Sports Conditioning and Injury Prevention

How to Handle Muscle Strains By Craig Devine

2009-10-12T21:04:00.000-07:00

How to Handle Muscle Strains
During The Season
By Craig Devine

Muscle strains are common during the soccer season, but how do you deal with them once they occur. These injuries are often mild but they can greatly limit performance and may linger for quite some time. Mild strains are most common and may effect the player for at least 2 weeks. Moderate strains result in more damage and weakness and may take 2-4 weeks to resolve. But, severe strains can result in muscle deformity and bruising and can take 4-6 weeks or longer to heal.

Once a muscle strain has been properly evaluated, the first goal is to restore full range of motion and strength. When this is achieved then the player can begin to run again to avoid too much fitness loss. Until this time the player should crosstrain to maintain fitness without stress to the healing injury. The speed of running intervals should increase until the athlete can sprint again fully without problems. Once the player can sprint fully without pain or limitations, then they can gradually return to practice play as tolerated. I would recommend that the player be able to train fully without problems before cleared for return to game play.

As the player recovers from the acute injury, strengthening exercises are the key to restoring full function. Strengthening exercises should be continued once the athlete returns to full play to avoid reinjury and maintain the patients functional level of play. These same exercises can be used in the off-season to help prevent muscular injuries to the common muscles injuries in soccer: Groin, Hip Flexor, Hamstring and Calves.

Playing soccer alone is not enough. As athletes continue to train and play all year long, they continue to use the same muscle patterns and imbalances develop. That is why it is good to have off-season phases to the training year to allow the athlete to recover from past injuries and strengthen to prevent further injuries and further develop as a player.

Quadriceps Contusion By Craig Devine

2009-08-25T04:14:00.000-07:00

The quadriceps contusion, or charlie horse, or dead leg is a common thigh injury. This occurs when a player’s thigh makes contact with another player. This muscle impact injury is easily treated, but if not managed at the time of injury can lead to a substantial time lost from competitive play.

A contusion to the quadriceps or thigh muscle can be quite painful at the time of injury. Most of the time the player quickly recovers, but there are some contusions that are more severe. As with all acute injuries ice is the most important immediate treatment. Along with ice, the athlete needs to be instructed to bend his knee as far as possible and maintain the flexion range of motion. If this does not occur, the swelling deep in the muscle will limit the range of motion and the worst complication can occur. The body interprets this deep injury close to the bone and begins to lay down bone within the muscle. This is called myositis ossificans. This significantly lengthens the recovery and can be difficult to treat.

The avoidance of this bone development is simple. When you ice the thigh immediately, wrap the ice on around the leg with the knee in full bend or flexion. Educate the player to continue to bend his knee to maintain the flexion motion. An ounce or prevention is better than a pound of cure.

The Role of a Good Warm-Up and Cool-Down - Craig Devine

2009-07-17T05:40:00.000-07:00

Players at any age need to understand the need for a correct warm-up and cool-down. I often see players arrive at the practice pitch, drop their stuff on the ground and proceed to shoot on goal, kicking the ball as hard as they can. Then when practice is concluded, they pick up their stuff and head to the car to go home. Properly preparing for practice or a game along with stretching after this activity is the foundation for athletes to perform at their best and help prevent injuries.

Soccer is a dynamic, reactionary game that requires the muscles and nervous system to be ready to respond. A good warm-up consists of dynamic, total body movements mimicking the movements of the game. This warm-up should start slowly and advance to a more explosive intensity to fully prepare the bodies tissues (muscles and joints) to take the stress of competitive play. The ball can also be included to increase the player’s technical touches to help meet the goals of that practice or be ready to control the ball once the game begins. The final benefit of a good dynamic warm-up is to stimulate the nervous system to produce a player that is completely ready to react with body control from the starting whistle.

When the practice or match is completed, please do not just walk off the pitch. The primary component of a good cool-down is prolonged stretches. These stretches should be held 20-30 seconds and best if repeated twice each stretch. Do not bounce at the end of the stretch, but just hold the muscle pulling feeling. The benefit of this stretching is to maintain or improve overall flexibility of the muscle units and joints they move. This cool-down time also allows the cardiovascular system to settle down after an intense practice or game.

An appropriate warm-up and cool-down is just as important as the technical and tactical parts of a training session. It only takes 10-15 minutes at the start and finish of each session. The warm-up time can include the ball to introduce the technical aspect of that training session. It also is the time for the athlete to focus on their game to compete at their best and be prepared to learn. The time of the cool down is also a good time for the coach to meet with the players. He or she can monitor good stretching form while reviewing the teaching points from that training session or having a quick game summary with the team. At the start of this fall season get in good warm-up and cool-down habits to play ay your best and help prevent injuries.

High Ankle Sprains - Craig Devine

2009-02-15T16:22:00.000-08:00

In the last installment we discussed the classic lateral or inversion ankle sprain. In this article we will talk about a “high ankle sprain”. The shin bones, the tibia and fibula, connect just above the ankle joint to form an arch over the main ankle bone, called the talus. There are ligaments that connect the tibia and fibula together and the primary structures are the anterior (front) talofibular and posterior (back) talofibular ligaments. There is also a broad connect tissue that spans the entire length up between the tibia and fibula, called the syndesmosis. In a high ankle sprain the ligaments and connective tissues between the tibia and fibula can be injured.

The difficulty with this ligament injury compared to the lateral ankle sprain is that every time you place weight on the foot the tibia and fibula spread apart stressing the high ankle sprain injured tissues. Therefore, there is often a period of non-weight bearing using crutches followed by a gradual return to walking stress in a protective boot. This greatly lengthens the recovery time and return to the pitch.

In significant ankle injuries there should always be a proper physician evaluation to determine the extent of the injury and possible syndesmotic or high ankle sprain. Fortunately, the frequency of a high ankle sprain is much less compared to the classic inversion ankle sprain. Next, I will discuss an ankle sprain that is very specific to our sport and this injury has driven the creation of fouls to limit the occurance of the Footballers Ankle.

Ankle Sprains - Craig Devine

2009-02-02T17:34:00.000-08:00

Originally the field of sports medicine’s goal was to develop surgeries and treatment protocols to restore athletic function after an injury. Over the past 10-15 years the focus has shifted to how we can attempt to prevent these injuries. This began with research to discover injury trends. Then specific injury prevention programs were designed to determine if that specific injury trend could be reduced. FIFA sports medicine professionals have collaborated to create F-MARC to lead the way with this research for our sport of football/soccer. The most common injury in soccer is ankle sprains, followed by a variety of muscle strains. My next few article topics will focus on these common injuries and how best to attempt to prevent them.

Ankle sprains are the most frequent injury in all sports, not just soccer. The classic injury is when the ankle rolls inward or into inversion. This injures the outside or lateral ankle ligaments. These injuries are graded in severity from 1 to 3. A grade 1 sprain is a mild injury and may result in only 1-2 weeks or less missed from play. A grade 2 is a moderate injury with more swelling and may result in 2-4 weeks lost from play. Finally a grade 3 injury is more a severe sprain that may result in 4-6 weeks lost from play due to longer healing time required. Research highlights that most ankle sprain re-injuries are due to incomplete rehabilitation. Therefore, seek proper evaluation from a physician and treatment in physical therapy to completely restore strength and neuromuscular control for the best chance of avoiding a re-injury. Taping and bracing can also help prevention as you return to match fitness.

Unfortunately, this common injury cannot be completely avoided. But, the best prevention is by performing balance exercises to train your ankle muscles to protect the joint. This balance training is called proprioception and can be easily incorporated into a practice cool down with single stance activities. For example, balance on the right foot while a partner tosses a ball for you to volley back with the free left foot, without touching the left foot to the ground. You can get creative to make your partner touch the ball with all parts of his body with balance control to also improve their ball control skills while improving balance on one foot.

There are also other ankle injuries such as high ankle sprains and footballers ankle that will be discussed in the next article installments. Train hard with passion, and stay healthy!

Shin Splints? - Craig Devine

2009-01-11T19:28:00.000-08:00

Shin splints are a common term to most people, but what is this problem? This is a general term that covers any pain at the shin area. Typically shin splints are an overuse injury that follows an increase in running activity or volume. As the spring season approaches, players increase their amount of running with pre-season fitness, indoor games and early practices. Classically, shin splints are a result of impact overuse or “too much too quick”. But there are a few instances that require more attention:
1) Proper running shoes. Running shoes that are older do not reduce the impact forces of running that can increase the risk of shin pain. Running shoes typically last 300 to 500 miles until the midsole material reduces its shock attenuation. Keep your runners new and in good shape.

2) Flat feet. Athletes with flat feet or low arches place increased stress on a muscle that attaches on the shin bone (tibia). The repetitive activity of running irritates this muscle resulting in shin pain on the inside of the tibia. The first treatment is to stretch the calf muscle/achilles tendon unit. A tight calf muscle will place more stress on the arch resulting in more flattening or pronation. If symptoms continue some athletes will require orthotic inserts to support the arch tissue to reduce pain with running and play, especially since there is no arch support in the soccer boot.

3) Finally, if pain continues despite conservative treatment a stress fracture should be considered. This will require evaluation from a physician with possible special testing (x-ray, bone scan or MRI).

Even though soccer requires running, this overuse injury is relatively rare. This is possibly due to participation on the softer grass surface. But, go to any high school early in the spring track season and this is probably the number-one injury complaint. The next sports injury topic will review a more common problem in soccer, muscle strains. Fortunately research studies outline that these injuries can be reduced, and I will tell you how this can be accomplished.

Athletic Position and Avoidance of Knee Injuries - Craig Devine

2009-01-10T08:27:00.000-08:00

The growth of the teenage years ushers the development of muscle strength and power that enhances the athletic ability of the player. The negative side of this age group development is that research highlights an increase in injuries. The goal of sports medicine professionals is to learn how to prevent these injuries. Through this brief article and ones to follow, I will hope to pass on what we know from recent scientific studies and how frequent soccer related injuries can be reduced.
The topic of this month’s article relates to the coaching provided to the athletes participating in the fitness sessions held this winter off-season. The Anterior Cruciate Ligament (ACL) is a central ligament that controls rotational stability of the knee. This is a common injury in soccer and most often is injured in non-contact, pivot movements when the knee is close to full extension and the knee collapses inward (valgus). The trouble with an ACL tear is that it cannot heal on its own and requires a surgical reconstruction to restore functional stability to the knee.
Research highlights that ACL injuries, like most injuries, commonly happen during games. Therefore, preventative techniques need to be broken-down and taught in a practice format to provide player learning to perform more athletic and instinctive movement patterns in a match situation. This is the same way we as coaches, teach the techniques and tactics of the game. There is a preventative program called “Sportsmetrics” developed by Dr. Hewitt at Cincinnati Sports Medicine. This program uses jump training, or plyometrics, to teach athletes proper athletic posture to protect the knee during cutting or change of direction movements. The goal is to teach the player to flex or bend the knee and hip in a squat movement pattern, while avoiding the knee from collapsing inward into a valgus position. This squat movement increases hamstring muscle action to dynamically stabilize the knee while the athlete is aware to keep his/her knees straight ahead and not pinch in toward each other.
In summary, the athlete can perform a jump over an object or off of a stable bench and focus on proper landing technique. A video camera or mirror can be utilized to help the athlete see the correct mechanics and reinforce learning. Then the athlete can be aware to use this learned knee and athletic body position during cutting, pivoting and change of direction movements to protect the knee. Remember these key points to reduce your knee injury risk:
Flex or bend the knee and hip in a squat position
Keep the back straight with vision/head up
Weight is distributed on the feet and not completely forward on the toes
Knees remain straight ahead and over the feet
Land softly so leg muscles control and protect the knee

Elite FC Sports Performance - Craig Devine

2009-01-10T08:22:00.000-08:00

There are 2 types of speed in relationship to running performance: top end speed and acceleration. Top end speed depends on your genetic muscle fibers. If you have more “fast twitch” fibers then you will be faster than your opponent. You can train to improve anaerobic fitness to recover quicker to make multiple runs (sprints) during a match and avoid fatigue. But, acceleration also has a large form component that can be trained to improve your first few explosive steps.

Acceleration has four main components that can be trained:
- Forward body lean
- Arm drive from the shoulders
- Stride power with knees driving toward your chest
- Light on your feet with pushoff from your toes

Learning to run more athletic can improve your acceleration on the pitch. Although this will not improve your speed on the ball, it will help you accelerate without the ball to separate from an opponent to get to a ball first or recover defensively. Quickness on the ball demands Elite ball control and this can also be trained with daily ball work to improve as an overall player.