Prevention, Treatment, Performance

Educational videos from the FIFA Medical Network (@FIFAMedical): Rehabilitation exercises for common football injuries

Recently Justin (@backtoyourfeet) was asked to help make some short educational videos for the FIFA Football Medical Network with @DrMarkFulcher. Here is a collection of the videos that are available on FIFA Medical Networks Twitter page (@FIFAMedical).

The first collection of videos demonstrate how to do some rehabilitation exercises for common football injuries. It is a great idea to see your physiotherapist as soon as you have an injury. They can diagnose what has happened, refer you for investigations or to specialists if necessary and give you great advice on what to do in the acute phase of the injury to help you get back to what you love doing.

The Muncie Straight Leg Raise is an exercise that helps to strengthen the quadriceps muscle and can be done safely quite early after an injury.

Hamstring injuries are one of the most common injuries in football. Confirming the severity and location of the injury can help with prediction for return to sport.

Eccentric exercises targeting the hamstring muscles have been shown to significantly reduce the risk of sustaining a hamstring injury, but have also shown to reduce the risk of re-injuring you hamstring. Doing the exercises regularly increases the chance of them being effective.

Patallae tendinopathy can cause pain in the anterior aspect of the knee, and often affect players who are more dynamic and can jump higher than their peers. As with most tendinopathies it is caused when the tendon is exposed to more load than it has capacity to cope with. Using a decline board helps to load the patallae tendon.

Managing Achilles tendinopathies can be frustrating for players as it can be difficult to get the balance of how much loading activities like running and jumping the tendon can tolerate before it gets aggravated. Isometric exercises can be used as a way of loading the tendon early in the rehabilitation process or during the season when the player has a high playing load.

Groin injuries can be frustrating for players and therapists. You can prevent groin injuries by doing the Copenhagen Adductor Exercise regularly.

If you have had a long-standing groin injury, then the 10-week Holmich Protocol has been proven to be effective as a treatment. It was first described in 1999 by Per Holmich in The Lancet (Hölmich et al., 1999) but is still one of the most validated programmes for footballers who have chronic adductor-related groin pain. There are two phases to the protocol, and they include exercises to build strength in the hip adductors, abdominals, glute’s and lower back.

The first phase of the @PerHolmich protocol can be used to help manage a player with adductor-related groin pain. Do you know how to initiate this rehabilitation programme? #FootballNetwork #FIFADiploma pic.twitter.com/lVCDKYdGl1

— FIFA Medical Network (@FIFAMedical) December 16, 2019

The second phase of the Holmich protocol is used to progress a player’s strength and improve function. Do you know what it involves? Have a look at this clip to see. #FootballNetwork #FIFADiploma pic.twitter.com/S68h3p2lFJ

— FIFA Medical Network (@FIFAMedical) December 23, 2019

Recently the programme was validated by (Yousefzadeh, Shadmehr, Olyaei, Naseri, & Khazaeipour, 2018) who found that the Holmich programme may be an effective treatment for long-standing adductor-related groin pain (LSAGP). However, they suggested more emphasis should be paid to the hip adductor muscles’ eccentric strength and have modified the programme to make it more effective. One of the exercises they included in their programme is the Copenhagen adductor exercise. The Copenhagen adductor exercise can reduce the risk of getting adductor injuries and should be done regularly to maximise the effect. Our Premier Football teams use the Copenhagen adductor exercise as well as the FIFA 11+ warm-up exercises to help reduce the risk of injury during the season.

When done regularly the Copenhagen adductor exercise can reduce the risk of developing groin pain by 40%. This video shows how the three progressions are done. #FootballNetwork #FIFADiploma
See the original paper from the @BJSM_BMJ to learn more: https://t.co/v6SclZeEz4 pic.twitter.com/9Z6NCVExMY

— FIFA Medical Network (@FIFAMedical) January 20, 2020

Groin pain does not just affect footballers. If you have had an adductor injury, or have groin pain that is restricting your ability to play football or achieve your calls then we would love to hear from you. Make an appointment and we can hep prescribe the best way to help you return to your sport.

References:

Hölmich, P., Uhrskou, P., Ulnits, L., Kanstrup, I.-L., Nielsen, M. B., Bjerg, A. M., & Krogsgaard, K. (1999). Effectiveness of active physical training as treatment for long-standing adductor-related groin pain in athletes: randomised trial. The Lancet, 353(9151), 439-443.
Yousefzadeh, A., Shadmehr, A., Olyaei, G. R., Naseri, N., & Khazaeipour, Z. (2018). Effect of Holmich protocol exercise therapy on long-standing adductor-related groin pain in athletes: an objective evaluation. BMJ Open Sport & Exercise Medicine, 4(1), e000343. https://doi.org/10.1136/bmjsem-2018-000343

Comprehensive rehabilitation after ankle sprains are important to reduce the risk of re-injury.

Adding in perturbation drills helps to reduce injury risk.