For goalkeepers, finger injuries are typically sustained by catching the ball on the end of the
finger, with fractures to the distal or middle fingers or the joints of the finger. Forearm fractures
and wrist fractures or sprains may also occur as the goalkeeper attempts to stop the oncoming shot.
Complaints of lower-back pain are most often the result of muscle strains or ligament sprains
and usually respond well to conservative management. However, persistent or recurrent back pain or radicular
syptoms should warrant a further diagnostic evaluation.
Groin injuries are perhaps the most common of injuries to the lower trunk, pelvis, and/or
upperleg in soccer. Chronic groin pain is often encountered in soccer players and is likely caused by the biomechanics
of forceful kicking in which abdominal muscles and hip flexors and adductors are repetitively stressed.
Lower extremity injuries account for approximately 60% or more of all soccer injuries.
Contusions to the lower extremities, muscle strains of the thigh, and ankle sprains
ate the most common acute injuries. Stress fractures and a variety of overuse injuries involving the
leg, ankle, and foot in adult soccer are overuse injuries frequently ecountered by soccer palyers.
Meniscal tears and ligament injuries in soccer typically result from pivoting or sudden
deceleration stresses.
Iliotibial friction syndrome presents as lateral knee pain that progressively worsens
during running after a pain-free start. A tight iliotibial band over the lateral
femoral condyle can result in an inflamed bursa with heavy training. Players with varus knees and an
oversupinated gait may be more prone to this condition. The treatment is generally conservative
with ITB stretching and occasional cortisone injection in the bursa.
Direct kicks to the anterior leg are quite common in soccer and may result in tibia fractures.
Fortuantely, the use of shin guards can significantly reduce the incidence of these injuries, and shin guards are now mandatory
in most youth leagues and many collegiate and adult leagues as well. Despite the protection offered by
shin guards, it is clear that the forces generated by a direct kick to the tibia can still be
sufficient to cause fractures and a fracture should be strongly suspected if an injured player is
unable to bear weight due to pain in the shin.
Ankle sprains are certainly the most common injuries accounting for lost playing time at all
levels. The basic regime of ice, elevation, and compression apply acutely to most ankle sprains
and a splint and crutches may be required for several days. owever, the trend has been away
from strict immobilizaton, even following severe sprains, and toward allowing the paitent to
begin weigth bearing as tolerated and early range of motion.
Most soccer players will sustain numerous subungual hematomas of the toes during their career. These injuries generally occur to the great toe as the result of a direct crush by the foot of another palyer or from the shear stresses of sudden stops and atarts as the toe impacts against the close-fitting toe box of the soccer cleat. For many players the toenail becomes dystrophic as the result of repeated damage to the nailbed. Although seldom a serious problem, it can become troublesome.