Written by Tyler J. Marshall, M.D., of OrthoAlabama Spine & Sports
Football holds a special place in the heart of Alabama for players and fans at every level. With the adrenaline rush of the game, however, comes the risk of injuries that can put players on the sidelines. As a sports medicine surgeon, I have seen my fair share of football-related injuries over the years. Because these injuries are so common, it’s important to know what to do when an injury occurs as well as how to prevent these injuries to keep players on the field.
Concussions are one of the most concerning injuries in football. They occur when there is a forceful impact to the head that stretches or tears brain tissue. This can result in a range of symptoms, which may include headache, dizziness, confusion, and memory problems.
When a player has a sudden impact from a tackle or collision, the brain can strike the inner skull surface, causing injury. Helmets are designed to absorb some of this force, but they cannot prevent all concussions, especially if improper tackling techniques are used.
What to Do:
- When a concussion is suspected, the player should be immediately removed from the game and evaluated by a medical professional.
- Rest and cognitive recovery are essential to concussion management. The player should avoid physical and cognitive exertion until cleared by a healthcare provider.
- In severe cases, prolonged rest and specialized rehabilitation may be necessary.
- Teach proper tackling techniques that minimize head-to-head contact, emphasizing the importance of using the shoulder to tackle rather than the head.
- Require players to wear properly fitted and maintained helmets, which can help reduce the force of impact.
- Educate players on the importance of reporting any symptoms of a concussion promptly and encourage a culture of safety where players prioritize their health.
Sprains and Strains
Sprains and strains are common injuries in football and can affect various parts of the body, including the ankles, knees, and hamstrings. These injuries often occur during quick direction changes, tackles, or when players land awkwardly.
A sprain involves the stretching or tearing of ligaments, which are strong bands of tissue that connect bones to each other at joints. In contrast, a strain involves damage to muscles or tendons, which attach muscles to bones. In football, quick cuts, sudden stops, and tackles can put excessive stress on these structures, leading to sprains or strains.
What to Do:
- For initial management, follow the RICE protocol: rest, ice, compression, and elevation.
- Seek medical evaluation for severe sprains or strains, as they may require bracing, casting, or even surgery.
- Follow a structured rehabilitation program to regain strength and flexibility, which is essential for preventing future injuries.
- Include flexibility and strength training in preseason conditioning programs to prepare players for the physical demands of the game.
- Teach proper landing and cutting techniques to minimize the risk of injury during quick direction changes.
- Ensure players wear appropriate footwear with good ankle support.
Fractures can happen in football due to high-impact collisions or awkward falls. Common fractures include broken bones in the wrists, arms, and legs.
When under any force exceeding their strength, bones can break. In football, tackles and collisions can put tremendous pressure on bones, leading to fractures.
What to Do:
- In the event of a fracture, immobilize the injured area to prevent further damage.
- Seek immediate medical attention for diagnosis and treatment, which may include casting or surgery.
- Follow the recommended rehabilitation plan for a full recovery, including physical therapy to restore strength and range of motion.
- Emphasize the importance of protective gear, such as pads and braces, to absorb and distribute impact forces.
- Promote proper tackling and blocking techniques to reduce the risk of high-velocity collisions that can lead to fractures.
Joint dislocations can occur when the bones that form a joint are forced out of their normal positions. Commonly affected joints in football include the shoulders and fingers.
Joints are critical to the body’s mobility, allowing bones to move in relation to each other. Ligaments and tendons hold these bones together and provide stability. In football, sudden and powerful forces, such as tackles or falls, can cause these structures to give way, leading to joint dislocations.
What to Do:
- In case of a dislocation, do not attempt to pop the joint back into place, as this can cause further damage.
- Immobilize the injured area and seek immediate medical attention for proper stabilization.
- Follow prescribed rehabilitation exercises to regain joint stability and strength.
- Strengthen the muscles around vulnerable joints through targeted exercises, which can help stabilize them.
- Ensure players use proper techniques for blocking and tackling to reduce the risk of awkward falls or tackles that could lead to dislocations.
The anterior cruciate ligament (ACL) is a critical ligament in the knee, providing stability by connecting the thigh bone (femur) to the shin bone (tibia). ACL tears are common in football and typically result from rapid direction changes, sudden stops, or direct blows to the knee, causing the ligament to stretch or tear.
The ACL is particularly vulnerable when players pivot or change direction abruptly. A forceful twist of the knee during such movements can strain or rupture the ligament.
Impact from tackles or collisions can also lead to ACL tears, especially if the player’s knee is struck from the side.
What to Do:
- When an ACL tear is suspected, immediate evaluation by a medical professional is crucial to confirm the diagnosis through physical examination and imaging.
- Treatment options may include surgical reconstruction of the ACL, followed by comprehensive rehabilitation to restore knee function.
- Rehabilitation is a critical phase for athletes recovering from ACL injuries, involving strengthening exercises, balance training, and a gradual return to sport-specific activities.
- Emphasize proper landing and cutting techniques to minimize excessive stress on the ACL during rapid direction changes.
- Strengthening the muscles around the knee, including the quadriceps and hamstrings, can help provide stability and reduce the risk of injury.
- Encourage the use of knee braces or sleeves for added support, especially for athletes with a history of knee issues.
Achilles Tendon Ruptures
The Achilles tendon is the thick band of tissue that connects the calf muscles to the heel bone (calcaneus). It plays a crucial role in foot and ankle movement. Achilles tendon ruptures often occur when there is a sudden and forceful contraction of the calf muscle, such as during sprinting, jumping, or pushing off the ground. In football, this can happen when players explosively push off the ground or make rapid, powerful movements.
One of the largest and strongest tendons in the body, the Achilles tendon is still susceptible to injury due to high-force activities. Ruptures typically occur when the tendon is overstressed beyond its capacity, causing it to tear partially or completely.
What to Do:
- An Achilles tendon rupture is a serious injury that requires prompt medical evaluation. Diagnosis may involve imaging, such as an MRI, to assess the extent of the tear.
- Treatment options may include surgery to repair the ruptured tendon or nonsurgical management with immobilization, depending on the severity of the injury.
- Physical therapy and rehabilitation are essential components of recovery to restore strength and flexibility.
- Incorporate specific exercises that target the calf muscles and Achilles tendon in preseason training to improve their strength and flexibility.
- Warm up adequately before practice or games to prepare the tendon for intense activity.
- Encourage players to listen to their bodies and avoid pushing themselves beyond their limits, as fatigue can increase the risk of tendon injuries.
On our football fields in Alabama, where the passion for the game runs deep, understanding, preventing, and managing injuries is essential. By focusing on proper training, equipment, and medical support, players, coaches, parents, and providers can work together to minimize the risk of these debilitating setbacks. Tackles and touchdowns are exciting on the field and in the stands, and with the right precautions and care for our players, they can stay that way.