Football is arguably the world’s most popular sport, with over 260 million people playing the game regularly, across 200 countries (Source). It’s played by males and females, the young and the old, the talented and the not so.
Its popularity is immense with the major tournaments and games attracting the most views of any other sport event, with the UEFA Champions League Final attracting 109 million viewers and the FIFA World Cup Final getting on average 500 million views.
But football is also a sport with high injury prevalence with reported rates of over 34% of all participants potentially suffering an injury. Although not as high risk as the contact sports like rugby it has a higher risk than other sports such as skiing, tennis and volleyball, with the lower limb being the most affected area (source).
So football is the most widely participated sport (260 million+), with the highest injury rate (34%) that’s potentially a staggering 85 million injuries.
If we could reduce this rate by even a few percent this would affect millions of people world-wide, reducing hospital costs, medical expenses, lost work hours and not to mention removing a lot of individual pain and anguish.
But is this possible?
Well we can’t change certain aspects of the game such as bad luck, hard tackles, player contact, weather conditions etc, but there are things that can be looked at in an effort to reduce the risk of injury in football, and this has been an area of research for years in the sport medicine world.
To try and reduce injury a logical step by step process is followed, first identify where the risk of injury is, determine the incidence of injury, determine the mechanism of each injury to be prevented, design and implement prevention interventions, and finally reassess the injury incidence to see if the intervention was successful or not (source)
But has this process made any impact?
Well simply put yes and no!!!
Studies have tried and failed to show a reduction of risk in certain areas such as stretching before playing (source). But have succeeded in other areas such as proving that an effective warm up does reduce your general risk of injury before playing football (source).
However, just using research and evidence to try and reduce injury in football is, in my opinion, dangerous, there are issues and factors that only an experienced coach, trainer or physio can make regardless of the research (source).
The three most commonly encountered footballing injuries that are seen in both professional and amateur football are…
1) Ankle 'sprains,
2) 'Pulled' hamstrings
3) Ruptured ACL’s (anterior cruciate ligament)
With groin pains coming in a close 4th…
So we will now have a very simplistic look at how you can potentially reduce your risk of suffering one or more of these injuries when playing football. The suggestions that follow are only a small part of the story and I acknowledge that I have made some gross generalisations but for simplicity I have kept it short and brief without going into to much geeky sciencey stuff.
The Ankle Sprain
Playing football which involves sharp twisting and turning manoeuvres combined with jumping and landing all on a semi rough surface all place your ankle at a high risk of rolling over and suffering a sprained ankle, which can be of various severity from a slight pulled ligament to complete rupture.
So how do you reduce the risk?
This is the skill of your body’s ability to maintain alignment and balance, it’s a multifactorial skill, involving more than just balance but also a whole range of your body’s other systems and senses, and some are better at it than others, but it is ‘trainable’ so ‘improvable’
Improving your proprioception has been shown to reduce the risk of suffering an ankle sprain in football (source)
So how can you do this?
Simple stand on one leg, but that gets easy and boring very quickly so challenge it further by standing on an uneven surface such as a ‘Togu’ trainer (below) or wobble board like these found here , via Hab Direct, if that gets easy then start to squat or move other parts of your body around and or close your eyes.
Strapping your ankles with various devices, from using tapes and ridged braces to elastic strapping wraps have also been found to reduce or risk of suffering a sprain ankle, especially if you have suffered one previously. (source) However straps and tapes are also only thought to last a few minutes before there mechanical effects are no longer working, but there is also thoughts that strapping can help via other neurological or psychological effects, but this is a massively debated area and one we won't get into.
An example of an ankle strap can be found here again via Hab Direct
The Pulled/Torn Hamstring
This is another common injury I used to see regularly in the physio room at Watford FC, read why here on my piece on hamstring injuries.
Although there are lots of factors that contribute to suffering a pulled hamstring, improving your eccentric hamstring strength has been shown to reduce these injuries (source) and in my experience when we give these exercises to the lads who have suffered with previous hamstring tears they rarely put a re appearance into the physio room.
Here’s two of the best exercises to do this
Gym ball curls
The ruptured Anterior Cruciate Ligament (ACL)
Finally the most serious of the most commonly seen injury in football is the rupture of the ACL, this is the ligament that runs through the centre of your knee that helps hold the femur and the tibia together and prevents one from sliding forward on the other when your leg flexes and extends. It is usually ruptured through a sharp twisting turn and usually with no contact with another player.
But how can you reduce your risk of this?
This is a little more difficult, as this injury is affected by a lot of factors you can’t control, for example playing surface, gender and anatomical make up. But some research does show that if you have more control over your knee into valgus (inwards) direction then you are less likely to suffer an ACL injury (source).
The way to do this is to improve your Gluteal (buttock) and core (trunk/abdominal) muscle strength.
For some great glute strengthening exercises that are used by most professional footballers, believe it or not, despite the silly look of them go here to watch my video demos of band walks.
For core and trunk strengthening I don’t think you can beat a plank and side plank exercise as shown below, there are lots of variations but if you start with these two you won’t go far wrong.
Finally a word on warming up.
As mentioned at the beginning of this article having a good warm up strategy and ensuring you do this for long enough in plenty of time before you start training or playing rather than rushing through a quick 5 minutes or not doing one at all, before you start is essential.
FIFA’s The 11+ (below) is a great warm up plan to start with and if done properly should be take about 15-20 minutes a lot longer than most people spend on their warm up, more details on it can be found here.
So in summary football is a great sport, popular, loved and played by many, but it is also a high risk sport for injury. You can reduce your risk of an injury when playing football by spending a few minutes a few times a week doing some prehab exercises and ensuring you do a good warm up such as the 11+ before training or playing.
Thanks and I hope you enjoy your injury free football…