Soccer Injuries in Children and Adolescents

Abstract

Participation in youth soccer in the United States continues to increase steadily, with a greater percentage of preadolescent participants than perhaps any other youth sport. Despite the wide-ranging health benefits of participation in organized sports, injuries occur and represent a threat to the health and performance of young athletes. Youth soccer has a greater reported injury rate than many other contact sports, and recent studies suggest that injury rates are increasing. Large increases in the incidence of concussions in youth soccer have been reported, and anterior cruciate ligament injuries remain a significant problem in this sport, particularly among female athletes. Considerable new research has identified a number of modifiable risk factors for lower-extremity injuries and concussion, and several prevention programs have been identified to reduce the risk of injury. Rule enforcement and fair play also serve an important role in reducing the risk of injury among youth soccer participants. This report provides an updated review of the relevant literature as well as recommendations to promote the safe participation of children and adolescents in soccer. Soccer is the most popular youth sport in the world and is 1 of the most popular team sports in the United States. 1 It is estimated that 3.9 million children and adolescents participate in soccer annually, 2 and from 1990 to 2014, the number of youth officially registered with US youth soccer programs increased by almost 90%. 3 Despite the wide-ranging health benefits of participation in organized sports, injuries occur and represent a threat to both athlete health and performance. 4 Unfortunately, recent studies suggest that injury rates in youth soccer may be increasing. Sportsrelated injuries represent a significant and increasing economic burden to the health care system, and the prevention of sports-related injuries in children has far-reaching health and economic benefits to the patient, the family, and the health care system as a whole. Given the number of children and youth participating in youth soccer, reducing the risk of injury among such a large group of participants has the potential to reduce attrition rates, promote lifelong participation in sport, and facilitate the

Reducing Injuries in Soccer (Football): an Umbrella Review of Best Evidence Across the Epidemiological Framework for Prevention

“…The incidence of injuries appears higher among males vs. females, and injury incidence is higher during games/matches vs. practice/ training for all participation categories, among both male and female players [10][11][12]. Soccer players younger than 12 years of age have a lower injury rate (1.0-1.6 injuries per 1000 h) compared to older players [9].…”

“…Injury incidence among soccer players differs across levels of participation, age, type of exposure, and sex. The incidence of injuries in soccer is mostly significant during games/matches, ranging from 9.5 to 48.7 injuries/1000 h among competitive male youth players, 2.5 to 8.7 injuries/1000 h among male professional players, and 12.5 to 30.3 injuries/1000 h among female players [9][10][11][12] (Table 2). The incidence of injuries appears higher among males vs. females, and injury incidence is higher during games/matches vs. practice/ training for all participation categories, among both male and female players [10][11][12].…”

“…Previous Injury A history of previous injury continues to be the most consistent and strongest risk factor for future injury, and this also holds true for specific injuries [9,[25][26][27][28][29]. For example, a history of previous hamstring injury is associated with future hamstring injury among male players [25,28], previous ACL injury is associated with risk of future ACL injury [29], and previous ankle sprain injury is related to the emergence of new ankle sprain injuries [27].…”

“…Early Sport Specialization Though there is a lack of substantive evidence for soccer specifically, early sport specialization has been found to be associated with a greater risk for overuse injuries across multiple youth sports [9]. One study showed that female soccer players 12-15 years of age playing on more than one team had increased risk for lower extremity overuse injuries [32].…”

“…Furthermore, eccentric hamstring strength (< 256 N) and single leg hamstring bridge scores of less than 20 reps on the right leg are associated with increased risk of hamstring strain [43]. Poor landing mechanics, specifically, increased dynamic knee valgus, is associated with increased risk for lower limb injury, including ACL injury [9,42,43]. Leg dominance and leg asymmetry also relates to increased risk of injury; a difference of 15% or greater, between an individual's dominant and nondominant limb, has been shown to predict future injury [42].…”