Jan 29, 2015
Examining Soccer Injuries

By Dawn Comstock

Dawn Comstock, PhD, is a principal investigator at the Center for Injury Research and Policy at The Research Institute at Nationwide Children’s Hospital. She is also an assistant professor at Ohio State University in the College of Medicine and the College of Public Health. Her research interests include the epidemiology of sports, recreation, and leisure activity-related injuries among children and adolescents as well as the life-long health benefits associated with an active childhood. She can be reached at [email protected].

Every fall, hundreds of millions of fans worldwide tune in to watch their countries battle in soccer’s World Cup. Although soccer has not always been as popular in the United States as it is in many other countries, this tide is quickly changing. In the past 30 years, U.S. high school soccer participation has increased almost five-fold among boys and almost 50-fold among girls. Soccer is a great sport to help keep children in shape while teaching important life lessons such as teamwork and goal setting. However, soccer players can be injured. Understanding how and why soccer injuries occur can help coaches and athletic trainers work with athletes to prevent injuries from occurring.

During the 2005-06 and 2006-07 school years, the National High School Sports Injury Surveillance Study collected information on soccer participation and injuries from a representative sample of 100 US high schools. This study found that US high school soccer players sustain an estimated 400,000 injuries each year. Injury rates are similar between boys and girls and are higher in competition than practice. On average, a high school soccer player sustains an injury once in every 210 competitions and once in every 730 practices.

Here is what the latest research tells us regarding what types of soccer injuries occur:

Most common boys’ injuries:

o Ankle sprains (16.5% of all boys’ injuries) o Thigh and upper leg strains (10.3%) o Concussions (9.3%)

Most common girls’ injuries:

o Ankle sprains (20.8% of all girls’ injuries) o Concussions (12.0%) o Knee sprains (10.6%) o Thigh and upper leg strains (9.6%) Amount of time lost following injury:

o Less than one week (55.0% of all injuries) o One to three weeks (28.6%) o More than three weeks (16.4%)

• Surgery was required following 5.6% of all injuries. Boys required surgery most often for knee injuries (29.2% of all boys’ surgeries) and head/facial fractures (14.7%). Girls required surgery most often for knee injuries (74.9% of all girls’ surgeries).

• Compared to boys, girls were 13 times more likely to sustain knee injuries requiring surgery.

• Illegal activity was reported to be related to 12.2% of all competition injures.

• The types of activities leading to injury were similar between boys and girls. The most commonly cited activities were general play (20.9% of all injuries), ball handling/dribbling (13.8%), chasing a loose ball (12.6%), and defending (11%).

Recently, there has been growing interest in the potential for injury while heading the ball. In this study, only 6.6% of all injuries were attributed to heading the ball. However, because the amount of time spent heading the ball is quite small compared to the amount of time spent doing other activities (general play, dribbling, etc.), spending a minute heading the ball may result in more injuries than spending a minute doing most other soccer activities. The most common injuries sustained while heading the ball were concussions (59.9%), sprains/strains (13.9%), and fractures (9.4%). The majority of injuries caused while heading the ball resulted from contact with another player (71.8%), followed by contact with the ground (16.1%) and contact with the ball (7%).

It is important to keep in mind that soccer injuries are avoidable. Sports injury surveillance systems such as the one discussed here highlight areas where training modifications and rule changes could decrease the number of children sustaining soccer-related injuries.

Here are a few potential injury-reducing interventions: • Sprains and strains are the most common injuries. Coaches should ensure all players maintain an adequate fitness level throughout the season and always warm up properly. Coaches should also pay attention to potential overtraining in their athletes, especially among players who participate in multiple sports.

• Researchers should continue to investigate why girls have a higher rate of severe knee injuries compared to boys. Uncovering these biological and physical differences can lead to potential training modifications, such as balance training and weight lifting.

• Illegal activity was related to a high proportion of competition injuries. This suggests that tens of thousands of injuries could be prevented each year by eliminating illegal activity. Parents, coaches, schools, and league officials must work together to change sports culture and reduce the impulse among athletes to participate in illegal activity.

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