It’s a Funny Old Game!

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Sports injuries sustained on and off the field commonly require varying degrees of treatment.

[dropcap]I[/dropcap]n 2014 the Football Association (UK governing body of football), in conjunction with the UK Premier League, Players Football Association and League Managers Association, changed the rules of the game regarding head injuries. They decided that injured players must leave the field until a doctor – not the management team – has determined whether the player is fit to continue.  This is to protect players who may be suffering from concussion.

Concussion has been a big concern in sport, not just football. In order to minimize the risks, there has even been discussion about limiting the number of times a player should head the ball. As well as the obvious injuries like bruises and cut eyes, there is a lot of controversy about the links between heading the ball and dementia. There are calls for a total ban on heading the ball for under-18s, adapting the game to the modified kick ball, minimizing contact, and using a plastic ball.

Initially it was thought that phasing out the big, heavy, leather ball, used in the early days of football, would reduce the risk of serious head injuries and long-term effects. Before rain the ball weighed 14 to 16 ounces; add rain into the equation and it gained an extra two to three pounds. The first synthetic ball was introduced in the 1960s but it was not until the late 1980s that the leather ball was totally replaced by the synthetic version. What nobody considered was that a lighter ball can travel faster, and therefore can have as much of an impact as the old, slower leather ball. But we all know that head injuries are not the first injury we think of in football. Following are four common football injuries, with symptoms, treatment and prevention advice.

1. The Anterior Cruciate Ligament

This is one of four ligaments that help to stabilise the knee; it is a very common injury in football. The ligament usually tears or ruptures when tackled from the side or when changing direction quickly when running, where the foot stays firmly as you twist, putting pressure on the ligament.

Symptoms: Pain (not always), swelling, instability. You may also hear or feel a popping or snapping at the time of injury.

Treatment: If not severe, (complete rupture) physiotherapy is the first line of treatment. However, a severe injury may require ACL reconstruction surgery.

Prevention: Strengthening the muscles in your legs, particularly the hamstrings and quadriceps. Ensure that you warm up properly.

2. Torn Meniscus

The menisci are made up of cartilage, and function to provide cushioning and protection to the knee joint. Injury occurs to the meniscus when combining the movements of bending, twisting, or pivoting or changing direction. Injury can also occur when there is impact to the outside of the knee.

Symptoms: Swelling and stiffness and, with a larger tear, the knee may lock and it is difficult to straighten out fully.

Treatment: Depending on the severity of the injury, the best treatment is ice and compression to help reduce the swelling. If the tear is large, surgery may be indicated.

Prevention: The best way is to strengthen the muscles in your legs with squats, leg raises, leg curls and so on.

3. Ruptured Achilles Tendon This is the tendon that runs from your calf to your heel bone.

Symptoms: You will hear a loud pop or snap followed by a sharp pain in the heel or calf. You will usually see a lot of bruising as well. The most obvious sign is not being able to stand on tip toes and having difficulty walking up and down stairs, and being unable to run.

Treatment: Depending on the severity of the injury you will either be managed in a cast for 6-8 weeks or, in some cases, scheduled for surgery to stitch the tendon back together.

Prevention: The best way is to warm up properly.

4. Hamstring Strain or Tear

The hamstring has to work hard in football and, as it fatigues, it is susceptible to injury.

Symptoms: Hamstring injuries fall into three distinct categories: grade I muscle strain where you may feel tightness in the back of the thigh and some discomfort when running; grade II muscle strain where you may feel discomfort or pain when walking and notice swelling and tenderness when the muscle is touched; grade III usually involves a partial or complete muscle tear, resulting in severe pain and weakness.

Treatment: Depending on the severity of the injury it may be as simple as using ice and compression. However, a grade III injury will require resting from active sport for months and possibly even surgery. Once recovered then a period of rehabilitation will be required to regain strength, balance and agility.