August 16, 2022 4 min read

April 5th, 2020

World Cup 2022: Overuse Injuries in Soccer

It's that Time of the Year

As we head into November, global sports enthusiasts will no doubt be heavily focused on the World Cup. This will also be the first ever World Cup to be held in the Arab world, which adds even further excitement for the sport and its fans. And with all the excitement and hopes of success for the various players and teams competing, there will also be the rising concerns around what happens if a top player, as the competition increases, gets injured?


While there will be lots of trauma occurring on the field, most of which will be difficult to avoid, there will also be a lot of overuse injuries which will interfere with a player’s performance. Maybe they will miss only a half a game, but when the competition is that fierce, this could be the difference between a celebration and a trip home. The good thing is that these types of injuries may be avoidable if the right approach is taken. Whether it’s a muscle strain, a ligament sprain, bursitis or tendonitis, the right balanced approach may help significantly.

“The man who moves a mountain begins by carrying away small stones.”
- Confucius

5 Keys to Prevention

Here are 5 often overlooked keys to preventing overuse injuries during pre- and post-workout training / competition:


  • Embrace Contrasting / Contrast Therapy – It amazes me how, still to this day, people are polarized in their approach to hot and cold therapy. They are either all in on hot or all in on cold. And if they use both, their selection is based on rules from the 1980’s. Not only do both have a diverse set of applications during both pre- and post-workout training / competition, but actually work best when used together in what is called contrasting or contrast therapy. Like the initial painful lesson people with standup desks learn, it’s not about one being better than the other, but the benefits to the body as it is forced to adjust physiologically to the different external factors caused by alternating exposure to both.


  • Train the Nervous System – While it takes a bit more effort and skill to address the nervous system pre- and post-workout/competition, it is the most important system to properly maintain during competition. From its role in communication across the body to its ability to sense and correct the most subtle malalignments that may occur during intense, high-speed motions, it is a much more important role player in overuse than strength and length. Not to say those are not of importance, but their role is often overemphasized at the expense of the nervous system.


  • Homeostasis via Supplementation– While I understand compounds from the hemp plant like CBD (Cannabidiol) and CBG (Cannabigerol) may still be controversial (SMH), their incredible ability to leverage the Endocannabinoid system for the purposes of re-establishing cellular homeostasis should not be lost in this conversation. So, if you cannot use phytocannabinoids, other compounds that fall into the adaptogenic category (ex. mushrooms) or the cannabimimetic category (ex. beta-caryophyllene, echinacea) should be used regularly in order to facilitate a faster cellular recovery in the athlete pre- and post- workout/competition.


  • Use Percussion and Vibration – Percussion and vibration do indeed overlap a bit in most people’s minds but can be differentiated based on their delivery and effects. Percussion, usually connected to a large amplitude of motion rather than the frequency of motion (ex. the often-large distance between the start and stop positions of a strong massage gun head as it moves through one cycle of motion) delivers a heavy impact to the body and can therefore be more efficient at increasing range of motion. Vibration, which is often connected to the frequency of motion rather than amplitude can provide a tremendous amount of proprioceptive input, making it more efficient at addressing the nervous system. In an ideal world, you can strike the balance and have both. Nonetheless, the important point here is finding a good tool for percussion and vibration and to use it regularly during pre- and post-workout training/competition.


  • Train the Mind as much as the Body- This perhaps should be number 1 on the list. What good is a perfectly functioning body if the mind is not as equally fit? Yes, I know overuse injuries are mostly described as being physical in nature, but the lack of intuition or ability to actively listen to one’s body during pre- and post-workout training/competition can be quite harmful and lead to a lot of missed opportunities to briefly rest or take small actions to allow for recovery. Whether it’s ten minutes of breathing, a mindful shower or meal, or a short meditation, the value of a quiet mind can be immeasurable for an elite athlete. And should an injury occur, cultivating present moment awareness will be incredibly helpful in allowing for patience while the body heals.


As the athlete evolves, so should the approaches we use and the perspectives we take on injury. Not to say that the “old school” approaches do not have merit, but innovation and ancient wisdom should always be put together and used for the benefit of the athlete as time passes. Looking forward to November!

Written by Gabriel Ettenson, MS, PT

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