Playing soccer safely

with advice from Jocelyn Arroyo‑Espinet, CPT
and Jim Liston, MA, CSCS

Playing soccer safely

With the Champions League final coming up in Berlin between Juventus and Barcelona, and soccer summer leagues starting soon, it’s a good time to think about playing soccer. And given the high rate of some injuries while playing soccer, it’s even more important to consider how to play the sport more safely.

As any athlete (or sports parent) knows, playing sports brings the risk of cuts, bruises and contact injuries (from running into an opponent or teammate). While many soccer injuries occur in the lower extremities (the hips, legs and ankles), some players may experience neck sprains or shoulder injuries after a collision with a fellow player or a fall to the ground.

Keeping your head in the game.Use your head… or should you?

One common category of soccer injuries that’s been getting more attention in recent years is brain injuries and concussions. Scientific American asked the same question in multiple articles in 2013 and 2014: Does heading a soccer ball cause brain damage? The short answer is, yes, it can; the author of the most recent article states that “heading a soccer ball can contribute to neurodegenerative problems, such as chronic traumatic encephalopathy.”

In addition, it seems that there is a correlation between the number of times a player heads the ball and the chance of brain injury, which is one of the reasons these researchers are recommending that players under the age of 14 not head the ball. Even if players aren’t showing signs of concussions, players can be at risk due to the repeated jolts to the head. First noted in football players, researchers are seeing that many small impacts can cause just as much damage as those harder collisions that are known to cause concussions. That said, any time a player suffers a serious collision or fall on the field, or if he seems to have problems with memory or trouble sleeping, or complains of chronic headaches, it’s time to head to the doctor for a check-up.

In soccer, the lower extremities have higher risks.Lower extremities, higher risks

Some lower extremity (LE) injuries are from overuse, or playing too frequently, says Jocelyn Arroyo-Espinet, a certified personal trainer at Progressive Physical Therapy, a Physiquality member in Southern California. As an experienced soccer player and coach, she has seen many of these, both on the field and in the clinic: tendonitis in the knee, Achilles tendon, quads or hamstrings; shin splints; pulled muscles, where the muscles in the groin, calf or hamstring become overextended; and stress fractures in the foot.

More serious LE injuries happen either 1) because the leg muscles and tendons, weak from overuse, tear or rupture, which can often cause ACL tears, or 2) when players collide or lose footing on slippery grass or turf, like a broken leg or sprained ankle. And while one 2010 study suggested that girls and women are at much higher risk for ACL injuries, Jocelyn points to a more recent paper showing that a) both men and women that play soccer have the same injuries, b) it’s more common to have non-contact injuries than those that are a result of contact (either with another player or with the ground/an object), and c) men have twice as many injuries as women.

Steps for soccer safetySteps for soccer safety

How can players reduce the risk of these injuries? Some of the steps happen before you even approach the field. Jocelyn advises making sure that all of your equipment is the proper size and worn correctly; wearing shoes that are too big, for example, could cause a small misstep and a big knee injury. She also suggests using synthetic balls: “Leather balls can become waterlogged and heavy,” she says, which can be more dangerous when heading the ball.

Jocelyn also suggests paying attention to what you eat. Hydration, of course, is very important; drink water before, during and after the game, and if it’s hot or if you’re playing in a tournament where multiple games are being played, a sports drink may be in order. (If it’s really hot, consider drinking it as a slushie.) Even more important, she says, is what you eat: “The energy needed to play soccer requires a balanced diet of fats, proteins, vitamins and carbohydrates. Make sure you are consuming appropriate amounts of each.” The U.S. Soccer Federation posts similar advice, suggesting balanced meals with fruits and vegetables, lean protein and healthy fats, and proper hydration.

Thorough warm-up programs have also been shown to reduce injury. Jim Liston, the co-founder of Physiquality partner CATZ Sports, explains, “The objective of the warm-up is to raise total body temperature and muscle temperature to prepare the entire body for physical activity.” This prepares each system in your body — cardiovascular, respiratory, and nervous, as well as musculoskeletal — by gradually increasing the demands on the systems and enabling them to accommodate the demands of more strenuous activity.

Jim notes that warm-ups for soccer players should utilize low-intensity movements and exercises that involve the body parts that will be involved in the sport. These warm-ups can also include exercises shown to reduce injury, like the PEP Program developed by the Santa Monica Sports Medicine Research Foundation, or the FIFA 11+ program developed by the Medical Assessment and Research Centre associated with the Fédération Internationale de Football Association, the international governing body of association football, futsal and beach soccer. Jocelyn adds that such strengthening programs will focus on the hips, hamstrings, and ankles to help reduce injury.

Jim reminds players that by increasing muscle efficiency, improving reaction time and stimulating muscle speed through thorough warm-ups, players will not only reduce their risk of injury, but often improve their athletic performance. Just remember to listen to your body — another key component of athletic performance is rest, says Jocelyn. As we have pointed out before, the more rested you are, the better you’ll perform.

Jocelyn Arroyo-Espinet

Jim Liston, MA, CSCS

Jocelyn Arroyo-Espinet, CPT, is a certified personal trainer at Progressive Physical Therapy, a Physiquality member with four locations in Southern California. She played soccer for 13 years and coached for five, from AYSO through the high school level. Jocelyn has a degree in kinesiology with an emphasis in applied fitness and has worked in the physical therapy field for nine years.

Jim Liston, MA, CSCS, is the co-founder of CATZ Sports, one of Physiquality’s partner programs. One of the country’s leading experts on training athletes and mentoring coaches, he has spent the last 20 years in the field of sports performance training honing his own abilities as a coach and a teacher.

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For further reading, look through our selection of articles on sports and fitness, in addition to the below links:


Keilman, John. Heading a soccer ball is risky even if concussions rare, researchers say. Chicago Tribune, April 28, 2015.

Moreau Physical Therapy.

Scientific American.

Longo, Umile Giuseppe, Mattia Loppini, Roberta Cavagnino, Nicola Maffulli and Vincenzo Denaro. Musculoskeletal problems in soccer players: current concepts. Clinical Cases in Mineral and Bone Metabolism. May-August 2012.

Heads up: Concussion in youth sports. Centers for Disease Control and Prevention, May 29, 2012.

The 10 nutrition rules to live by. U.S. Soccer, January 17, 2012.

The brain injury guide and resources. Missouri Department of Health and Senior Services and the MU Department of Health Psychology.

What is FIFA 11+? Fe´de´ration Internationale de Football Association.

O’Connor, Anahad. Head injuries on the football field. New York Times, September 8, 2011.

Stein, Jeannine. ACL injuries could be influenced by gender and which leg dominates, study finds. Los Angeles Times, August 2, 2010.

Kolata, Gina. To beat the heat, drink a slushie first. New York Times, April 27, 2010.

Mandelbaum BR, HJ Silvers, DS Watanabe, et al. Effectiveness of a neuromuscular and proprioceptive training program in preventing anterior cruciate ligament injuries in female athletes: 2-year follow-up. The American Journal of Sports Medicine, July 2005.

The PEP Program: Prevent injury and enhance performance. Santa Monica Sports Medicine Research Foundation.

The material and information contained on this Web site is for information only and is not intended to serve as medical advice or consultation.

Consult your personal physician before beginning any exercise program or self-treatment.