With the football season in full swing, we’ve seen an increase in football injuries over the past few weeks, unsurprising when an estimated 11.8 million people play football in England. Most of the injuries we see here in clinic are caused by a traumatic event such as a collision, but there is still a fair share that develop over time, and more injuries tend to occur during competitive fixtures rather than training.
Hamstring strains & tears
Hamstring injuries are very common at all levels of football performance, and happen when one or more of your hamstring muscles are severely over stretched. The severity of hamstring injuries are graded 1-3: 1 is the least serious with few muscle fibre damaged; grade 2 injuries are more painful and will often impact your ability to take part in further physical activity and may also impact other everyday activities; and grade 3 injuries are the most serious and will often cause extreme pain and an inability to walk. Hamstring strains and tears most commonly happen when swinging your leg through to strike the ball.
Grade 1 & 2 injuries typically only require conservative management, including rest, anti-inflammatories and rehabilitation exercises. If a grade 3 injury is determined to be a complete tear, surgery may be required.
A thorough warm-up and cool down will allow your muscles to be prepared for the physical demands of football. Gym based strength and conditioning training should also be a regular part of your week to help maintain muscle strength and joint mobility.
Ankle sprains
In football, ankles are particularly vulnerable due to the fast paced nature of the sport, with quick and explosive changes of direction. Ankle sprains occur when the ligaments that support the ankle are damaged by being stretched further than they should be. Similarly to hamstring strains, ankle sprains are graded 1-3, with 1 being minor discomfort and grade 3 injuries indicating complete ligament rupture.
Typically ankle sprains will present with pain, limited range of movement, swelling, bruising, and difficulty tolerating weight-bearing activity. In most cases, conservative management will be sufficient in returning an athlete to sport, however in severe cases of grade 3 injury where there is ongoing ankle instability, surgery may be suggested to reconstruct the damaged ligament to help stabilise the joint.
Training should include proprioceptive work, and plyometric training in order to optimise ankle stability, and reduce the risk of ankle injury.
MCL sprain
Your MCL (medial collateral ligament) is the ligament on the inside of your knee. Injury to the MCL is most common when you are tacked from the outside and receive a direct blow to your knee, forcing it to twist inwards. Symptoms of an MCL injury typically include pain, swelling, knee instability, and tenderness.
Most MCL injuries heal well with conservative treatment, and rarely require surgical intervention. Rehabilitation will focus on restoring full range of motion, followed by a progressive exercise programme to strengthen all of the soft tissue structures around the knee so they are better able to withstand the demands placed upon them in football.
ACL injury
The ACL (Anterior Cruciate Ligament) is a significant ligament in your knee that provides stability. The ACL is most commonly injured when pivoting or changing direction, and women are up to 8 times more likely to suffer an ACL injury than their male counterparts taking part in the same sport. Injury to the ACL commonly occurs with sudden change of direction, twisting without moving your feet, landing awkwardly, and sudden deceleration. These movements can result in your ACL stretching to the point of failure.
ACL injuries are characterised by inability to weight bear, reduced range of movement, the feeling of your knee giving way, and significant swelling in the immediate post-injury phase.
Following an ACL injury, consultation with an orthopaedic specialist is required. They will be able to assess the severity of damage and advise the best treatment plan. In most cases of a complete rupture, reconstructive surgery is usually recommended to allow the best of chance of restoring knee stability for a full return to sport.
Meniscus tear
Your meniscus is the layer of soft tissue that protects your tibia and femur from rubbing on each other. Meniscus tears frequently happen with sudden changes in direction, pivoting, or from receiving a direct external force to the knee.
Minor meniscus tears will result in pain and swelling, and will often respond well to conservative management. Some meniscus tears can heal themselves, while others won’ t be able to heal, but even in these cases surgery is not always recommended for a full return to sport. In cases of severe or complex tears, pieces of meniscus can form a flap, or completely detach into the joint space, this can give the sensation of your knee locking or giving way. In these instances, surgery is likely to be recommended to either repair the meniscus, or to remove the damaged areas.
Hernia and groin strains
Hernias and groin strains are common in footballers due to the significant stresses that are placed through the pelvic region during kicking, sprinting and turning.
Inguinal hernias are the most common type of hernias among footballers, and are a protrusion through an area of weakness in the connective tissue of the inguinal canal (an area of the hip region). Typically there will be pain and stiffness in the area of the hernia, which initially you may be able to play sport through, but will worsen over time. Consultation with a specialist is required, but typically a hernia repair surgery will be recommended.
Groin strains are caused by over-extending your adductor muscles in your inner thigh. Similar to hamstring strains and tears, mild injuries may cause some pain during movement, but pain is usually manageable. In more serious cases, there can be severe pain when moving, and bruising will usually appear within 48 hours. Severe tears may require surgery, but majority of groin strains respond well to conservative treatment and have a positive prognosis for return to sport.
Preventing common football injuries
Unfortunately injuries are a part of playing sport. However, there is plenty you can do to help reduce your injury risk, including:
- Warm up and cool down (Find out how to warm up here: httpss://hlmsportstherapy.co.uk/2020/08/07/what-should-i-be-doing-to-warm-up-properly/)
- Vary your training- include strength training, mobility work, and general conditioning into your weekly schedule
- Make sure your fuelling your body right- this includes keeping hydrated (Check out our previous blog post How does hydration reduce injruy risk?)
- Allow for rest and recovery- no one can train every day to the best of their ability. Fatigue can increase your risk of injury, so it is important to make sure you are getting enough rest.
This blog post is not designed to replace a full assessment from qualified healthcare professional. If you have a football injury that you would like to discuss, or to book an appointment, contact us.
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