Recently, I had the opportunity to present to a local soccer club and their coaches on injury risk and reduction for the sport of soccer. In order to understand this, a “Needs Analysis” must be done. A Needs Analysis is a two-part analysis breaking down the sport into two components:
Today, our primary focus will be on evaluating the sport itself. This can be further broken down into:
Movement & Physiological Analysis
Soccer is a very lower-body dominant sport involving the hip, knee and ankle joints and muscle groups including the quadriceps, glutes, hamstrings and calves. A soccer athlete must be able to run, jump, accelerate, decelerate, land, cut, kick, pass, head, shuffle, tackle – all while handling a ball and avoiding defenders. Oh, they also need the ability to sprint and jog throughout the duration of a 90+ minute game. Now, you’re talking about a dynamic athlete with a sound aerobic and anaerobic energy system. That’s A LOT.
Here’s a more thorough breakdown:
Sports injuries are inevitable. It comes with playing sports – exposure already puts you more at risk. You cannot prevent sports injuries, but you can help mitigate and reduce the risk of them happening – especially ones that are non-contact or overuse in nature.
Here’s a breakdown of the most common injuries in soccer:
A study done in 2017 by Khodaee et al. tracked detailed information on injury rates among high school soccer players over a 10-year period (2005 – 2014). You can see those below broken down by gender and injury diagnosis.
Muscle strain, ligament sprain and concussions are highest as expected.
What’s most interesting is the girls’ ligament sprain – very high for both practice and competition as compared to the boys’ group. Females are 2-5 times more likely to tear their ACL than males in a similar sport. There are a lot of factors that play into this and nothing is definitive. We do know that strength and neuromuscular control are big modifiable factors from an injury risk standpoint.
In another study from 2015, Waldén and company analyzed 39 videos for movements related to non-contact ACL injuries in professional soccer players. They found that pressing, kicking, and heading were the 3 most common movements in relation to ACL injuries.
Heading (check that right leg in D - ouch)
Cool, so now what do we do with all of this? Make some superhuman soccer athletes.
Have a plan in place to address these different components. It’s important to create a program for these athletes to develop these athletic characteristics – i.e. lower body strength, power, repeated sprint ability, cardiovascular endurance, change of direction and reactive agilities. Injuries happen all the time in soccer, but if we know what joints and muscles are most at risk, then we can better prepare these tissues to withstand the stress of the sport and build more resilient and robust athletes.
Dr. Ravi, DPT
Baechle, Thomas R., and Roger W. Earle. Essentials of Strength Training and Conditioning. Champaign, IL: Human Kinetics, 2016. Print.
Turner, E., Munro, A. G., & Comfort, P. (2013). Female Soccer: Part 1—A Needs Analysis. Strength & Conditioning Journal, 35(1), 51-57.
Sprinting, rapid change in directions, lateral agility, precision footwork, and even the low profile cleats, soccer is a sport that requires an incredible about of ankle strength and stability. It’s no wonder the injury rate in soccer is so high. In fact, studies have shown that more injuries have been recorded in soccer than in volleyball, basketball, rugby, boxing, and swimming, and to no surprise, the majority of soccer injuries at at the lower extremity. In order to prevent injury and boost performance, it’s crucial that you focus on improving your ankle strength and stability.
Before we dive too deep into improving performance and recovering from injury, let's quickly take a look at the anatomy of the ankle.
The outside (lateral) component of your ankle is comprised of both dynamic (muscles) and static (ligaments) stabilizers, which are designed to keep your ankle from rolling.
Now these names and long and technical and it’s not really all the important to know what there names are, but what is important is knowing that these structures all work synergistically to keep your ankle from rolling. That means that if you’re not targeting both systems (dynamic and static stabilizers) in your programming, you are setting yourself up for increased risk of injury.
In order to best set yourself up to prevent ankle injuries, you need to focus on not just ankle strengthening exercises, but proprioception as well. Proprioception simply means your joints awareness of where it’s at in space and this predominately comes from mechanoreceptors found in the three ligaments we mentioned earlier. Below are three drills that are fantastic at improving ankle proprioception.
Half Kneeling Balance Drill: Must be able to maintain balance for 60 seconds. Progress by adding weight to one side, being on foam surface, or by closing your eyes.
Clock Balance Drill: Complete three full rotations, both clockwise and counterclockwise.
Single Leg Med Ball Toss: To improve lateral stability. Complete 30 seconds of tosses with focus on high velocity.
Now as we mentioned earlier, your static stabilizers work synergistically with with your dynamic stabilizers and are equally important to focus . This is where ankle strengthening comes into the picture. Below are three great drills to strengthen your ankles.
Banded Side Step Up: Complete 3-4 rounds of 30 seconds in each direction. The key is to keep the band at the bell of your feet.
Single Leg Jump Rope: Should be able to perform for 60 seconds and without a significant difference in difficulty side-to-side.
Single Leg Volleys
Thanks for reading,
Dr. Jake, PT, DPT
Dr. Danny and staff's views on performance improvement, injury prevention and sometimes other random thoughts.