Tips To Prevent Soccer Injuries
	LOWER LEG INJURIES AND TECHNIQUE
	Studies are required on the causes and prevention of lower leg injuries.    Which features of footwear are protective against soccer injuries? Where should the balance lie between foot protection and stabilizing effects of footwear and flexibility of shoes etc.? What is the interaction between footwear and specific playing surfaces? Do cushioning effects of footwear mask longer term damaging effects? Research studies need to take into account measures of exposure such as hours played, hours of training, position on the field etc. Evidence on the effects of interventions between footwear and surfaces should be reviewed with reference to other sports. Where the effectiveness of countermeasures have been proven and regulated eg. shin guards, enforcement at all levels of the game during practice and competition should occur. Shin guards and footwear should be further and continually developed. Equipment such as shin guards and footwear should be fitted with professional advice. The use of wobble board training should be encouraged.
	HEAD INJURIES
	Use only plastic coated balls. Once water resistance qualities are lost, replace the ball. Use the appropriate sized ball for the age and gender group playing. Teach the player to head correctly and to maintain eye contact with the ball before and after contact is made (Dods, undated). Ensure the head and neck are kept rigid at impact and, once this basic technique has been acquired, only then progress to the standing jump and finally to the running jump (Dods, undated). The development of strong neck musculature, to keep the neck rigid at impact (Dods, undated). Strengthen the hip flexor and abdominal muscles for the ballistic action in the standing header. Children should be specifically trained and monitored in terms of correct heading technique. Investigations should be made into the advantages and disadvantages of a lightweight helmet for soccer. Epidemiological research into the incidence of head injuries and associated factors should be undertaken. Current evidence is not conclusive, thus further controlled studies of heading need to be conducted. The recommendations made by NHMRC should be endorsed.
	FACIAL INJURIES
	Investigate the advantages and disadvantages of developing a light weight soccer helmet. Epidemiological research into the incidence and circumstances of eye, dental and face injuries should be undertaken based on participation rates. Barriers to the use of mouthguards should be determined. Mouthguards should be used by all players.
	GOAL POSTS
	Ensure both portable and permanent goals are securely anchored to the ground. Ensure portable goals are made of a lightweight material. Dismantle, remove, tie up or secure to a permanent structure portable goals after use. Cover goals with protective padding. Conduct further research into goal post design. Conduct epidemiological studies looking at the mechanism and types of injuries associated with goal posts.
	RULES OF THE GAME
	Players need to be educated that foul play is not an acceptable part of the game. The deterrent effect of the send off rule with limited substitution, should be examined in comparison with the benefits of encouraging injured players to leave the field with unlimited substitution. Rules need to be enforced.
	CROWD CONTROL
	Ensure that the FIFA regulations are fully enforced
	PHYSICAL PREPARATION
	More research into the role of warm-up, training and conditioning as an injury prevention measure for soccer is needed. Controlled research studies should be undertaken into the benefits of different types of warming-up, cooling-down and stretching practices. Information about warm-up, cool-down and stretching techniques should be developed and widely promoted to improve specific knowledge of techniques and effectiveness. Simple fitness testing should be conducted prior to soccer competition to ensure adequate fitness levels for competition. Appropriate education and monitoring of players should be conducted regarding nutritional and hydration demands of soccer, particularly as intensity increases with a training program, and emphasising complex carbohydrate intake. Recreational soccer players should not train excessively. If fitness is the overall goal, soccer drills could be interspersed with other activities. Soccer players should consider some form of cross-training (eg. bicycling) to improve their fitness levels and remain injury free. Soccer skills and fitness should be built-up gradually. Soccer players with potential biomechanical abnormalities (eg. leg length discrepancies) should have these assessed by a professional who can recommend corrective actions. More research is needed to determine the threshold and optimal levels of the various training factors under which soccer players are likely to remain injury free. A campaign aimed at increasing soccer players’ awareness of the injury consequences of training errors should be developed and promoted.
	PREVENTING OVERUSE INJURIES
	More research into the etiology of overuse injuries needs to be undertaken. Soccer players should be educated about the risk and severity of overuse injuries. Soccer players with potential biomechanical error (eg. leg length discrepancies) should have these assessed by a professional who can recommend corrective actions. Coaches and trainers should be educated in the importance of gradual increases in training, particularly pre-season or in the early part of the season.
	ENVIRONMENTAL CONDITION
	Risk management plans to control environmental hazards should be developed, implemented and monitored for facilities. More research into the role of environmental conditions such as playing surface and weather conditions should be undertaken in a controlled manner. Soccer should not be played under extremes of weather conditions. Adequate player hydration should be ensured. Soccer players should use a broad spectrum sunscreen in high ultra-violet conditions. A wet globe bulb temperature system should be available at all soccer matches which are played under hot and humid conditions to assess heat load. Risk management plans should incorporate specific regulations regarding the environment. Further research needs to be conducted on the interaction between footwear and specific playing surfaces. Evidence on the effects of interventions between footwear and surfaces should be reviewed with reference to other sports.
	MODIFIED RULES AND CHILDREN
	The modified rules version of soccer (Rooball) should be widely implemented. Children should be encouraged to play with smaller sized balls as in Rooball at all times. Children and adolescents should be taught correct techniques and procedures. The use of shin guards should be enforced.
	EDUCATION AND COACHING
	All coaches should be accredited and undergo regular re-accreditation. Coach education schemes should be updated regularly to ensure they provide current information. Instruction clinics for the wider community should be developed and made widely available. Education resources for informal soccer need to be developed and disseminated. Schools should seek advice from the Aussie Sports Program in terms of modified rules, as well as the state organization for guidance on program development.
	FIRST AID AND REHABILITATION
	Controlled research is needed to determine the effectiveness of taping and bracing of ankle and knee joints in the primary presentation of injury. Taping or bracing should be considered by professionals in the prevention of re-injury of ankle joints. Return to play after injury should only occur after full recovery. Qualified first aid personnel should be available at all sporting events. Conduct research into the biomechanics of acceleration, deceleration, jumping, cutting, pivoting, turning, heading and kicking of the ball. Ensure that all players have prompt and adequate first aid treatment. Further players should undergo controlled rehabilitation before returning to play after an injury.
	INDOOR SOCCER/FUTSAL
	Well designed studies are required to determine the relative risk of injury between indoor and outdoor soccer. Epidemiological studies in terms of the mechanism of injury and the relation to the games surrounds needs to be conducted. Risk management plans should be prepared, implemented and monitored based on the apparent risk of futsal.
	GENERAL SUMMARY AND CONCLUSIONS
	Improved data collection about the occurrence of soccer injuries and their associated factors needs to be developed and maintained. Data about injuries and their associated factors in recreational soccer needs to be collected. Data collections should conform to guidelines for sports injury surveillance being developed and promoted nationally. Information about preventing soccer injuries should be disseminated widely through soccer broadcasts, soccer equipment points of sale, soccer and general magazines. Guidelines for minimum safety requirements for soccer events (including the need for mobile phones, telephone contacts, first aid kits, etc) should be developed and widely disseminated. Future research studies to determine risk factors and to evaluate the effectiveness of countermeasures need to be controlled. Risk management plans for sporting bodies, clubs and associations should be developed, implemented, enforced and regularly reviewed.
	Source: Monash University Accident Research Centre – Report No. 125
	Authors: A.C. McGrath & J. Ozanne-Smith