Orthocarolina explains female soccer Injuries and causes in kids & older athletes

With warmer weather upon us, soccer season is in full swing. Help keep your kids and teens on the field and out of the doctor’s office with this insight on female soccer injuries from former professional soccer player and PA-C Andy Hylton of OrthoCarolina.

Scoop: It’s a known fact that female athletes are more prone to ACL injuries than males. Why is this the case?

Andy Hylton: It has nothing to do with athletic ability, it’s truly a cause of how women are made. Females have wider hips than males with the obvious reason being for child bearing purposes. There is something that is called a Q- Angle, basically the line that goes from the knee to the hip; and in women, this angle is larger. It just puts more stress on their knees so when they do a sport or activity, there is a greater potential for knee injuries.

ACL injuries are obviously very serious and can lead to a good amount of downtime as well as arthritis and other issues down the road. What are your suggestions, if any, for avoiding such injuries?

The are sort of two ways that one can injure their ACL. Number one is just when you have a contact injury; your foot is planted, somebody hits you, and your knee just gives out. The truth is, those are just accidents and we can’t do anything about those.

But there are injuries in which people are just off balance, fall and twist awkwardly and consequently injure their ACL. Those are the people that we can hopefully help. There are two recommendations for helping those people avoid injuries. Number one is focusing on flexibility, especially flexibility in the hips. Whenever you get hit, the first place that absorbs all of those forces are your hips. So, if your hips are nice and flexible, that helps. Hip strength is also important. As you’re hit and as you rotate, if your hips are nice and strong, that helps to stabilize those forces. So, hip strength and flexibility is number one. The second thing is concentrating on strengthening quads. Anything that the hips can’t absorb is then absorbed by the quads muscles. Good, strong quad muscles help to protect the ACL.  Basically, whatever the hips can’t absorb is translated to the quads. If quads aren’t strong enough, the instability is transferred to the ACL, which cannot handle the forces and in turn gives out.

As far as soccer injuries in younger players, what are the differences you see in kids under 12 vs. older children and teenagers?

Generally, with kids younger than 12, they don’t often tear something; they’re more susceptible to overuse injuries. The two main things we see is Sever’s disease, which is a growth plate injury in the heel and the other thing is something which is called Osgood-Schlatter disease, which is a growth plate injury of the knee. In the 12 and younger age range, we often see more growth plate injuries which is because they are being active, running, jumping and that puts a lot of stress on those growth plates. So, it’s important that we keep kids flexible. Once they get past that 12 and under age, knee injuries and ankle sprains become more prominent.

When playing a sport, one is always running the risk of enduring an injury. With that said, is there anything a parent can do to help prevent their children under 12 from injuring themselves on the field? 

Parents have a big role in this. The biggest issue these days is that parents are putting their 8, 9 and 10-year-olds in these soccer programs, which are great, but then on the weekends they’re having them do extra sessions and they basically have their kids play five to six times a week which is excessive.  It’s fine to have a structured environment two to three times a week but the rest of the time, kids should not be doing these forced, regimented soccer programs. With kids 12 and under, overuse injuries is what were trying to protect them from. Three, maybe four days, is enough. It’s also important to help children maintain flexibility. Inflexibility just increases the risk for injuries. If you get a child stretching while they’re young, it just becomes a part of their lifestyle as they go on playing in high school and college.

What is a good indication that an injury is serious and requires medical attention instead of just an at-home bandage treatment? 

If a young, healthy kid comes in and the knee is swollen, then that needs to be evaluated because something is going on. Young, healthy kids don’t swell for no reason. Generally, it can point to an ACL or meniscus tear; generally something on the inside of the knee has torn. The biggest thing that parents need to be aware of is that if a child has a lot of swelling, it suggests a knee injury and that needs to be evaluated. The same goes for ankle injuries as well. If there’s not a lot of swelling, you can just watch it and see how they do. But if there is a substantial amount of swelling in either the knee or ankle, that’s a red flag that something is going and and it needs to be evaluated.

What are your suggestions for ensuring a full recovery after a soccer injury?

The question is, ‘Can we learn from an injury?’ What was the cause of an injury; was it that someone got hit and injured? If that’s the case, that’s just an accident and unfortunate. The players that didn’t get hit and injured, they’ve lost their balance and twisted and torn something; those are the patients we really want to go after. They already had some type of muscle imbalance somewhere.

So then the question is, ‘What was the reasoning behind the injury?’ If it’s a non-contact injury, that suggests that either there’s some type of hip weakness, quad weakness, etc. Based on the injury, that really helps identify what is your weak link and how we can have you return to the field better than when you were before you were injured. That’s the goal of any type of rehab program; to get you back playing better than you were before. If we send you back the same way, you’ll get injured again. It gives us an opportunity to realize why you were injured, where was the weak link and then we can address the weakness.

Andy Hylton is a P.A. (Physician Assistant) in OrthoCarolina’s Pineville office and also has a degree in Athletic Training. He has played professional soccer in the U.S. and England, and also played for Great Britain’s soccer team in the World University Games (Olympics for students) in Beijing, China. Andy treats all ages and orthopedics needs, particularly sports medicine injuries and conditions. For more info: https://orthocarolina.com/physicians-pa/detail/181