and well-being of children and youth
Soccer (football) is the most popular sport in the world. It is a sport played by those of all ages, all skill levels and both genders. It has consistently been the most popular sport for children and youth in Canada since 1998, with both boys and girls aged 5 to 14 recording a 44% participation rate in 2005.
The relative simplicity of the rules, accessibility to play, minimal equipment required, and relatively lower cost of involvement in soccer may explain why it is the most favoured sport for children.
Soccer is considered a relatively safe sport, but injuries do happen. Most soccer injuries affect the ankle, knee and foot. Minor muscle strains and contusions are most common. However, some serious injuries can occur in soccer, including knee injuries and concussions.
One of the most serious knee injuries that can occur in soccer are ACL injuries. The ACL is an important stabilizer of the knee, helping to provide stability when cutting, pivoting, jumping, landing and changing direction. ACL injuries are rare in prepubertal and skeletally immature players but the incidence appears to be increasing, especially in female athletes. [4,5] For teenagers, injury prevention programs such as PEP (Prevent Injury, Enhance Performance) and the FIFA 11 have been shown to reduce the incidence of this injury.[5-7] These preventative programs focus on neuromuscular training, including strengthening and flexibility exercises, plyometrics, balance and technique training, and risk awareness.
Head injuries and concussions are also increasingly recognized in soccer. The Canadian Academy of Sports Medicine (CASM) recently published a discussion paper suggesting that soccer be regarded as a contact sport, in which players are at risk for head injuries and concussions. The recommendations emphasize: the importance of safe play and respect for opponents; concussion awareness and education for coaches, parents and players; and evaluation of all concussed players by a medical doctor familiar with diagnosis and treatment of sport-related concussions. The latest concussion management guidelines by the Concussion in Sport Group were published in May 2008.
Playing Smart Soccer is an injury prevention program developed by the Think First Foundation of Canada in conjunction with the Canadian Soccer Association. The program was developed to promote safe soccer for players aged 6 to 14 and is available as an education booklet in both English and French. It is written for parents, coaches, teachers, and officials. The user-friendly format includes sections on diverse injury prevention strategies including player behaviours, equipment (player and field), fitness and conditioning, technique and skill development, nutrition and hydration, environment, responsibilities of parents/coaches/referees/organizations, soccer-specific injuries and basic first aid. Table 1 (below) shows the suggested Fair Play Code for players, coaches, parents and officials.
Soccer is the world’s most popular game and the favoured sport of Canadian children. It is a safe activity for most participants, but injuries do happen. Creating a fun and safe playing environment is important. There are many steps that players, parents, coaches, referees and health personnel can take to help reduce the risk of injury in soccer. As paediatricians, we are in a unique position to advocate for our patients and children in our communities. Together we can promote regular physical activity and safe participation in sport. The ThinkFirst Safe Soccer Program is an excellent resource to provide to patients, parents, teachers and community coaches. The complete program can be downloaded from the ThinkFirst website, along with information on concussion, as well as player, parent and coach handouts.
Further questions or information requests can be directed to either Kristin Houghton or John Philpott.
Table 1: Fair Play Codes
FAIR PLAY CODE FOR COACHES
FAIR PLAY CODE FOR PLAYERS
FAIR PLAY CODE FOR PARENTS
FAIR PLAY CODE FOR OFFICIALS
PAEDIATRIC SPORTS AND EXERCISE MEDICINE SECTION
Executive: Drs Laura Purcell, Children’s Hospital of Western Ontario, London, Ont. (President); Merrilee Zetaruk, Winnipeg, Man. (Vice President); John Philpott, Toronto, Ont. (Secretary); Michelle McTimoney, IWK Health Centre, Halifax, N.S. (Member at Large); David Fecteau, Trois-Rivières, Que. (Member at Large)
Principal Authors: Drs. Kristin Houghton, BC Children’s Hospital, Vancouver British Columbia, and John Philpott, Toronto Ontario (Dr. Philpott and Dr. Houghton are members of the Smart Soccer Committee of ThinkFirst Canada)
Correspondence: Dr. Kristin Houghton, Division of Rheumatology, Department of Pediatrics, UBC, Vancouver British Columbia, firstname.lastname@example.org.
1. Dvorak, J., et al., Football, or soccer, as it is called in North America, is the most popular sport worldwide. American Journal of Sports Medicine, 2000. 28(5 Suppl).
2. Ifedi, F., Sport Participation in Canada, 2005, in Culture, Tourism and the Centre for Education Statistics Research papers. 2008, Statistics Canada: Ottawa. p. 1-101.
3. Peterson, L., et al., Incidence of football injuries and complaints in different age groups and skill-level groups. American Journal of Sports Medicine, 2000. 28(5 Suppl).
4. Ireland, M.L., The female ACL: why is it more prone to injury? Orthopedic Clinics of North America, 2002. 33(4): p. 637-51.
5. Silvers, H.J., E.R. Giza, and B.R. Mandelbaum, Anterior cruciate ligament tear prevention in the female athlete. Current Sports Medicine Reports, 2005. 4(6): p. 341-3.
6. Mandelbaum, B.R., et al., Effectiveness of a neuromuscular and proprioceptive training program in preventing anterior cruciate ligament injuries in female athletes: 2-year follow-up. American Journal of Sports Medicine, 2005. 33(7): p. 1003-10.
7. Gilchrist, J., et al., A randomized controlled trial to prevent noncontact anterior cruciate ligament injury in female collegiate soccer players. American Journal of Sports Medicine, 1476. 36(8): p. 1476-83.
8. Delaney, J.S. and R. Frankovich, Head injuries and concussions in soccer. Clinical Journal of Sport Medicine, 2005. 15(4): p. 216-9.
Last updated: Apr 23 2014