Physical Therapy for Common Football Injuries
Football is a high-contact sport with one of the highest sport injury rates. Common football injuries include concussions, ACL tears, ankle sprains, turf toe, shoulder dislocation, rotator cuff tears, and hamstring strains. Physical therapy provides effective treatment for football-related injuries, helping the athlete to safely recover and return to sport when fully healed. Physical therapists help athletes regain strength, function, and range of motion through a targeted therapeutic exercise and strengthening program while managing pain and minimizing the risk of future injury.
Common Football Injuries
Football is an incredibly physical, high-contact sport with one of the highest sport injury rates between full-contact tackling, running, leaping, and cutting. According to the National Safety Council, in 2019, there were 292,306 football-related injuries. Preseason training has the highest injury rate compared with the in-season and post-season. However, football players are nearly seven times more likely to get injured during a game than in practice. The most common type of injury among football players involves injury to the lower limbs. Per the NCAA, injuries to lower limbs account for 50.4% of football injuries. In terms of position-related injuries, linebackers are injured most often, accounting for 13.5% of injuries. Running backs and receivers account for 11% of injuries each and quarterbacks make up 5.8% of injuries.
An athlete may be more at risk for incurring a football injury when he has improperly warmed up or cooled down, heightening the risk of a muscle strain. Other risk factors for injury include overuse due to prolonged intense activity, improperly fitted protective equipment, or resuming competitive play too soon after an injury, increasing the probability of reinjury. Insufficient training in the technique and mechanics of a player’s position, such as proper blocking, tackling or throwing, and lack of appropriate conditioning can also increase the risk of injury.
Football injuries can result from a traumatic event like a direct blow to the body or head, causing a concussion, a knee or shoulder injury, or an ankle sprain. Injuries can also result from overuse, such as a hamstring strain, Achilles tendinitis, patellar tendinitis, or low back pain. During training camp in the heat of August, athletes may be in danger of heat-related injuries that could lead to heat exhaustion.
Common football injuries include:
Concussion: Concussions can occur when an athlete receives a traumatic blow to the head or a direct blow to the body that creates a whiplash of the athlete’s head and neck. A concussion is a traumatic brain injury that can cause blurry vision, nausea, dizziness, headache, or difficulty concentrating.
ACL or MCL Tear: The ACL and MCL are ligaments that surround the knee to keep it stable. Tearing of the ACL or MCL can occur due to a direct force to the knee or from cutting or a fast pivot. The athlete commonly experiences pain, an audible pop in the knee, swelling, and difficulty standing on the injured leg. A meniscus tear can also occur, which is a tearing of the cartilage of the knee.
Patellar Tendinitis: Patellar tendinitis involves injury to the tendon that connects the kneecap to the shinbone when the tendon becomes inflamed and irritated. Pain develops gradually due to overuse and repetitive loading that strains the patellar tendon.
Hamstring Strain: A hamstring strain can occur due to excessive stretching or tearing of the muscle or tendon fibers due to either a sudden movement at the start of exercise or from overuse of the muscle during a high-intensity interval.
Shoulder Injuries: Shoulder injuries, such as shoulder dislocation or separation or a rotator cuff tear, often occur due to a full contact hit. Once a shoulder is dislocated and comes out of its socket, the ligaments around the shoulder are looser, heightening the possibility of an injury occurring again. A rotator cuff tear can result from an acute trauma like a direct hit by another player or to the ground or from degeneration of the tendons from repeated overuse.
Ankle Sprain: An ankle sprain occurs when excessive stress is placed on the ligaments of the ankle and they are stretched beyond their limit. Ankle sprains account for 45% of all sports injuries in the United States. An athlete will immediately experience pain and swelling with tenderness to touch, bruising, and stiffness and weakness in the ankle.
Achilles Tendinitis: Achilles tendinitis involves tightening and irritation of the Achilles tendon and can be caused by weak calf muscles. It often results due to overuse of the tendon and leads to pain, stiffness, and tenderness along the heel when running.
Turf Toe: Turf toe occurs when the big toe is forced into an extreme position of hyperextension, causing a sprain in the main joint of the big toe. It can happen when an athlete pushes off to sprint or is tackled with the front of the foot fixed and jammed into the ground when competing on artificial turf.
Low Back Pain: Low back pain can result due to the bending and leaning forward required of many football positions and from repetitive motions practiced for specific plays that place a strain on the low back muscles. Offensive and defensive linemen are particularly vulnerable to low back pain due to their position; quarterbacks can experience back pain after being tackled from behind.
Physical Therapy Treatment
Physical therapy provides effective treatment for football-related injuries, helping the athlete to safely recover and return to sport when fully healed. Physical therapists help athletes regain strength, function, and range of motion while managing pain and minimizing the risk of future injury. The physical therapist initially evaluates the injured area and performs a series of tests to assess the athlete’s current state. From there, the therapist designs a treatment program tailored to the athlete’s specific goals, needs, and condition. During the acute phase of the injury, the therapist uses ice and heat modalities and manual therapy to manage any swelling and reduce pain and inflammation. The patient is then progressed to therapeutic aerobic exercise and targeted strengthening program to restore mobility, function, range of motion, and strength to the injured area.
Most football-related injuries do not require surgery. Instead, physical therapy is often recommended as the first course of treatment to restore function, manage pain, and regain strength. Should surgery be necessary, post-surgical rehabilitation with a skilled physical therapist is essential to ensure proper healing and restored mobility.
Certain injuries have very specific protocols to manage injuries such as a concussion or an ACL tear and rehabilitation. Following a concussion, physical therapy involves vestibular rehabilitation, balance training, manual therapy, and a graded, gradual aerobic exercise program that does not intensify symptoms. ACL rehabilitation involves a 9 to 16-month rehabilitation process that is carefully monitored by the physical therapist. The athlete must pass a thorough, evidence-based return to sport testing protocol in order to safely return to competition and prevent future re-injury.
Are you a football player that was recently injured or is experiencing chronic pain? Work with our sports medicine physical therapists to address pain, restore function and strength, and return to competition safely!
