There are three injuries that I encounter on a regular basis in my clinics at Crystal Palace Academy and Kinetic Academy among the young footballers I work with: Osgood-Schlatters disease (OSD), Severs and Hamstring strains.
OSD is a growth related condition of the patellar tendon in the knee that is often related to high levels of activity during periods of growth; in particular repetitive quadriceps (thigh muscle) contractions. This is why it is so common for young footballers, as repeated quadriceps contractions are an integral part of the game in movements such as ball striking, jumping and changing direction.
This type of injury was historically associated with prolonged periods of rest from sport, affecting player’s technical developments and returning behind their colleagues at clubs. Now a number of football academies, namely Crystal Palace, Brighton & Hove Albion and Brentford are adopting ‘The Strickland protocol’ to treating OSD. This protocol consists mainly of myofascial release massage (MRM) and graded stretching and the research evidence so far suggests that this approach results in a significantly earlier return to sport than the previously used ‘let them grow out of it’ approach.
Sever’s Disease is a growth related disorder which affects the heel just below the Achilles tendon. It is often very painful when walking and attempting to run; its onset usually coincides with a growth spurt and a high level of physical activity. In a Football Association audit of 3805 injuries within academies, these growth related conditions, accounted for only 5% of total injuries, but can often result in the longest amounts of time away from football.
Muscle strains make up the largest proportion of total injuries within academy football (31%). Hamstring strains are a common and often troublesome type of muscle strain, as it is a muscle group that produces a comparatively high amount of force. This, as well as a lack of appropriate end stage rehabilitation, is perhaps why they have a higher re-injury rate when compared to other muscle injuries.
Players in the higher age groups (17-19 years) are more likely to receive an injury of this type than those in the younger age groups (9-16 years). This puts the emphasis of appropriate injury prevention to the forefront as you develop as a young aspiring footballer and here are some top tips on how to reduce the risk of receiving these injuries:
- Monitoring training load – Not training intensely the day before or after a game is key! Rest and recovery are as important for your muscles as training itself.
- Sport specific strength and conditioning – A lot of emphasis has traditionally been placed on static stretching for injury prevention, but a flexible muscle is not as important as a strong, robust muscle for sport. This strengthening process must be done under the guidance of a trained professional who has an awareness of football specific conditioning, especially with regards to young people.
- Nordic Hamstring protocol – because the lion’s share of hamstring injuries are recurrences of previous strains, many football clubs now include eccentric strengthening protocols to prevent future strains. A research study in 2011 showed that hamstring injury rates reduced by 85% with a Nordic hamstring protocol. This exercise should be done in a slow process, gradually building up repetitions and sets, in order to reduce the effects of delayed onset muscle soreness (DOMS)
Nordic Hamstring curls are shown in the pictures below.
Start Position End Position
Ben Austen BSc MSc MCSP – Crystal Palace FC Academy, Kinetic Academy
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