle sprain
  • Hamstring strain or tear
  • Calf strain or tear
  • Anterior cruciate ligament damage
  • Wrist fracture
  • Contusion issues
  • Adductor tear or strain
  • Broken metatarsal

Soccer, sports and ankle pain, injury or accident on a field during a game, exercise or training. Muscle sprain, broken joint or medical emergency of a man athlete at a football pitch during a match.

What are the Main Causes of Football Injuries?

  • Poor training session design & training load management
  • Lack of strength, stability & endurance to perform the activities required
  • Injury history
  • Contact or contusion related issues
  • Muscle fatigue, structural or biomechanical issues
  • Age of the soccer or football player
  • Environmental issues (playing surface, pitch or climate)

Having briefly overviewed the importance of understanding injuries and the types of injury sustained in the game or training, we must digest how we can assist players & further explore injury prevention in football and what are the main causes of soccer injuries?

What is Injury Prevention?

  • Injury prevention in a sporting context is an effort to prevent or reduce the severity of athletes, or players’ injuries caused by external & internal factors
  • Developing processes & interventions to minimise the risk of injury before they occur, is a key factor when it comes to injury reduction.

Within soccer cohort’s lower injury incidence & higher match availability have been associated with increased points per league match.

Similarly, these key measures are furthermore associated with an increase in clubs seasonal coefficient points system, reflecting success in the various international or continental (UEFA, CONEMBOL, ASIAN) Champions Leagues or Copa Libertadores equivalents across the world.

Young Soccer Players in Team on Training with Coach. Boys Training with a Gym Ball. Stability Training On Junior Male Soccer Team. Coach Instructs Players How to Exercise with Gym Balls Properly

As reported in this context, modern day soccer involves continued, intensive cycles of training & games which predisposes players to greater injury risks & the most common injuries caused due to the accumulation in fatigue.

Previous investigations within this area has already found significant correlations between low training & match availability due to injury, with decreased team success (Arnason et al, 2004) –  which is quite a common sense statement on the fact that ‘teams need their best players available more of the time to be successful’. Furthermore, teams and clubs with less resources or limited financial budgets will be placed under greater stress during fixture congestion, and further highlights the needs of these clubs to maintain high levels of training availability & have their best players available.

During the current COVID-19 pandemic, we heard from many managers asking for more time between games & the increased injury rates across the 2020 season.

The majority of injury prevention training studies surrounding football injuries today have generally examined the effects of individual components on injury incidence. However, this is not representative of a soccer specific environment where the time constraints are very apparent emphasising the need for the development of a mixed conditioning approach that allows for the simultaneous development of several fitness qualities, inclusive of injury prevention strategies.

From a practical perspective, injury prevention programs are generally implemented with the expectation to elicit improvements in performance, through increasing players’ availability & reducing lay-off durations when injury does occur, whilst reducing the incidence of injury.

Injury Prevention Exercises for Soccer

What are some ways to practice soccer injury prevention?

Key elements that should be included within these strategies according to previous research in this area are:

  • Functional strength development – linked to sport specific movements.
  • Eccentric strength – overloading the key muscle groups related to injury.
  • Isokinetic testing – in order to highlight key areas of strength focus.
  • Balance & proprioception training – strengthening key areas & joints linked to injury.
  • Plyometric exercises – development of strength & power linked to robustness.
  • Training load management – ensuring coaches balance fatigue, fitness & freshness.
  • Functional movement screening – ensure players or athletes are capable of moving with sound efficiency before loading or training.

Football Balance Training. Youths on Stability Sports Training on Balance Cushions. Young Soccer Players Improving Core Strength, Balance and Stability Skills. Grass Football Field. Coaching Soccer

When discussing the injury which causes the greatest financial burden to teams, clubs, players & organisations through competitive & training time loss – hamstring strains & tears are the greatest….

The increase in the specific strength of the hamstrings can be very helpful in the prevention of team sport injuries: one specific study amongst professional soccer players involving them performing a 10-week strength training program, emphasized how eccentric hamstring overload exercises significantly reduced the incidence of injury in the control group with a decrease from 67% to 20%.

Pre-existing injury is one of the most important factors, and as a result the preventative work performed is imperative to minimise the initial risk.

Through the medical & sport science links from within FIFA, a specific warm-up program known as the FIFA 11+ which consists of 10 simple & short exercises aimed at structuring a warm up & injury prevention strategy that requires minimal equipment. The FIFA 11 + consists of 3 stages: 1) running exercises & 2) strength-plyometrics & balance followed by 3) 2mins of more extensive & increased intensive exercises.

How to Implement Injury Prevention Programs in Soccer

Injury prevention strategies as they are known within a sporting context, are a common feature in a practitioners training schedule & increased as an area of research & innovation in recent times.

Despite numerous training exercises available & implemented within a multicomponent training program, there seems little evidence-based guidance as to what exercises may be considered effective in actually reducing the incidence of injury.

A recent study in elite level soccer reveals how a multi-component injury prevention program (ie. Proprioception, Functional Strength, Core Development & Mobility) within the elite level of the game can have significant effects on the incidence of muscle strains & tears, which are regarded as the most commonly encountered injury in soccer across many levels. However, the findings from within this study did reveal that the injury prevention strategy used may not be adequate in reducing the total number of injuries.


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Further Developments

The realm of injury prevention strategies has witnessed a remarkable surge in research and literature reviews in recent years. Simultaneously, the demand for specialists focused on injury prevention within football has been on a consistent rise, leading to a burgeoning field of sport science jobs.

The influx of sport science graduates into the job market is accompanied by a pressing question: What comes next? How does one transition from completing a sport science degree to securing a position in professional football? This entails comprehending the intricacies and soft skills indispensable for careers within the realm of sports.

Navigating this transition is an intriguing journey, particularly when moving from academia to the dynamic world of professional football. The landscape of injury reduction, prevention, and return-to-play strategies, pivotal in both team and individual sports, has taken centre stage.

These facets play a foundational role in optimizing performance and coaching effectiveness. Addressing this need, ISSPF Faculty members have meticulously curated specialized courses. These offerings cater to sport science students, coaches, individuals operating within the game, and enthusiasts eager to delve deeper into the domains of soccer science and performance coaching.

For those seeking to embark on this enlightening path, the link below connects you to the highly popular and meticulously designed ISSPF-endorsed and accredited online course on Injury Prevention and Return to Play in sport science and sport coaching. This course seamlessly amalgamates sport science research and practical illustrations spanning diverse levels of team sports.

Tailored to encompass a broad spectrum of roles, whether you’re a physiotherapist, psychologist, coach, manager, or strength and conditioning coach, this course intersperses football science components throughout its curriculum. It delves into the nutritional, psychological, physical, and social dimensions of the subject matter, propelling your personal and professional growth to new heights.

Why Is This Course of Paramount Importance?

  • Delve into the most efficient training methods and gain insights into holistic player fitness development, alongside tactical strategies and training methodologies.
  • Acquire a nuanced understanding of enhancing player development and preparation through a contemporary game model approach.
  • Learn to strike a harmonious balance between technical, tactical, and physical training elements, culminating in peak performance.
  • Elevate decision-making prowess through an enriched grasp of tapering and soccer periodization.
  • For coaches, trainers, and individuals entrusted with the holistic training, preparation, and coaching facets for both individual athletes and team sports.

Whether you’re seeking to deepen your understanding of footballer preparation, training, and development, or aiming to enhance your coaching and training methodologies, this course offers a comprehensive toolkit. It empowers you to navigate the dynamic landscape of football with precision, confidence, and an elevated perspective.


ISSPF Injury Prevention Course

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