Soccer is a great way to burn calories, work on coordination and just generally blow off some steam, but kicking that ball around can lead to injury if female players aren’t careful. Dr. Mike Dockery at OrthoCarolina told us female athletes are twice to eight times (!!) as likely as their male counterparts to suffer an ACL tear.
The risk of ACL injury in female collegiate year-round high-level soccer and basketball players is approximately 4.4% – 5% per year, compared with 1.7% for males.
We asked Dr. Dockery to give us the lowdown on soccer injuries in women, and what we can do to avoid them. Here’s what he had to say:
• Biology is to blame. Women have different landing biomechanics, especially when we jump or change directions suddenly. We tend to land more erect than men, and we generally have a smaller “notch” (this is related to the shape /opening in the knee for the ACL), and smaller ligaments. It’s possible that we also have more laxity or looseness in our knees and ligaments in general than men.
• ACL injuries and concussions are more common in soccer players than other athletes. Dr. Dockery said skiing, soccer, basketball and football are the highest risk sports for ACL injuries. That’s because these sports involve combinations of running, cutting and pivoting. And as the number of girls and women participating in sports continues to increase, so does the number of injuries, including ACL tears. For women, basketball, soccer and volleyball tend to be higher risk sports for ACL injuries. Approximately 70 percent of ACL injuries are non-contact injuries — a deceleration event and sudden change in direction with a planted foot (i.e., cutting maneuver) is the most common mechanism of non-contact ACL injury.
• A sprained ankle is the most frequently diagnosed soccer injury. Sprain and strains frequently involve the lower extremities, especially the thigh, knee and ankle, Dr. Dockery said. But the upper extremities aren’t immune. Fractured wrists and fingers (from trying to break falls) are also common.
• High schoolers who don’t play regularly could be more prone to injury. Dr. Dockery said in high school-age players, those with low exposure (less than one hour per week) were three to 10 times more likely to sustain a time-loss injury compared to other players. It’s likely because of their lower technique and skill level, as well as poorer conditioning.
• Overuse injuries are most common in younger adolescent players. Usually related to overtraining or incorrect training, overuse injuries can plague younger players. Dr. Dockery said time/duration of training and frequency of practice and games is important, especially when some athletes play on multiple different teams (school and club) at the same time/season. Breaks between seasons helps to allow bodies to heal and helps avoid burnout too. Cross-training may be helpful for some sports.
• Grass vs. turf could have an effect, but it isn’t certain. Some studies have shown a higher risk for injury on artificial surfaces, but this is not shown by all studies.
• Risk of injury is slightly higher for games (compared to practices).
How can we prevent injury, no matter what age group we fall into?
1. General strategies include proper warm-up, stretching, conditioning and use of protective equipment. Although using braces or taping can decrease ankle injuries, the same has not been shown with the effectiveness of functional braces in preventing non-contact ACL injuries to the knee. Parents and coaches should have realistic expectations of children’s performance to avoid early burnout, and to prevent injuries that arise when young athletes attempt to perform beyond their abilities.
2. Use shin guards, adequately secured and padded goalposts, nonabsorbent balls for wet playing fields and proper cleats. And think carefully about “heading” the ball – there are concerns about permanent cognitive impairment as well as risk for concussion, and therefore coaches should probably minimize the use of heading with young athletes.
3. When cutting or landing, make sure your knees are over your toes. According to Goal Nation, you can assess your risk for ACL injuries by having a coach or friend watch you jump from a stair or bottom row of a bleacher and landing on two feet. If you have a strong core, hips and thigh muscles, you should land with feet slightly apart and knees slightly bent and facing forward. If there’s a muscular weakness or imbalance, you will likely land the jump with one or both knees falling or facing inward and will be less stable overall.
When should I see a doctor?
Dr. Dockery said each athlete is different in her tolerance to injury and all reasonable complaints should be taken seriously, especially when there is a history of a specific event/injury.
- Ankle sprains – Is it tough or impossible to bear weight on it, or does the bone feel tender? If so, see a doctor. There could be a fracture.
- Knee injury – Did you feel or hear a “pop” followed by a fairly rapid onset of swelling (within an hour)? If so, see a doctor. Often in these cases, athletes are unable to keep playing and may need to be helped off the field, with an ACL tear or kneecap dislocation as a possible culprit.
- Obvious deformities – It may seem obvious, but if one of your limbs is crooked, see a doctor. You likely have a fracture or dislocation and need prompt medical attention.
- Possible concussion – Any signs of a concussion should result in immediate removal of the athlete from practice or play to see a medical professional immediately. These symptoms include headache, confusion, lack of coordination, memory loss, nausea, vomiting, dizziness, ringing in the ears, sleepiness and excessive fatigue.
For more information, contact a professional at OrthoCarolina.