Soccer is a game that is played throughout the world and is becoming more and more popular each year in the United States. As soccer gains popularity the number of participants increases. There are currently many different indoor and outdoor leagues and fields throughout San Diego County. These leagues are filled with individuals of all ages and skill levels. They range anywhere from ex-professional players to “weekend warriors” who play once a week. As more and more people sign up for soccer more injuries can occur.
I see a wide variety of injuries related to soccer. Most of theses musculoskeletal type injuries occur in the lower extremities, which include the hips, knees and ankles. At our sports medicine practice we see a direct relationship between injuries, age and frequency of play. As a person ages and increases their frequency of play they are more likely to sustain an injury at some point. There are many different muscle/tendon/ligament type injuries that can occur while playing soccer. Some of the most common injuries include—various muscle strains, ACL and PCL tears, MCL and LCL tears, shin splints, patellar and achilles tendonitis or tendonosis, groin pulls, meniscus tears, ankle sprains, hamstring and quadriceps strains.
Common Soccer Injuries
Below is a list of some of the more common soccer injuries that we treat in our clinic on a regular basis.
Anterior Cruciate Ligament Tear (ACL)
The ACL is a strong band of tissue that connects the femur to the tibia. This ligament is located deep inside the knee joint. The ACL adds stability to the knee and prevents it from twisting and sliding forward. The ACL is most commonly injured when the foot is planted and the knee is contacted from the side such as getting “slide tackled” in soccer. This force causes hyperextension and extensive twisting of the knee causing the ACL to tear. The extent of the tear depends on the amount of force and twisting the knee has undergone. Many times the athlete will hear a “pop” after the injury. This usually is the result of a complete tear of the anterior cruciate ligament. When the ACL is injured, swelling around the knee will usually come on very quickly. The athlete will describe the knee as being very unstable and sometimes too painful to bear weight on it. Initially crutches should be used in order to take pressure off the knee. An MRI should be considered to see the degree of the ligament damage.
The meniscus is a “C” shaped piece of cartilage that sits in the knee joint and provides both cushioning and stability for the knee joint. There are 2 menisci in both knees. One on the inside and one on the outside within the knee joint. These menisci help to balance and distribute the stresses and weight across the knee joint evenly. When there is a tear in the meniscus this will result in pain and limited motion in the knee joint. There will sometimes be swelling on the inside or outside of the knee depending on which region is damaged. This damage usually occurs when the foot is planted and the knee is twisted or turned very quickly. As with soccer you are constantly cutting back and forth with the ball and planting the foot when taking a shot on goal. This is the prime movement for injuring the meniscus. Over time wear and tear of the meniscus can occur making it more prone to injury. Tears are usually categorized into 3 stages—minor or grade 1, which are microscopic tears and can be fixed with ultrasound treatments, myofascial release, Kinesiotaping/Rock Taping and exercise therapy. Custom orthotics or over the counter shoe inserts are sometimes used in conjunction with these therapies in order to reduce the stress around the knee region. The second type of tear is moderate or a grade 2 tear. These tears are slightly larger and can take longer to heal. These will cause more pain and usually cause an increase in swelling around the knee. The knee will be very stiff and sometimes the person will describe a sharp pain in the knee joint when walking. Any bending, squatting or twisting movements may cause an increase in pain. The same therapy as above would apply to this grade of injury. The final type of tear is a severe or a Grade 3 tear. This will usually require surgery. A grade 3 tear will cause the knee to lock or catch during various movements especially running or sprinting. The injured player will describe the knee as being “unstable” and will sometimes hear a clicking sound when walking. This type of tear usually requires surgery and can be diagnosed with an MRI.
Medial and Lateral Collateral Ligament Sprains (MCL & LCL)
This type of injury occurs when there is a blow to the inner or outer side of the knee such as someone slide tackling you in soccer. This contact will cause excessive stretching and/or tearing of the ligament. This can also occur by any unwarranted twisting on the knee. These ligaments connect the femur to the tibia and help to prevent lateral motions of the knee. When one of these ligaments is injured the inner and/or outer knee will be tender to the touch. There is often mild swelling near the joint and the athlete will have the feeling of the knee giving way. If the ligament ruptures during the contact the athlete will sometimes hear a pop or snapping sound. The degrees of injury can be easily