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Advice Jan 14, 2014

Three strategies to help avoid soccer injuries: Safety, Gear, Move

WendyLeBolt-HeaderYou bought in to injury prevention the first time they took the field and you yelled, “Tie your shoelaces!”

Safety first is the natural posture of a parent. Somehow, when kids are small, they don’t notice the laces. It’s the rare peewee game that the referee doesn’t have to whistle to a halt so everyone can “check their laces.” It became such a problem for some of my kids that I invested in some Sweet Spots.

Sweet Spots

Sweet Spots

Remember those rubber straps that fit over laces, supposedly to smooth the surface for striking – and handed them out as an award for “most likely to…have their laces untied.”

Usually, it wasn’t until they sent a boot flying further than the ball that they noticed anything awry. And then, with a quick shove of the boot they jumped back into action. Yep. When they were small, that was my major concern: would they trip and fall and skin their knee? Injury prevention: double-tie those laces.

If they stuck with the game to the next season  – which in the old days was the following year – we purchased a new pair of cleats because they had grown out of last year’s version. Pretty soon, we found the brand and model that fit the best, and we stuck with those. Sometimes we stuck with a pair a bit too long.

worn out cleats

When kids play a lot of soccer, their feet deserve better. You can’t neglect the parts that are doing all the work and taking all the pounding and expect them to spring back. Sooner or later they’ll complain, and the more they play…the more sports, the more surfaces, the more demanding … the more of a beating the feet take.

The nature of soccer requires movement in all directions, plus jumping and landing, bending and flexing, give and take. The feet may contact the ground thousands of times during a match, requiring the plantar fascia (the connective tissue in the bottom of the foot) and the Achilles tendon to act as shock absorbers in the effort.

Cleats (soccer lingo: boots) are not designed to cushion. Good ones have flexibility and a snug fit but no padding, no arch support and no lateral support. They’re designed for traction on grass or turf. Indoor shoes give a bit of a rubber grip but that’s all.

[ + Read Grip and Rip! Why we’re shopping for soccer cleats all wrong ]

While running shoes cushion the landing at the heel and basketball shoes offer lateral stability against rolling an ankle and tennis shoes cushion the ball of the foot, soccer cleats have, well, cleats. Those feet are pretty much on their own. To practice safe soccer, we need to pay attention to them.

Even before the risk of ankle sprain, ACL, or concussion kick in, elementary aged kids who are growing fast can be beset by foot and heal pain. It ranges from minor irritation and rubbing due to improperly fitting shoes and poor socks to severe pain at the site of attachment of the Achilles tendon with the actively growing heel bones. That will spell time on crutches or in a protective orthotic boot.

Here is a 3-pronged strategy to help avoid these injuries: Safety, Equipment, Training

1. Safety

Injury prevention begins with making the space safe. Clear away any slipping or tripping hazards. Toss backpacks and extra clothing well away from the touch lines or goal mouth. Close and secure water bottles. If you’re indoors, slick spots can mean disaster.

“Tie your shoelaces!” still works, but since the kids are doing the tying, be sure they are tying them snugly and securely. Taking time to lace them up properly, starting at the toe. Don’t let kids slip them on and off without re-tying them. Get kids in the habit of taking footwear off after games and switching to sandals or sneakers. Do not have them running errands with you or going to get lunch between tournament games still wearing their cleats and shin guards.

2. Gear

Shoes: Get shoes that fit well and check regularly to see that they haven’t grown out of them. Go to a store with knowledgeable personnel to provide good recommendations for fit. It’s NOT a good idea to wear hand-me-downs unless the kids are quite small and the boots have little wear. I know shoes are expensive but each kids’ feet are different. Once the shoe is broken in it is re-shaped to the feet of the owner. That means that the next owner will have their feet broken in by the shoes instead of the other way around.

Socks: Invest in good, comfortable, well-fitting, synthetic socks. When they get stretched out or start bunching or showing signs of wear, toss ’em. Blisters are a completely avoidable menace. If there is rubbing or friction anywhere, try different socks or different inserts (below) or, if need be, different shoes.

Be sure they have their cleats. Borrowing someone else’s ill-fitting shoes is both embarrassing and unsafe. I have loaned a few pair in my time as coach, but the better practice is probably to have the player sit for the game they came unprepared to play. Next time, they will remember their cleats.

Inside the shoes: replace the insoles that come in the shoes (which are basically a piece of cardboard) with an insole that has some cushion. The thin liner will pull away easily from the sole of the shoe by prying up the edge with your thumb under the medial arch.

You don’t need to run out immediately and buy a pricey product. You can purchase basic insoles at your local discount retail stores or at many drugstores and medical supply stores. They come in different thicknesses. Some are sized. Some are cut-to-fit. Take out the shoe’s original liner and use it as a template to trace around.

Here are some options:

Full length flat cushion. Notice wear patterns.

Full length flat cushion. Notice wear patterns.

3/4 length fits easily into cleats, settles at the midfoot. Good is they need arch support.

3/4 length fits easily into cleats, settles at the midfoot. Good if they need arch support.

Sized for the shoe, these offer some cushion but also heel stability and arch support.

Sized for the shoe, these offer some cushion but also heel stability and arch support. This athlete has even added a metatarsal pad for additional cushion.

I don’t recommend the much more expensive Superfeet for soccer footwear, although they may work for running shoes.

Do not jump immediately to orthotics, which require a prescription and are very expensive, until you have exhausted the options above and addressed the movement practices listed below. Orthotics are hard-fitting and designed to compensate for foot shape or improper foot mechanics. They are corrective and thus meant to be worn in all your shoes. (I have not yet found them to work for women’s dress shoes or heels.)

3. Movement Mechanics and Training

Watch the way your kids move. Growing throws them off balance. Many compensate for their reduced balance by “cheating” in their stance. They roll feet inward with toes pointed slightly (or more than slightly) outward. This stabilizes them by widening  their base of support, but it comes at the expense of their Achilles tendon/foot-ankle complex which now pushes off at a mechanical disadvantage. Fewer muscle fibers are doing all the work and tugging on new bone. This causes trouble and may spell injury.

Re-orient their push off, not with words or instructions but with repetitions of good form. The foot and ankle are designed to work as a hinge. Give them cues about keeping their toes and heels in line when they stretch or jump and land or perform lunges. Have them rock forward and back to remind their limbs how to support good form.

Be gentle. Don’t push. Just rock and  hold. Up on toes and hold. Sink back on heels and hold. Insist on perfect alignment. Because they are growing, these tissues are fragile and the places of attachment may complain a bit. Back off if there is any soreness. Stick to good form, gentle movement and many repetitions.

Once they can execute the movement without discomfort and reproduce it with good form, then they are ready to add running, jumping, strength and power.

[ + Read: strengthening the foot ankle complex ]

It’s a simple formula: safety, gear, move. Kind of like ready, set, go, all grown up.

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