Jan 4, 2019Prioritizing sports medicine in the Arizona Arsenal Soccer Club
Across the nation, millions of boys and girls play youth soccer. Those participation numbers don’t come without injuries.
However, unlike at the high school or college level, youth athletes don’t always have access to sports medicine services for treatment. Whether due to cost or a lack of staff, this feature is one that many youth organizations are unable to provide, which leaves athletes vulnerable.
But at the Arizona Arsenal Soccer Club, we’ve made sports medicine a priority through our Health and High Performance Division. In the five years since its founding, we’ve been successful in reducing injuries and optimizing physiology with our youth athletes.
As a byproduct of these efforts, the results on the field have been exceptional. In this year’s Arizona State Cup, we had four champions, a runner-up, and two third-place finishes among our girls’ teams. Meanwhile, the boys’ side posted a champion and three semi-finalists the year before.
Now an established part of the club, our injury prevention program continues to evolve and enrich performances. We believe that by investing time and bringing a few dedicated individuals on board, other youth sports groups could follow our lead.
How it works
Arsenal was established in 1992 as the Gilbert (Ariz.) Soccer Club. The original number of participants was approximately 60. Today, our organization has more than 750 players spread across more than 50 teams and ranging in age from under 10 to 18.
Five years ago, club President Jim Cope and long-time Director of Coaching Tim Barmettler started discussing how to improve the physical ability of the Arsenal players in a formal way, using the major college performance enhancement programs as a model. From those conversations emerged the Health and High Performance Division, and Jim asked veteran strength coach Tim McClellan to be involved.
Our first objective was reducing or eliminating the ACL tears that run rampant in the sport. To accomplish this, we focused on reducing force in eccentric landings.
As a byproduct of these efforts, the results on the field have been exceptional. In this year’s Arizona State Cup, we had four champions, a runner-up, and two third-place finishes among our girls’ teams. Meanwhile, the boys’ side posted a champion and three semi-finalists the year before.
Now an established part of the club, our injury prevention program continues to evolve and enrich performances. We believe that by investing time and bringing a few dedicated individuals on board, other youth sports groups could follow our lead.
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To get the department off the ground, the first priority had to be developing an exceptional staff. McClellan has been in the community for 35 years and had gotten to know many talented performance enhancement coaches in the area. He reached out to a number of them, and, thankfully, several agreed to provide their expertise and talents. The Health and High Performance Division was incorporated with only a few Arsenal teams at first, but the desire to participate quickly spread throughout the rest of the club.
Now, the department is made up of sports medicine physicians, physician assistants, orthopedic surgeons, physical therapists, athletic trainers, and strength and conditioning coaches. The sports medicine care is provided via referrals, and our athletes typically receive same-day service. The doctors and physical therapists are amazingly accommodating.
Our strength staffers are all paid consultants. We pay for them with increased annual dues. Most of them work somewhere else during the day and just come to Arsenal’s sessions at night.
Our staffing model allows for a seamless integration of medical services with injury prevention and conditioning, which provides Arsenal players with care that rivals professional organizations. For instance, say an Arsenal player incurs an inversion ankle sprain during a Sunday game. It is not uncommon for them to see the Arsenal team physician first thing Monday morning, get an MRI and/or X-rays, have the results read, and then go to an appointment with an Arsenal physical therapist that afternoon.
Defining our focus
Determining the goals for our sports medicine program helped narrow our focus and prioritize what was most important. We established two main objectives for Arsenal’s Health and High Performance Division:
- Reduce the potential for injuries.
- Maximize physical performance.
To reach these goals, we identified the injury patterns and performance demands for soccer. This was tackled by Alex Onofrei, MD, Arsenal Team Physician and physician at Arizona Family Medicine and Sports Medicine in Mesa, and Matt Midkiff, DPT, PT, CSCS, owner of Foothills Physical Therapy-Mesa, who works for Arsenal in the evenings. They shared the youth soccer injuries they’ve observed the most over their more than 35 years of combined private practice.
Lower-extremity injuries were revealed to be the most prevalent, including hip flexor and groin strains (especially early in the season), ankle sprains, contusions from contact, and ACL tears. As a result of this injury analysis, we made sure to target these areas with proper prehab and strengthening exercises.
Additionally, our performance enhancement staff observed the physical deficiencies in Arsenal players as they moved. Some of the issues identified were tightness and restriction in ankle dorsiflexion, asymmetrical hip shift in squatting movements, unilateral tightness in the groin and iliotibial band that restricted economy of movement when running, and inadequate hip musculature stabilization, which led to insufficient eccentric decelerating ability. All of these deficiencies would lead to increased injury risk if left unaddressed.
Program design
From our research, we came up with a number of priorities for our training. Many of them involve building strength and power to improve performance and prevent injury.
Our first objective was reducing or eliminating the ACL tears that run rampant in the sport. To accomplish this, we focused on reducing force in eccentric landings. We devised sagittal, frontal and transverse plane movements for every workout. Exercises included double- and single-leg forward, backward and side hops with varying landing instructions. As athletes got accustomed to these drills, we would progress by having them hop over hurdles, and then hop while tethered to a resistance cord.
The second priority was implementing resistance training for all actions initiated and governed by the hamstrings, groin, and glutes. Since soccer injuries often occur when these muscle groups cannot handle decelerating loads eccentrically, we emphasized training these movements with differing speeds of concentric and eccentric contractions. We used variations of squats, lunges, bridges, and dead lifts to develop this area.
A third priority for our program was strengthening all of the hip-stabilizing muscles, since we identified weaknesses here during our initial evaluation of soccer needs. An often overlooked and under-valued method for increasing stabilizer strength in the lower body is isometric training, which we incorporate, along with power position holds, lateral squat holds, pause squats, pause trap bar dead lifts, and plank holds.
Core strengthening also is an objective. Soccer players must engage their cores to change directions without losing proper biomechanics. We break core strengthening exercises into five categories: stabilization, extension, rotation, flexion, and lateral flexion.
Although it requires a slightly different focus and more flexibility, creating a sports medicine and performance plan for youth athletes can be done. And when done correctly, it enables them to thrive in a healthy, supportive system.
