It is widely known that that soccer is the most popular and most commonly played sport in the world, with an estimated 270 million active soccer players participating in the game as of 2014. Like all sports, there is an inherent risk to injury in soccer with a higher risk of injury to the anterior cruciate ligament (ACL) relative to other sports. ACL injury causes a significant loss of time from competition in soccer, which has served as the strong motivation to conduct research that focuses to determine the risk factors for injury, and more importantly, to identify and teach techniques to reduce this injury in the sport.
Majewski et al. conducted a study of sport injuries over a 10-year period and observed 19,530 sports injuries in 17,397 patients. Soccer was found to account for the largest number of injuries; 37% of all injuries reported of which the majority were related to the knee at 39.8%.
Another review of the literature revealed that there was an increase to incidence of injury during soccer games which increased with age. Approximately 60-90% of all injuries were located to the lower extremity, particularly at the ankle, knee and thigh.
In recent years, FIFA created a standardized intervention program for soccer to prevent contact and non-contact soccer related injuries called the FIFA 11+. It is a 10-15 minute exercised based warm up program, if implemented properly can help to reduce soccer related injuries especially to the lower extremity. The 11+ program includes exercises which focus on core stabilization, eccentric training of thigh muscles, proprioceptive training, dynamic stabilization and plyometric drills performed with good postural alignment
In addition, many studies have concluded that multi-component programs show better results than single-component preventive programs to reduce the risk and incidence of ACL injuries in soccer players. Any combination of lower extremity plyometrics, dynamic balance and strength, stretching, body awareness and decision-making, and targeted core and trunk control appear to be successful training components to reduce ACL injury risk factors, especially in females.
It is important for a pre-season injury prevention program combined with an in-season maintenance program to help prevent injury in any sport, especially soccer. The key-limiting factor for success of any preventative program is compliance through activation and execution. With proper program execution, this may in fact be the factor for overall success of knee injury interventions targeted to soccer players, regardless of age, ability, or gender.
Jess Thomas MS, ATC, CHC
