Injury Prevention

General Comments: As the saying goes, it is much easier to prevent an injury than to correct one. Coaches may not even realize that when they teach their players proper stretching, Incorporated plyometrics into their drills, work to develop strength and cardiopulmonary conditioning, and teach the proper technical skills of the game, they are doing much to prevent injuries as well as improve performance. Most “certified” trainers and coaches who live in the competitive realm of soccer, have training in these areas. However, many coaches reside in the recreational side of the sport and often are simply “dads” who volunteer to help with their son or daughter’s team. Unless these dads have a background in sports, sports injury or fitness, they probably know very little about injuries, soccer safety, injury prevention or conditioning techniques. Large soccer organizations like AYSO, large clubs and state soccer organization often have basic training programs and coaching certification programs for those parents who want to learn more, however it is not normally required that they do so. Smaller organizations (Boys and Girls clubs, YMCA, city recreational programs) generally do not have these training programs. (There will be some exceptions).

Note: This posting deals with the physical preparation as part of injury prevention. Other aspects of injury prevention are addressed in each of the separate categories, including Field Safety, Player Equipment, etc.

Pre-Season Screening: High schools require players to have a pre-season physical exam prior to playing. This is not required in recreational or club soccer to my knowledge. Parents might consider having a sports participation physical for their child before signing them up for any organized play or sports. This would also be a good time to update any needed immunizations. (See communicable diseases in this website).

It is not the purpose of this posting to give you a program to use for your team/player, but to advise you of the importance of conditioning and injury prevention. Attending coaching classes, learning from more experienced coaches, and browsing the internet for ideas will provide information needed to develop a program of your own.

Proper Technical Training (skill development): Clearly the development of proper soccer skills is a prime part of injury prevention. It is my opinion that players who do not have good skills are more likely to sustain injuries as they attempt to perform soccer moves that they are not trained to do. Developing balance and coordination both with and without the ball, produces a player who is in “control” of their body while playing the game. Teaching players the correct method for jumping and landing (part of a plyometric program) is an essential component of a knee injury prevention program, particularly ACL injuries.

Fitness: In this I include strength, flexibility and cardiopulmonary conditioning. Good strength, flexibility and stamina all play a role in injury prevention. Strength training can be accomplished in a variety of ways. Most commonly coaches will include core strengthening (abs, and back), plyometrics (jumping drills), lunges, etc. At higher levels and in high school age players, gym equipment may be used. Lack of strength is a major contributor in knee injuries, back strains, ankle injuries, and muscle strains. Flexibility: Stretching has been a primary tool for coaches as part of their practice and game preparation for decades. I can tell you that as a Physical Therapist, I use stretching programs on a regular basis. A good and effective flexibility program does not have to take 30 minutes to do. Time is usually limited at games and as part of practice, so quality of the stretching component is more important than the quantity (duration). Coaches should instruct their players in proper technique and muscle groups.

A good stretching program might look like this:

• A brief pre-stretch warm up of light jogging for 5 minutes to get the muscle warm and blood flowing before stretching.
• Two 30 second stretches for the primary muscle groups (Hams, Quads, Groin, Calf, and back). For goalkeepers, upper body must be addressed. Stretches should be static in nature, without bouncing. There are good illustrations on the Internet for coaches regarding stretching positions. The total routine need not take longer than 10 minutes.
• Post activity stretching: This is often neglected and may be just a important as the pre-activity stretch. After playing, muscles have tightened. They are rich in blood flow and very warm, and as such, are more pliable and easily stretched using the same techniques. This provides flexibility that will carry over to the next game.

Cardio: Fatigue is a key contributor to injuries. When players are tired they lose control of their bodies, their technical ability is reduced, and they are unable to physically adjust to the demands of a free flowing game like soccer. There are many different approaches to cardiopulmonary conditioning, but generally for soccer, coaches will combine a few long runs with sprint intervals which mimic the requirements of soccer. This is normally done both with and without the ball.

Agility and Balance: This can also be part of the technical side of training, as this is developed in “ball drills”. It can also be done independent of the ball, depending on coaching philosophy. There are multitudes of drills and activities that promote the development of good balance and agility. Lack of either of these characteristics puts a player at greater risk of injury.

Warm up & Cool down: It is very important to provide a good warm up prior to engaging in vigorous drills.   starting with an easy run, followed by a stretching session, and then some work with the ball can be part of a good warm up.   Building intensity of the session is essential.   Cooling down is very important as well, and can actually take longer than a warm up.  It is never good to end a practice session with the most physically demanding portion of the session.   Finishing with something less intense, slower paced, and finally a good end of practice stretching session for muscle that have become tight with exercise.

Player Education: When they are old enough (say around 12 or so), players can be taught strategies to prevent injuries. Emphasizing the importance of personal responsibility for stretching, strength, and conditioning will help the player “own” responsibility for themselves. With my patients who I see in physical therapy, education is vitally important in the success of their program. Telling a player to stretch or do plyometrics drills is not enough. They need to be instructed in why they are done and what they can do for the player. If the player is “invested” in their own program, they are much more likely to follow through.

In Summary: New and inexperienced coaches should take a coaching class, find a coaching mentor (someone with experience), and browse the Internet for programs and ideas. A good resource might be a parent on your team. On my first competitive team, I had 6 former soccer coaches, two EMT-Firefighters, a personal trainer at a fitness center, 4 club administrators, 2 school teachers, and a physical education instructor. If you are a new coach, and there are not coaching classes available to you, and you have no qualified parents to assist you, I suggest finding a local soccer club and ask if you can observe practice sessions run by licensed, experienced coaches. I am sure they would be more than happy to have you sit in on a few sessions.