Despite the protective equipment and stringent safety precautions and rules in organized leagues, football is still a sport with a high incidence of injury. Between professional, collegian, junior, and recreational players, there are millions of people actively participating in American football each year. Football-related injury data collected by the National Electronic Injury Surveillance System from 2001-2005 was analyzed by the Injury Prevention Center of Rhode Island Hospital in 2009. It was estimated that 1,060,823 males between the ages of 7 and 17 were treated in emergency rooms for football-related injuries.
How Do Football Injuries Occur?
Football injuries can be broadly categorized as traumatic injuries, which usually occur from physical contact with another player, the ground, or the ball, or cumulative overuse injuries, such as from over-training.
By its nature, football is a physically demanding and high impact sport. Football centers around a high amount of expected and unexpected physical contact between players, such as when linemen collide with one another off the line of scrimmage or when a running back is tackled. There are also distinct physical requirements and risks for injury based on the specific position of play. For example, wide receivers must frequently make quick stops and starts, cuts, jumps and dives for the ball, and sprint at high speeds; quarterbacks must make powerful throws with their arms and absorb hits that they often don‘t expect; and kickers must make powerful kicks and risk being hit with their leg in an awkward position.
Most athletes, especially those participating in organized play, will also undergo countless hours of practice, weight training, and endurance training. This is where overuse injuries usually come into play. If the football player tries to do too much, too fast, too often, and/or too vigorously, it leaves them prone to suffering an overuse injury.
What Are Some Common Injuries In Football?
Knee Sprains
A knee sprain is the abnormal stretching or tearing of one or more of the ligaments in the knee.
The knee joint is composed of the femur, tibia, and patella bones. There are four main ligaments, two collateral and two cruciate, in the knee that connect to these bones and work together to keep the knee stabilized during movement.
The medical collateral ligament (MCL) is located on the inside aspect of the knee and the lateral collateral ligament (LCL) is located on the outside aspect of the knee. These ligaments control how far the knee moves to either side.
The anterior cruciate ligament (ACL) is located toward the front aspect of the knee. The posterior cruciate ligament (PCL) is located toward the back aspect of the knee. The cruciate ligaments form an “X” pattern across one another inside the knee joint. Together, they prevent the tibia from sliding too far forward or backward during leg movements.
The ACL and MCL are the most often injured knee ligaments in football, but any of these ligaments can be stretched or torn when a force is applied to the knee that causes it to move past its normal range of motion or when the surrounding muscles violently contract. In football, sprains commonly occur from the knee being twisted with the adjoining foot planted, hyperextension of knee, landing on a flexed knee, suddenly stopping from a high-speed sprint, or being directly hit on the knee.
Sprains are graded based on how severely the ligament was stretched or torn:
Grade I - the affected ligament is stretched or has microscopic tearing, but the knee remains stable and fully functional.
Grade II - the affected ligament suffers moderate tearing and the joint becomes loose and moderately unstable.
Grade III - the affected ligament suffers significant to complete tearing and the joint is highly unstable. The injury often makes it impossible to bear weight on the affected leg.
Torn Knee Cartilage / Menisci Injuries
A torn meniscus is often colloquially referred to as torn cartilage. There are two menisci in the knee, one located on the lateral side of the tibia and one on the medial side of the tibia. These tough, rubbery, crescent-shaped pieces of cartilaginous tissue act to cushion the ends of the bones inside the knee joint. The medial meniscus is more prone to injury because it’s attached to the medial collateral ligament and less free to move. In fact, menisci tears commonly accompany knee sprains.
Menisci tears are most often seen during a direct impact to the knee or when the knee is twisted too far during pivot, cutting, or twisting movements. The menisci may also wear over time and suffer degenerative microscopic tears from repetitive knee movements.
Tears to the knee menisci are often described by how it’s torn. Some of the most common types of tears include:
* Degenerative tears - the edges appear jagged or frayed.
* Longitudinal tears - any sized tear along the length.
* Bucket-handle tears - a longitudinal tear that also involves a section of the meniscus becoming detached from the tibia.
* Radial tears - a tear that extends inwardly from the edge of the menisci.
Shoulder Dislocation
The shoulder joint is the most mobile joint in the human body. As such, it’s highly prone to dislocation. A dislocated shoulder involves the humerus bone separating, or dislocating, from the scapula bone in the glenohumeral joint. The dislocation can be a partial subluxation, meaning the humerus is only partially out of its socket, or a complete dislocation, meaning the humerus is completely out of its socket. Dislocations can occur when the shoulder slips to far backward, forward, or downward, but the most common is an anterior dislocation from the shoulder slipping too far forward. Anterior dislocations are commonly seen when a player has his arm outstretched to throw or catch a ball and is hit on the back of the shoulder.
Shoulder Separation
Shoulder dislocations and separations are often confused as the same injury, but they are actually two very different injuries. A separated shoulder involves the ligaments that hold the acromioclavicular (AC) joint in place. The AC joint is on the distal end of the clavicle bone and serves to attach the scapula and acromion process of the shoulder blade. This shoulder injury most often occurs when a player falls or is forced to the ground shoulder first or with an outstretched arm. This can result in several types of shoulder separations:
* The acromioclavicular ligament may stretch or tear (sprain).
* The acromioclavicular ligament may suffer a grade three sprain and the coracoclavicular ligaments may suffer a grade one or two sprain. This causes the shoulder bones to slightly separate and create a bump on the top of the shoulder.
* The coracoclavicular ligament may be pulled from its attachment to the clavicle, which is called an avulsion injury. This results in the clavicle being displaced.
Of course, these are just a few of the injuries common to football players. Bursitis, tendinitis, hip pointers, stingers, muscle and bone contusions, fractures, stress fractures, concussions, ankle and wrist sprains, muscle strains, spinal and back injuries, turf toe, Achilles heel injuries, and sports hernias are also common concerns for football players.
