Soccer Knee Injuries and How to Prevent Them

Soccer Knee Injuries and How to Prevent Them

The Increasing Popularity of Soccer

The 2018 FIFA World Cup begins this week, and with it an increased focus on the sport of soccer at all levels. Soccer is the most popular international team sport, and has become the fastest growing team sport in the United States. Not only does soccer provide an enjoyable form of aerobic exercise, it also helps develop balance, agility, coordination, and a sense of teamwork. With more people playing soccer, it is not surprising that the increase in soccer’s popularity has led to an increase in the number of soccer-related injuries, particularly as children get older and their level of play intensifies. Soccer players must be aware of the risks for injury, and injury prevention, early detection, and treatment can keep kids and adults on the field long-term.

Knee Injuries are Common in Soccer

Sprains and strains around the knee and ankle are very common in soccer, and the severity of the injuries varies. Common injuries that may require surgery include cartilage tears and anterior cruciate ligament (ACL) sprains in the knee. ACL injuries in particular have led to the most concern, especially amongst middle and high school aged females, their families and coaches. Although ACL injuries can happen from direct contact to the knee, the injury most often occurs with no direct impact on the knee, typically when a player lands after a jump or twists their knee sharply after planting their foot to change direction.

How to Prevent Soccer Knee Injuries

Several strategies can help prevent soccer injuries, ranging from stretching and warming up to careful inspection of the field and wearing proper cleats.

  • Maintain proper fitness. Conditioning-related injuries, such as strains and sprains occur most often at the beginning of a season when athletes are most likely to be out of shape. It is therefore important to be in good physical condition at the beginning of soccer season. To achieve a higher fitness level, a balanced fitness program is recommended during the off-season that incorporates aerobic exercise, strength training, and flexibility. If an athlete is out of shape at the start of the season, they should gradually increase their activity level and slowly build back up to a higher fitness level. Proper conditioning is particularly important for girls to prevent knee injuries. The twisting and cutting in soccer make girls particularly vulnerable to non-contact injuries of the ACL, which they suffer at a rate two to ten times higher than boys. In addition, girls are predisposed to instability or dislocation of the kneecap (patella), which causes pain and problems under the kneecap. Proper conditioning (especially building up hamstrings and inner quadriceps muscles) and teaching girls to pivot, jump, and land with flexed knees and employ a three-step stop with the knee flexed instead of a one-step stop with the knee extended have been shown to prevent some of these injuries.


  • Warm up and stretch. Research studies have shown that cold muscles are more prone to injury. Also, unlike sports like gymnastics or swimming, soccer does not develop natural flexibility. As a result, it is important to always take time to warm up and stretch before playing soccer, especially your hips, knees, thighs, and calves. Stretching is particularly important for soccer players between the ages of 10 and 13 who have less natural flexibility because their bones are growing faster than their muscles. It is also critically important for girls, who need to strengthen and stretch leg muscles to reduce the risk of ACL injuries. Recommended warm-up activities include jumping jacks, stationary cycling or running or walking in place for 3 to 5 minutes. Afterwards, slowly and gently stretch, holding each stretch for 30 seconds.


  • Cool down and stretch. Stretching after playing soccer is often neglected because of forgetfulness and busy schedules. Stretching can help reduce muscle soreness and keep muscles long and flexible. Be sure to stretch after each practice or game to reduce your risk for injury.


  • Hydrate. If you have not had enough fluids, your body will not be able to effectively cool itself through sweat and evaporation, and even mild levels of dehydration can negatively affect athletic performance. Waiting until you are thirsty is often too late to hydrate properly, and it is therefore important to plan times to re-hydrate. A general recommendation is to drink 24 ounces of non-caffeinated fluid 2 hours before exercise. Drinking an additional 8 ounces of water or sports drink right before exercise is also helpful. While you are exercising, break for an 8 oz. cup of water every 20 minutes.


  • Choose the right footwear. There is some evidence that molded and multi-studded cleats are safer than screw-in cleat, and therefore molded cleats or ribbed soles are recommended. Although shoes with screw-in cleats often are associated with a higher risk of injury, they should be worn when more traction is needed, such as on a wet field with high grass.


  • Playing surface. By some estimates, fully 25% of all soccer injuries result from poor field conditions, and the playing surface must therefore be kept in good condition. Holes on the playing field should be filled, bare spots reseeded, and debris removed. Awareness of poor field conditions that can increase injury rates are everyone’s responsibility; don’t leave it to the referee to check the field for holes, puddles, broken glass, or stones or other debris.


ACL Injury Treatment from Avalon Orthopedic

If you have suffered an ACL injury, call the knee specialists at Avalon Orthopedic today at (818) 206-8686 for a consultation.



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