Dynamic Warm Up
Bounce heel-toe walk
Bounce heel-toe walk with large arm circles
High step (high knees) with arm pump
High step with elbow cross
High step buttock kick
Straight leg high step with toe touch
Lunge with twist
Side lunge with reach to floor
Safety Training
Prevention
Medical emergencies
Musculoskeletal Injury First Aid
Soccer specific injuries
Tolland Soccer Club
First Aid kits
Medical release forms
Soccer Injuries
3 million children in organized soccer (2000)
150,000 soccer related injuries yearly
Highest injury rates in 11-14 year-olds*(2007)
45% of injuries occur in children <15 years old
Female > male
Females have increased joint laxity after puberty
81% of injuries are to lower extremities
Prevention
1. Environmental
• Hydration
• Lyme disease
• Insect repellant
• Tick checks
• Tick removal
• Sunscreen
• Lightning safety
If you can hear it, clear it*
• In terms of age, news stories indicated that more than half (8 of 13) of soccer casualties in the U.S. were between 11 and 15 years old.
* National Lightning Safety Institute
2. Parking lot safety
• Stranger safety
• Field assessment
• Stable goal posts
• Predictable surface
Prevention: soccer specific
1. Supervision of kids
• Control the bench!
• Equipment
- Mouth guards
- Shin guards
- Stable goal posts
• Skill level
• Training
- Flexibility
- Core
- balance
2. Emphasize proper skills
• Heading
- > 12 years old
- Eyes open
- Forehead
- Thrust into ball
- Chin tucks
• Tackling- U12
• Goalkeepers
- Pads
- falling
• REST: train no more than 90 minutes/day, 3x/week
Emergency Care
• Wounds
- Stop bleeding
- Direct pressure for 10 minutes- no checking!
• Cleanse
• Assess edges of wound
• Cover with dressing
Emergency Care
• Cardiac arrest
- Comotio cardis
- AEDs
• Respiratory Arrest
- Choking
- Absent cough, can't speak
- Heimlich maneuver
CONCUSSION
1. "Complex physiological process induced by trauma from
biomechanical forces"
• Caused by direct blow or impulsive force
• May or not involve loss of consciousness
• Involves neurological impairment
• Post-concussive symptoms may persist
• Most common in 12-17 year-olds (soccer)
2. Simple concussion
- Progressively resolves over 7-10 days
• Complex concussion
- Persistent neurological symptoms with exertion
- LOC greater than 1 minute
- Multiple concussions
- ?? Relationship to incidence of ALS
• ALL CONCUSSIONS require medical evaluation
Concussion Signs and Symptoms
• Cognitive signs:
- Loss of consciousness
- Confusion
- Amnesia
- Unaware of score, game
• Physical signs
- Loss of balance
- Slurred speech
- Seizure
- Delayed responses: motor and speech
- Vacant stare
- Poor play
• Symptoms
- Nausea/vomiting
- Headache
- Dizziness
- Vision/hearing disturbance
- Irritability/emotional changes
When a player shows ANY symptoms or signs of a concussion:
• The player should not be allowed to return to play in
the current game or practice.
• The player should not be left alone; and regular
monitoring for deterioration is essential over the initial few
hours following injury.
• The player should be medically evaluated following
the injury.
• Return to play must follow a medically supervised
stepwise process.
• A player should never return to play while
symptomatic.
• When in doubt, sit them out!''
Prague International Conference (2004)
Return to Play Recommendations
• Athletes should complete the following step-wise
process prior to return to play following concussion.
1. Removal from contest following and signs/symptoms of
concussion.
2. No return to play in current game
3. Medical evaluation following injury
• Stepwise return to play
a. No activity: physical AND mental rest until asymptomatic
b. Light aerobic exercise
c. Sport-specific training
d. Non-contact drills
e. Full-contact drills
f. Game play
Emergency Care
• Neck injury
- Stinger
-- Pain in neck and arm, numbness and tingling in arm,
weakness in arm
-- Rest until function returns
• Possible neck fracture
- Numbness/tingling or loss of feeling in extremities, neck
pain, inability or reluctance to move
-- Stabilize neck and call 911: DO NOT MOVE PLAYER
Emergency Care
• Eyes
- Younger players more likely to sustain eye injury
- Injury to eye
-- Cover both eyes and transfer to hospital
-- DO NOT remove objects from eye
• Injury to orbit
- Tender to touch, bruising
- Cover eye and transfer to hospital
- Concussion?
Emergency Care
• Injuries to the mouth
- Teeth
-- Reinsert tooth in socket if possible
-- Save tooth and transport in milk or wrap in gauze and
place between player's cheek and gum
-- IMMEDIATE referral to dentist
-- If chipped, immediate referral to dentist if bleeding or
severe pain
• MOUTHGUARDS
** Cameron et al, 1997
Heat Illness: Prevention
US Soccer Federation Guidelines*
• 12-16 oz. fluid 30 minutes before game
• Every 20 minutes during game
- <90 lbs. 5 oz.
- >90 lbs. 9 oz.
• Every 20 minutes for 1 hour after game
• Sports drinks increase voluntary drinking by 90% in
kids
*Adapted from the American Academy of
Pediatrics
Signs of dehydration
• Excessive thirst
• Dry lips and tongue
• Irritability
• Lethargy
• Dizziness
• Nausea
• Vomiting
• Muscle cramping
• Red, flushed face
• Dark yellow urine
Heat Illness Emergency Care
• Heat injury/illness
- Heat Cramps
-- Muscle cramps (calf,abdominals)
-- Hydrate, rest, cool, massage cramping muscles
- Heat Exhaustion
• Heavy perspiration
• Pale, cold, clammy skin
• Nausea, vomiting, collapse
• Hydrate, rest and remove from play, cool
- Heat Stroke
• Red, hot, dry skin; altered mental status; LOC;
Rapid, thready pulse
• MEDICAL EMERGENCY: CALL 911
• IMMEDIATELY Cool with ice, cold towels, water spray
- Cool to a rectal temp of 103.5 before transport
Emergency Care
• Allergy
- Bee stings
-- Epi-pen
• Food allergy
- Child must bring own snack or clear snack with parent first
Illness
• Asthma
- Inhaler on hand
- Watch for cough, wheezing, shortness of breath, pale skin
• Diabetes
- Disorientation, erratic behavior, fatigue
- Awareness of diet/medication needs
Musculoskeletal Injury First Aid
• Contusion (bruise)
- Ice, Compression, Elevation (if applicable) (ICE)
- Rest, ICE (RICE) if contusion to thigh or upper arm
restricts knee/elbow range of motion
- Most common soccer injury
Musculoskeletal Injury First Aid
• Sprain
- Injury to ligament
-- Ankle, knee, A-C joint
- Joint swelling, loss of motion, pain, tenderness
- Rule out fracture
• Strain
- Injury to muscle or tendon
- Hamstring, quadriceps, groin
- Pain with resistance and stretch, weakness
• RICE
- Referral to physician if:
-- Unable to bear weight on lower extremity
-- not improving in 2-3 days
Musculoskeletal Injury First Aid
• Fracture
- Pain, swelling, DEFORMITY, restricted joint motion, pain
with weight bearing, loss of function
- Splint and transfer to hospital
-- 911 if open fracture or fracture of large bone
- Ankle, nose, wrist (goalkeepers)
- 3-9% of injuries
• Dislocation (fingers, elbow, shoulder, ankle)
- Traumatic disruption of the normal alignment of the joint
usually involving ligament tear
-- Deformity, loss of motion, severe pain
-- Splint and transfer for X-ray and reduction
-- DO NOT ATTEMPT TO REDUCE
Return to Play following injury
• Lower extremity injury
- Full, painfree range of motion of joints
- Run without limp/pain
- Stop/start, cut
• Upper extremity injury
- Full range of motion in joints
- Throw without pain
Emergency Plan
• Assess player status
• Designate a person to call 911
• Send someone to direct the ambulance
• Review Medical Release form for pertinent information
and have available for EMTs
• If parents are not available, go with the injured
player and turn over team to asst. coach
• Get medical clearance before return to play if formal
treatment was required
WHEN IN DOUBT CALL 911!
Soccer specific injury: Knee
• MCL sprain
- Medial knee pain
• Meniscus tear
- Medial knee pain
• ACL tear
- Medial and internal knee pain
- Caused by cut, stop/start, twist, contact
- Signs and symptoms
-- Pain
-- "Pop"
-- Swelling
-- Loss of ROM
-- Hesitant to bear weight
• Prevention: footwear, fitness, field
• Knee injuries resulted in the most time lost from
competition and produced the greatest number of cases requiring
surgery
* Morgan 2001
Soccer specific: Ankle
• Lateral ankle sprains
- Pain on outer aspect of ankle
- Pain with motion
- Pain with weight bearing
- Swelling
- Treatment
-- Ice, rest, ROM, balance, and agility training
Chronic injuries
• Stress fractures
- Feet
- Tibia
• Osteochondral fracture
- Talus (ankle)
- One time or repeated trauma
Chronic Injuries
• Spondylolysis
- Defect in lumbar vertebra
- Low back pain
- Related to training time
-- Training recommendations are no more than 1 _ hours per
day 3 days per week
• 3 months rest
Murase, 1989
Chronic injuries
• Apophysitis
- Osgood-Schlatters disease
- Sever's disease
-- Risk factors
weight
tight calf muscle
age 10-14
Conditioning routine
• Warm up: jog 3-5 minutes
• Dynamic warm up ( see attached)
• Static stretching (30-45 seconds)
-- Hamstrings
-- Quadriceps
-- Groin
-- Calf
-- Hip and Low back
• Balance and proprioception- single leg exercise
- Poor balance related to increased ankle injuries especially
in males*
• Core
- Hips and trunk
*Hrysomallis, 2007
Email questions to:
laurie.devaney@uconn.edu
Phone: 875-4628
Thank you for your attention!
PLAY IT SAFE