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Some facts and figures and advise about injuries from an expert physiotherapist and soccer trainer by: Barry Crocker

Generally soccer is a safe and healthy form of exercise and competition for youngsters. In the United States about 3 million young players are involved in high school and community soccer leagues.

Participation is increasing at about 22% per year.

There are about 150,000 soccer related injuries per year and about 45% of those occur to players 15 years old and less.

No matter what precautions are taken injuries will happen when 22 kids are in competition for one ball. This fact has to be accepted. These injuries are usually the result of trauma and if the game is being played within the laws and spirit of the game, they may be considered an acceptable risk.

There are however some injuries which stem from overuse, overtraining and wrong types of training, which can be prevented.

Inappropriate intense training of youngsters often cause overuse injuries such as stress fractures, tendonitis, and shin splints. These sorts of injuries may often be prevented with a healthy balance of training, games and rest.

Flexibility training is important in youngsters, particularly adolescents who may be growing quickly. In these young players flexibility may be considered more important than strength training. Emphasis should be placed very early on correct stretching and adequate warm ups.

Coaches should always be aware of players with predispositions to injury, such as multiple ankle sprains. When such conditions are recognized correct advice should be sought and preventative measures taken. This could involve
bracing etc.

Players with medical conditions like asthma should be educated by trained medical personnel.

In later articles we will deal with more specific conditions, but this article will deal with the types of injury we may see in soccer.

Studies show that the injury rate in soccer is 2% to 5% -- with females reporting injury more frequently than males.

Fatal injuries are extremely rare and almost always involve goalposts falling on top of players.

The most frequent soccer injury is the soft tissue contusion or bruise.

Fractures are uncommon and are 3% to 9% of all injuries.

Traction injuries around the knee and ankle are common in young players. These conditions are often called Osgood Schlatters disease and Severs disease.

I often see these conditions early in the season when grounds are hard and kids are training intensely. In the ³good old days² when constant kicking of a big old soggy leather ball played havoc with the extensor mechanism of the knee, Osgood Schlatters was much more frequent. Today with better equipment and better training techniques involving flexibility training, we see it less often.

Surprise surprise, the American Medical Association (Pediatrics) came up with the conclusion that around 80% of soccer injuries involve the lower limbs. It also stated that around 26% of injuries were to the knee and 23% to the ankle. One really interesting statistic is that with fractures, the
upper limbs are more frequently injured than the lower.

Ball heading is always a controversial subject. There have been several inconclusive studies. Further investigations have to be made on the long-term effects, but I would suggest that while heading remains an integral part of soccer, great efforts should be made to ensure that players learn the correct technique. Having said that I also believe that heading
should not be taught or encouraged before age 11/12.

Mouth guards have been advocated for soccer players. I have only seen 4 teeth knocked out in 40 years of soccer and two were mine!

Should we play injured? Players with minor aches and pains (24/48 hours duration) can usually be allowed to play. Severe or persistent pain should be evaluated, as should swelling and loss of movement.

All in all soccer is a safe sport to play as long as some foresight and precautions are employed.

Remember the 6 Ps:

Prior Proper Preparation Prevents Poor Performance

Some material and references from Healthlink, Medical College of Wisconsin, Milwaukee.
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Barry Crocker is a Registered Physiotherapist with a private Practice in Abbotsford British Columbia (OASIS Physiotherapy)

He immigrated to Canada in 1977 to work for the WCB. His passion for soccer soon drew him to the Vancouver Whitecaps where he looked after the youth development players and assisted with the first team.

In 1983 he moved into private practice, and realized the dream of a lifetime by becoming the Physiotherapist to the Canadian World Cup Team.

In 1986 he was selected to represent Canada at the World Cup Finals in Mexico. He worked for Tony Waiters and Bob Lenarduzzi as the Canadian team ³physio²

In 1986 he became a founding director of the Vancouver 86ers.

Since being in Abbotsford he has served on the Abbotsford Youth Soccer board as Technical Director for the last 8 years. He has formed the Training Academy and has been instrumental in bringing former national team captain
Colin Miller into the club as Head Coach.