PCSL - Soccer and Your Body

By Roy Gillespie B.Sc. P.T., M.C.P.A., C.A.F.C.I - Pinnacle Sports Physiotherapy, Kelowna, BC

Rupture of the anterior cruciate ligament (ACL) in the knee is the injury the injury that causes the longest lasting disability to soccer players. The anterior cruciate ligament connects the tibia to the femur. It is located in the center of the knee and "crosses" the posterior cruciate ligament (i.e. cruciate = cross in Latin). The ACL prevents excessive rotation and hyperextension in the knee. An injury to the ACL leads to instability (a giving way feeling). A recent study from the International Journal of Sports Medicine sheds some light on the causes of ACL injuries. The study was done in Denmark last year.

The researchers, from a hospital clinic, surveyed 113 patients. All were admitted to the clinic with an ACL rupture. Their findings were as follows:

Goalies sustained as many ACL injuries as other players
62 ACL injuries occurred on the opponents half of the field - 18 of them inside the penalty box
There was no statistical difference between the numbers of players in defensive and offensive roles at the time of the injury.
30 of the injured players were in contact neither with other players nor the ball at the time of the injury and 58 were in contact with the ball alone.

Only 17 sustained an ACL rupture while being touched or pushed
56 had intended to change their direction towards the side of the injured knee at the time the ACL was torn, while only 10 had intended to turn toward the uninjured side
26 sustained their injury when landing after heading a ball, of whom 20 were being tackled by an opponent in the air, so jeopardizing their landing
19 had a previous injury other than an ACL injury in the now ACL-injured knee

In summary, the mechanism behind ACL ruptures differs from that of other soccer related injuries because only a small fraction of the injured players had contact with another player at the time of the accident. The authors concluded that tackling and kicking do not contribute significantly to ACL ruptures in soccer. Secondly, 2 distinctive actions - change of direction and landing after heading - are responsible for the vast majority of ruptures. If players could be trained to perform these particular moves more safely, the risk of injury could be substantially reduced.