Common Sports Injuries in Soccer:
Acute and Chronic

Acute: Traumatic injury

1. Ankle Sprain - Probably the most common injury on the soccer field.  Usually the player will land on the outside of the foot and roll over the ankle, causing a strain or tear in the ligaments.
   
   Treatment:  All ankle sprains should be treated immediately with ice, elevation, and compression.  The most effective form of icing post-injury is an ice bath for seven minutes every hour, or a cold pack for fifteen minutes every 2 hours.  It is important not to stress the overstretched ligaments, so avoiding movement in the direction of your pain is important, and in severe cases crutches are necessary to allow for the ligaments to heal.  A complete medical assessment of the severity of the ankle sprain should be done as soon as possible in order to ascertain exactly what should and should not be done for the injury.  Follow up exercises to speed recovery and prevent further injury can be provided by a physical therapist.

2. Contusion - A hard blow may sometimes result in immediate swelling and a visible pooling of blood at the site of trauma.
   
   Treatment:  Acute care involves icing and compression over the injury.  An ace bandage can easily be wrapped around the thigh or calf.  Contusions to the shin should be carefully observed because the pressure can build up in the compartment, requiring aspiration.  An MD should address any such pressure symptoms or excess tissue swelling.

3. Muscle strain/pull - If a muscle is overstressed, it can result in micro tears of the muscle tissue.  The pain is usually elicited with active use of the given muscle or when the muscle is stretched.
   
   Treatment: In cases of muscle pull ice and compression, and massage are useful. One should avoid stretching the muscle until a medical professional ascertains the severity.  In general a muscle pull should resolve in 7-10 days. If it does not further examination may be necessary.

4. Back Pain - Back pain or stiffness in a child is quite unusual.  If the child is not considerably better within 2-3 days after the complaints begin a medical professional should be consulted. Back pain occurring mainly at night, especially in a child, is of major concern and medical attention should be sought.

5. Runner's cramp - A "stitch" in the side is usually caused by loss of fluid or over-exertion.
   
   Treatment:  Drinking a sports drink, eating a banana and applying pressure directly to the area of pain, then slowly stretching out the cramped area can also be helpful.  Being prepared well prior to activity by having good fluid intake and a carbohydrate snack 1-2 hours before can help prevent this.

Chronic: Over use injury

1. Osgood-Schlatter Disease - Mostly occurring in young athletes, Osgood-Schlatter's is characterized by chronic pain at the top of the shinbone.  It really is a severe form of tendinitis, which comes about from excessive forces on the patellar tendon from jumping and running.  This can lead to separation of the tendon from the bone. Addressed with appropriate rest and modification of training, it usually will resolve.

2. Sever's Disease - Mostly occurring in young athletes, this is characterized by a chronic pain at the heel where the Achilles tendon attaches. It is an inflammation of the growth plate in the heel bone.  X-rays will show a bony change at the site of the Achilles insertion. Appropriate training around the injury, shoe modification, and activity modification will be necessary.

3.  Patellar tendinitis - A chronic inflammatory response to the patellar tendon secondary to overuse.  The athlete will complain of pain just below the knee cap and it is usually very tender to touch.  Most often a biomechanical disadvantage due to inflexibility and/or weaknesses are to blame.  A good biomechanical evaluation may find what is responsible for the tendonitis, and a specific program set up by a physical therapist can eliminate the pain.  Performing an ice massage regularly will also be helpful.

4. Stress fractures - Most stress fractures in athletes occur in the lower limbs and they usually have a slow onset of about 2 - 3 weeks, starting with pain just during activity, but then progressing to resting pain.  The fractures result from a failure within the bone to adapt to the repetitiveness of certain activities and the torque of the muscles acting across the bone.  Many times the fracture cannot be picked up by x-ray, and a bone scan or MRI (a better choice for children) is used for diagnosis.  Rest of the area integrated with alternative exercising is essential for the proper healing of this injury.

5. Shin Splints - Pain on middle, inside, or outside the lower leg with activity can indicate shin splints.  Often shin splints are caused by a rapid increase in running mileage, improper footwear, running on hard surfaces, or poor flexibility.
   
   Treatment: Ice massage to the area before and after exercise, stretching the calf muscles, inserting cushions in the shoe and a biomechanical evaluation by a physical therapist who can recommend appropriate shoe inserts and flexibility exercises.