Physical Therapy for Common Soccer Injuries
Soccer is an incredibly popular sport with over 13 million Americans playing soccer, three million of whom are youth soccer players. Due to the intensity of soccer’s kicking, sprinting, fast changes in direction, and contact and the increase in year-round competition, both traumatic and overuse injuries can occur. Most soccer injuries occur in the lower extremities, particularly to the ankle, knee, and hamstrings. Physical therapists can help soccer players recover from injury safely through a comprehensive rehabilitation program that includes targeted aerobic and strengthening exercises, manual therapy, and functional sports training.
Common Soccer Injuries
Soccer is a physically demanding sport with powerful kicking, sprinting, quick changes in direction, and contact that contribute to injury. Increasingly, youth athletes are participating in year-round competition from regular season fall and spring soccer to winter indoor leagues. Year-round competition in the same sport can increase the risk of overuse injuries in the athlete. A soccer injury is more likely to occur during competition than in practice when the physical demands, contact, and intensity of soccer are heightened. Most soccer injuries occur in the lower extremities, affecting the ankle, knee, and hamstrings particularly.
The five most common soccer injuries include:
Ankle Sprain: Ankle sprains occur when the ligaments in the ankle joint are overstretched or even torn from twisting, tripping, landing from a jump, or turning rapidly when the foot is planted. Ankle sprains account for 15-20% of all soccer injuries. The athlete will experience pain, swelling, a throbbing sensation in the ankle, and instability in the ankle joint. Recurrent ankle sprains are common if the original rehabilitation did not sufficiently restore muscle strength and improve balance.
ACL Tear: A tear of the anterior cruciate ligament, which provides stability to the knee, is a serious injury that is more common among female soccer players (due to the alignment of the female hips and knees). ACL injuries can occur with movements that involve a rapid change in direction, such as suddenly kicking the ball across the body, forcefully twisting the knee when pivoting, or landing awkwardly after a jump or fall. The athlete often experiences a popping sensation in the knee, severe knee pain and swelling, and difficulty putting pressure on the injured leg.
Shin Splints: Shin splints are an overuse injury that can occur when the athlete’s legs are overloaded too quickly with excessive running or jumping. The shinbone becomes inflamed, causing tenderness in the shinbone and strain in the muscles where they connect to the bone. The muscles can develop micro-tears due to overuse, causing pain in the middle or bottom third of the inside of the shin. Pain may be sharp to the touch or ache during or after exercise. If unaddressed, shin splints can lead to stress fractures.
Hamstring Strain: A hamstring strain is one of the most common muscle injuries in soccer, accounting for 50% of muscle injuries. Hamstring strains are more common in men than women and often occur during games while running at high speed or when kicking. A hamstring strain involves a tear in the hamstring, a muscle in the back of the thigh that is responsible for controlling the leg as the foot swings forward. The athlete often experiences a sudden sharp pain in the back of the thigh, bruising and tenderness to touch in the injured area, and difficulty walking or running.
Concussion: A concussion is a mild traumatic brain injury that can cause physical, cognitive, and behavioral symptoms. Soccer is among the top five sports causing concussions and the #1 concussion-causing sport among women. Concussions can result from heading the ball, body-to-body contact between players, falling, or slamming into the goal post (particularly for goalies). Symptoms can include dizziness, nausea, headaches, sensitivity to light and sounds, mental fog, blurred vision, and quick cognitive fatigue.
Physical Therapy for Soccer Injuries
Physical therapy provides customized, hands-on rehabilitation for all soccer injuries, tailoring the physical therapy program to the specific injury to reduce pain, restore strength and motor control, and safely return to sport. The physical therapist first focuses on reducing the athlete’s pain through cold and heat modalities. From there, the therapist focuses on improving the flexibility and range of motion of the injured area through manual therapy and therapeutic exercise. The therapist also addresses muscular imbalances or deficiencies through a targeted strengthening program before progressing to functional return to sports training.
For an ankle sprain, the physical therapist strengthens and conditions all muscles of the lower extremities with a particular focus on the foot-ankle complex as well as engaging in balance training to teach the ankle muscles to respond to changes in the environment. For shin splints, the therapist helps the athlete design a modified cross-training program to gradually increase activity without placing too much stress on the shin area and teaching modified take-off and landing techniques. Hamstring strain rehabilitation specifically targets strengthening the hamstrings, quadriceps, and glutes to ensure there is appropriate muscle strength and balance between the muscle groups.
Both ACL rehabilitation and concussion rehabilitation follow specific protocols to ensure a safe recovery and return to sport. ACL rehabilitation normally takes from 9 to 16 months to fully recover. The therapist initially works to improve the range of motion of the knee and contraction of the quadricep to promote knee extension and strength during the first 6 weeks. The therapist then carefully progresses the athlete through knee strengthening and loading to sport-specific functional training and return to sport testing through the 9-month mark before the athlete can return to sport safely.
Concussion rehabilitation involves vision and vestibular rehabilitation, balance testing and training, manual therapy, and a graded aerobic exercise program that does not intensify symptoms but allows the athlete to adapt to the physiological demands of activity over time and regain physical fitness. Timely and well-monitored treatment for a concussion is essential to achieve a full recovery and a safe return to sport.
