The perils of football
‘Football injuries can be caused by a direct impact, for example following a tackle or non impact such as twisting awkwardly,’ says Gemma Freeman, a physiotherapist from Horder Healthcare.
‘It’s often the combination of physical contact and moving and twisting at high speeds that can cause problems.
‘There are a few things you can do, however, even at amateur level to reduce your risk of injury.
‘Firstly, it’s important to prepare your body for activity by completing a thorough warm up, consisting of aerobic activity, including dynamic and static stretches.
‘It’s also important to have the right equipment e.g. footwear and shin pads as these can help reduce the risk of injury.’
Here we take a look at some classic football injuries and Gemma gives some practical advice on how they can be treated.
Soft tissue injuries
These are commonly seen in football and these include injuries to muscles tendons, fibrous connective tissue that joins muscle to bone, and ligaments which join bones to other bones.
Muscles are strained or torn when some or all of the fibres within the muscle fail to cope with the demands placed upon them. A muscle is most likely to tear during sudden acceleration (for example sprinting for the ball) or deceleration (slowing down). These are classified in three grades. A grade 1 strain only involves damaging a few fibres of the muscle, there will be localised pain but no loss of strength. A grade 2 strain is a tear of a significant number of muscle fibres with associated pain and swelling. Pain will be produced by a muscle contraction and strength and movement will be reduced. In this instance, the player is unlikely to be able to continue with the match. A grade 3 strain is a complete tear of the muscle and it may require different management for example protective bracing or surgery depending on where in the muscle the tear is.
Below, Gemma explains an example of a common muscle injury seen in football.
Hamstring muscle injury
• What is it? The hamstring muscle runs down the back of the thigh from the pelvis to below the knee.
• What goes wrong? When you’re playing, a sudden acceleration for example such as sprinting for the ball may overload the hamstring muscle causing it to tear.
• Symptoms: Hamstring injuries vary in severity depending on the grade of the strain. With any hamstring injury, you are likely to experience pain at the back of your leg.
• Treatment: Physiotherapists recommend the RICE protocol which stands for Rest, Ice, Compress and Elevation. If you have a severe injury you will benefit from treatment as early as possible from a chartered physiotherapist. The physiotherapist will want to minimise the bleeding, reduce the swelling and inflammation. Subsequent treatment to promote efficient scar formation and allow you to return to sport as quickly and as safely as possible may include soft tissue therapy, stretching and strengthening exercises.
Ligament injuries are also commonly seen in football and can vary in severity on a scale of 1-3. The immediate management of ligament injuries will be the same as for a muscle injury, but grade 3 ligament sprains may require surgery.
Below is an example of a ligament injury seen in football.
Anterior Cruciate ligament injuries
• What is it? The Anterior Cruciate Ligament (ACL) is one of the four major ligaments within the knee joint. It originates on the femur (thigh bone) and attaches to the tibia (shin bone). Its main function is to stop excessive forward movement of the tibia and assist in limiting rotation of the knee.
• What goes wrong? The majority of ACL tears occur in a non-contact situation as Theo Walcott and Michael Owen both know. The ACL can be torn when a player is landing from a jump, pivoting or slowing down suddenly.
• Symptoms: You may hear a loud “pop”, experience severe pain or a feeling of your knee giving way, an inability to walk and weight bear and you will be unable to continue with your activity. Afterwards, your knee may begin to swell.
• Treatment: ACL ruptures can be difficult to diagnose at first due to the swelling. It’s important to seek treatment after a few days and a physiotherapist would be able to diagnosis the signs of an ACL tear using special tests. If it is suspected that you have an ACL tear, the physiotherapist is likely to refer you to an orthopaedic consultant who may organise an MRI scan to confirm the diagnosis. Surgery is usually recommended for people who want to return to sport.
The rehabilitation after an ACL reconstruction is lengthy and you are likely to need a lot of physiotherapy treatment to regain movement, improve your strength and stability and prepare you for a return to sport. This may take up to 9 months.
As well as soft tissue injuries, footballers can also sustain bone injuries such as fractures (breaks) whilst playing football. A fracture can be caused by direct trauma such as a tackle or indirect trauma such as a fall or a twisting injury. Fractures may be closed or open (where the bony fragments puncture the skin). There are various types of fractures that can occur and they will require different types of management.
Below is an example of a common fracture seen in football.
• What is It? The metatarsal bones are the five long bones in the foot.
• What goes wrong? Footballers are particularly prone to fractures in the metatarsals – usually due to over-use which can cause a stress fracture, but also due to impact, twisting or a combination.
• Symptoms: With an acute fracture you will experience pain in the area and swelling and bruising may be present. It will be difficult to weight bear on the foot and your movement may also be restricted. You will need an x-ray to confirm that there is a fracture.
• Treatment: The management of an acute metatarsal fracture will vary. In most cases, your foot will have to be immobilised in a “boot” or a plaster cast for up to six weeks. After this period physiotherapy can help you regain your movement, strength, balance and get you back to playing sport as soon as possible.