Some of the best female athletes in the world will take the field as the FIFA Women’s World Cup begins later this week. Given the controversy regarding the use of artificial turf instead of natural grass, as well as females having greater risks for Female soccer playernoncontact knee injuries than males generally, it will be interesting to see if many serious injuries occur.

I think it is crucial for the field of sports medicine to not only seek more effective treatments for musculoskeletal injuries but also to continue to develop and implement strategies and programs to prevent the injuries in the first place.

In a study recently published in the British Journal of Sports Medicine, Alan McCall and other researchers surveyed all 32 team physicians of the teams competing in the FIFA 2014 World Cup. They aimed to determine what types of injury prevention strategies these doctors and medical staffs used with their elite male athletes.

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The survey offers insight into perceived risk factors for injury in soccer. It also demonstrates the ways each medical staff tried to assess the risk factors, monitor the health of the players and engage them in regular exercise programs.

The top 5 perceived intrinsic risk factors for injury

1. History of previous injury
2. Accumulated fatigue throughout the season, such as too many matches in a short period of time
3. Presence of a muscle imbalance
4. Physical fitness level
5. Balance and coordination

The top 5 perceived extrinsic risk factors

1. Reduced or inadequate recovery time between matches
2. The volume of training with the professional clubs prior to the World Cup
3. The volume of training during the World Cup and congested schedule of matches
4. The number of matches played during the club season and poor quality of the pitches
5. The facilities for recovery

The 5 most common screening tests used by national team physicians to assess injury risks

1. Flexibility
2. Physical fitness
3. Joint function and mobility
4. Proprioception and balance
5. Evaluation of muscle endurance strength and peak strength

Soccer ball on field in sunlightThe 5 most commonly used tools to monitor players

1. Daily medical screenings of players
2. The number of matches played or minutes played
3. Subjective wellness of the players
4. Heart rate
5. Other biomechanical markers, such as blood tests

All 32 national teams and their medical staffs tested and monitored their players before and during the FIFA World Cup. 94% created an “individual player risk profile” for each player. 91% of the teams implemented an injury prevention exercise program, and all but one of those teams customized the exercises to the risk profiles of the individual athletes.

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Finally, 26 of the 32 national team physicians felt that their injury prevention strategies were effective at decreasing injuries, but they admitted they could have improved.

These findings are certainly encouraging. Despite the World Cup being arguably the most important soccer tournament in the world, national team doctors largely tried to prevent injuries instead of pushing athletes to play no matter what. We still need far more research to help us design the most effective injury prevention strategies and the best ways to implement them. Then we need to find ways to get these programs into soccer at all levels of the sport.

How do you think we can best prevent musculoskeletal and other injuries in soccer (football)? If you play soccer, does your team perform regular injury prevention exercises? Share your ideas and experiences below!

McCall A, Davison M, Andersen TE, et al. Injury prevention strategies at the FIFA 2014 World Cup: perceptions and practices of the physicians from the 32 participating national teams. Br J Sports Med 2015;49:603–608.