If you follow football games at the stadium or on TV, you’ve probably seen the scene where an athlete rushes forward and suddenly stops to put his hand behind his thigh.
Even more traumatic are episodes where the player stumbles or takes a blow and falls to the ground with knee or ankle pain.
Injuries in this sport are more common than you might think. An indication of the scale of the problem comes from the Brazilian Football Confederation (CBF), which monitors major medical complications during matches in Series A and B of the national championship.
During the 2019 season, for example, 645 athletes were analyzed. Of these, 214 (33% of the total) suffered at least one injury.
In other words, a third of the players who took part in the competition had to stay in the medical service at some point.
The most affected parts were the muscles (37%). It should be noted that 62% of injuries occurred without any physical contact with opponents.
The most affected body parts were the thighs (40%), the head (14%), the ankles (11%) and the knees (11%).
Dr. Jorge Pagura, one of the project managers at the CBF, says the survey helps to better understand what is happening on the ground – and to develop strategies to prevent many of these episodes.
“We were able to prove that muscle problems are widespread and understand how relevant skull and knee injuries are,” he says.
Orthopedist Moisés Cohen, president of the medical commission of the São Paulo Football Federation (FPF), explains that during a match, the athlete changes direction and makes unexpected movements every six seconds – which helps to understand the high risk of problems in the muscles, joints and bones.
“Imagine the role of an attacker. He has to watch the goalkeeper, chase the ball and maybe change direction halfway if the opposing defender bounces the ball,” he describes.
“In other words: we are not talking here about a sport with pre-established gestures. Everything can change in a second of play,” he adds.
Below you can see what is happening in each part of the body where football-related injuries are most common.
The muscle is nothing but a set of fibers, which slide over each other in contraction and relaxation movements.
During the game, they are essential for running, jumping and the movement of the leg passing or kicking the ball.
As they are constantly stressed throughout the game or training sessions, the muscles are the main places where injuries develop.
“Generally, they are the result of a major effort, when there has been wear or fatigue,” explains Mateus Saito, orthopedic specialist in sports medicine at Vita Ortopedia.
In other words, the strain was so great that the muscle simply couldn’t handle it and stopped working as expected.
And here are some typical jargons, very common when transmitting football matches.
The first of these is contracture, which occurs when the muscle contracts inappropriately and does not return to its normal relaxed state. It may or may not represent something more serious, depending on the medical exam.
The second is stretching. In this, the muscle stretches more than it should, and some of the fibers that make it up even break.
However, the problem is more serious when this stretching is greater and there is total rupture of the muscle (or part of it).
Also in this area, another great adversary of footballers is pubalgia, an inflammation that appears in the pubis, near the hip.
“It’s an area where many muscles in the lower limbs are connected and where our center of gravity is, on which all our kicking movements and our balance depend,” says Saito.
With advances in medicine, professionals in the sector are now able to clearly define the site of the injury – and, while the athlete recovers, he even does exercises focused on other parts that have not not been affected.
Physiotherapy sessions, pressure treatments, ice and heat are also essential. In some more serious cases, it is necessary to resort to surgery.
“One thing that has changed a lot in our behavior in recent years is the decrease in the use of anti-inflammatories. Recently, some studies have shown that these drugs can even hinder the healing process,” adds Mr. Saito.
“Today, we favor simple analgesics to make the pain go away while focusing on healing.”
We are talking here about the place where two bones connect, which allow specific movements, such as the knees and ankles.
These regions are also very vulnerable to blows from an opposing athlete.
Shocks and collisions during a game can lead to very serious injuries, such as those affecting the ligaments, a type of fibrous tissue which, as its name suggests, connects the ends of one bone to another.
Holes in the pitch or the way players fall after making a jump are another source of injury for these structures: the knees and ankles risk “turning” the wrong way, which can certainly lead to very serious consequences. painful.
In such situations, these ligaments stretch beyond their limits and, in the most severe cases, rupture completely.
This, in turn, impedes joint movement and even match continuity.
When a famous athlete is diagnosed with such a condition, it’s common for terms like “collateral ligament”, “meniscus” or “cruciate ligament” to make headlines. These are the names of certain parts of the knee joint that end up being injured.
“Surgical intervention will depend on the degree of the injury and the extent of stretching or rupture of the ligament,” says Cohen, who also works at Israelita Albert Einstein Hospital and Instituto Cohen in Ortopedia, Saúde e Esporte, both located in São Paulo.
In the most severe cases, the athlete usually stays out for about eight months, until they can recover and resume their activities.
Cohen explains that with advances in medicine, the goal for professionals in the industry is to avoid surgical procedures whenever possible and preserve as much of the body’s original structure as possible.
“In the past, we used to remove the meniscus and the player would come back straight away. But in the medium and long term, he suffered more wear and even osteoarthritis, because today we know that this structure is an important buffer between the bones of the femur and the tibia”, underlines the orthopedist, also professor at the Federal University of São Paulo (Unifesp).
Bones can be affected by two main injuries: fractures and dislocations.
Fractures occur when the bone breaks after a blow or a violent fall.
“In dislocation, two jointed bones move and dislocate,” says Saito.
Contrary to what many people think, this dislocation of bones typical of dislocation is not always something simple.
In these cases, a medical examination will indicate what needs to be done to put the bones back in their place – or to restore them after the fracture.
It may be necessary to undergo surgery or to spend time with the part of the body immobilized by a cast and bandages (or more modern protective equipment).
Physiotherapy and other therapeutic resources can also be an integral part of the recovery process.
While most of the most common injuries are the result of accidents, experts agree that most injuries are preventable, whether in amateur or professional sport.
“FIFA itself has developed an 11+ program over the last decade, which provides guidance on how to prevent these issues,” says Pagura.
FIFA’s initiative includes a series of warm-up and stretching exercises that help prepare the body for the game.
For those who play amateur football, using proper equipment (like good quality shoes) and avoiding unnecessary bumps or collisions are also valid measures.
The CBF doctor also recommends that people observe their own bodies and look for signs of damage to muscles, bones or joints.
“Pain that does not go away forty-eight hours after a match should be medically examined,” he says.
Finally, Mr. Saito reminds us of the importance of an active lifestyle as a means of preventing famous injuries and other health problems.
“Exercise is medicine. When you practice physical activity, you help prevent diseases such as hypertension, diabetes and even depression,” he recalls.
“And, throughout the workouts, it is important to work the muscular structure, even to protect the joints,” he concludes.