Common Sports Injuries: Football Edition

The World Cup has officially kicked off! At a time when the whole world is tuning in to football matches, we can connect all the fun and excitement back to our healthcare education. Whether it’s athletes at the highest level of their sport or kids playing in their local park, there are common sports injuries that occur. This article covers the most prevalent amongst footballers.

Hopefully, we don’t see too many injuries while watching football matches for the next month. But, in the event that we do, we can use it as an opportunity to review how to take a basic sports injury history or recognize a mechanism of injury.

Here are the some of the most common injuries amongst footballers:

Knee Ligament Injuries

Anterior Cruciate Ligament

• ACL tears are common in football and often result from twisting or valgus strain with the foot fixed

• Associated injuries include MCL and meniscal tears, forming the ‘unhappy triad’

• Clinical features include haemarthrosis, pain, reduced range of motion, and a sensation of a ‘pop’

• Swelling occurs rapidly due to the vascular nature of the ACL

• Diagnosis is made using the anterior drawer test and Lachman test, with MRI used for confirmation

• Management involves surgical repair or reconstruction if instability persists, as ACL injuries do not heal on their own

Medial Collateral Ligament

• MCL injuries are the most common isolated ligamentous injury of the knee, typically caused by excessive valgus force from a direct blow to the lateral aspect

• The MCL provides medial stabilisation and resists valgus laxity and medial rotational instability

• Clinical features include localised tenderness and opening of the joint on valgus stress

• Associated injuries to the ACL are common, especially with greater valgus force

• Diagnosis is made using the valgus stress test and MRI for confirmation

• Management is usually conservative, with physiotherapy and bracing for 6–8 weeks; most injuries heal without surgery

Posterior Cruciate Ligament

• PCL injuries are less common among footballers but can occur in goalkeepers when the knee is flexed and a force drives the tibia backwards

• The PCL is stronger than the ACL, making injuries less common but often associated with other ligamentous injuries

• Clinical features include pain, instability, posterior sag sign, and positive posterior drawer test

• Swelling is less pronounced than in ACL injuries, and patients may be able to bear partial weight

• MRI is used to confirm diagnosis, showing fibre discontinuity in ruptured PCL

• Most isolated PCL injuries are managed with rehabilitation; surgical reconstruction is reserved for symptomatic instability or combined injuries

Meniscal Injuries

• Meniscal injuries are common knee injuries that can occur acutely, often in young adults during sports involving rapid changes in direction like football, or as a degenerative process in older adults

• The medial meniscus is more frequently injured than the lateral meniscus, largely due to its fixed position, making it more susceptible to twisting forces

• Meniscal tears may be traumatic, associated with ligamentous injuries such as anterior cruciate ligament (ACL) tears, or degenerative, occurring with minimal or no trauma

• Clinical features include a tearing or popping sensation, pain, joint line tenderness, and sometimes mechanical symptoms like locking or instability of the knee

• There is an increased risk of meniscal tears in knees with prior ACL injuries, and chronic instability can predispose to further meniscal damage

Ankle Sprains

• Ankle sprains are among the most common lower limb injuries, with lateral sprains occurring more frequently than medial sprains

• The mechanism typically involves inversion or eversion of the ankle, resulting in damage to the lateral or medial ligament complexes, respectively

• Lateral sprains often affect the anterior talofibular and calcaneofibular ligaments, while medial sprains involve the deltoid ligament complex

• Clinical features include pain, rapid swelling, and tenderness over the affected ligament complex, with chronic cases potentially leading to instability and repeated episodes of the joint giving way

• Diagnosis is guided by clinical assessment and the Ottawa ankle rules, which recommend X-ray imaging if specific criteria are met

• Initial management is conservative, focusing on analgesia, RICE (rest, ice, compression, elevation), and physiotherapy, with surgical intervention reserved for chronic instability or associated injuries