How to Prevent the Most Common Injuries in Soccer

From the feet to the head, every body part is vital, and at risk, when playing soccer. As the men's 2022 World Cup begins, we asked orthopedic surgeon Christopher Ahmad, MD, chief of sports medicine in the Department of Orthopedic Surgery at Columbia University Vagelos College of Physicians and Surgeons, about injuries to players of all ages and abilities. 

“During the World Cup many players are energized—especially our youngest—and commit themselves to high intensity training with dreams of one day making it to the next level and representing their country in the World Cup. Reaching for the stars is excellent mentally and physically, but a major problem is injury,” says Ahmad, who was head team physician for the New York City Football Club during their 2021 MLS Cup championship season. 

Soccer is personal for this doctor. Ahmad dreamt of going pro as a kid and made it as far as Columbia University, where he played for the men’s soccer team while preparing for a career in sports medicine.  

"It was the best path to stay connected to the game I love, contributing to players and teams in a profound and meaningful way,” says Ahmad. He still hoped to be a player himself. But the day before his medical school entrance exam, he was injured in a match. This personal injury intensified his interest in taking care of athletes.  

“The worst and most devastating injuries can take such a lengthy time to recover that careers are profoundly impacted,” says Ahmad. “That’s what every athlete fears and that’s what I help prevent and treat every day.” 

Top 3 worst soccer injuries 

Soccer is a physical sport. Whether you’re a pro or it’s your first practice, here’s what to watch for: 

1. Concussion 

The most common soccer injury—nearly one-quarter of all soccer injuries—is concussion. Concussion can happen to any player—men, women, and youth—and can have lifelong effects if not managed properly. Among kids, learning proper technique for heading the ball is one of the best ways to prevent concussion.

Concussion is an injury that requires parents and coaches to be knowledgeable about the signs and symptoms. Concussion symptoms can occur immediately or within minutes or hours after the injury. Failure to recognize a concussion can lead to further injury and lengthy or even permanent symptoms. 

• Any soccer player sustaining a blow to the head should be evaluated.
• If a concussion is suspected, an athlete should not resume play until evaluated by a concussion specialist. Even if symptoms resolve, that player should not go back into a game or attend practice. 
• Players who lose consciousness, exhibit seizure activity, loss of coordination, and/or disorientation, must discontinue play. 
• Other signs of concussion are more subtle, such as feeling in a fog, nausea, headache, difficulty concentrating, balance problems, and being sensitive to light or noise.
• Some athletes with concussion become emotional with sadness.

Columbia Orthopedics has a dedicated concussion program that provides in-depth diagnosis and recovery treatments to return athletes to play.

2. ACL injuries

Tears and sprains of the knee's anterior cruciate ligament (ACL) are common in any sport or activity involving sudden stops, changes in direction, and jumping and landing. These injuries are especially prevalent in soccer. 

ACL injuries can happen to any player, but women and people assigned female at birth have more risk. Risk can be reduced with individualized prevention strategies. Talk to your doctor to make a plan for you or your child if the team does not have a doctor.  

• Without proper diagnosis, treatment, and rehab, ACL injuries can reoccur. A reinjury compounds the devastation of an initial injury. 
• ACL injuries uniformly require surgery for return to play. Surgical techniques today are better than ever.

3. Hamstring strains 

During the World Cup, some of the best players will probably be sidelined with hamstring strains.

Biologic treatments, such as platelet-rich plasma (PRP), can accelerate return to play. PRP is a regenerative treatment that accelerates recovery by using a person’s own blood platelets, which contain elements essential to healing in soft tissue and bone. Studies show PRP, an alternative to surgery, is effective when injected in the injury site.

Columbia physicians have developed hamstring prevention strategies, imaging protocols for improved diagnosis when hamstring injuries occur, and rehab programs that include biologic treatments for rapid return to play. 

How to prevent soccer injuries 

Modifying risk factors like weakness and muscle imbalance decrease injuries.  

Ahmad, who helped developed ACL and hamstring prevention strategies, says: "Just 10 minutes of focused exercise a few times a week can prevent injury. The issue is compliance. If athletes do not do the exercises, there is no risk reduction. Our goal is to work with coaches and parents to maintain and improve compliance." 

The 2022 FIFA World Cup kicked off Monday, Nov. 21; the final is Sunday, Dec. 18.