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December 18, 2010
Be aware of common injuries

Interview by Mike Woitalla (from Soccer America's Youth Soccer Insider)

Dr. Dev K. Mishra, who has served as team doctor at the professional, national team, college and high school level, is the founder of SidelineSportsDoc.com. We asked Dr. Mishra about injury trends he has observed in youth soccer; whether there are different injury patterns between boys and girls; and what coaches can do to help keep their players healthy ...



SOCCER AMERICA: What trends have you seen in the past years in youth soccer injuries?

DR. DEV MISHRA:
There’s two things that we’ve seen that have really risen dramatically.

One is that it seems that for whatever reason we’re seeing a much larger number of overuse injuries than we used to see even 10 years ago.

These would be things like tendonitis, stress fractures, things that result from repetitive usage of an extremity. That’s No. 1.

No. 2. We’re seeing a rise in certain traumatic injuries at a much earlier age than we used to. For soccer players it’s principally ACL tears.

There seem to be many factors involved in that. Whether it’s more kids playing, different style of play, different surface, or mechanical issues like muscle weakness.

But we’re seeing ACL tears in children as young as 12 and 13 years old – which used to be really quite rare 15 years ago.

SA: Are there different injury patterns for boys and girls?

DR. MISHRA:
Girls tend to become physically mature earlier than boys do and certain injuries such as ACL tears happen at a younger age in girls than they do in boys.

We see adult-type injuries a little earlier for girls than we do for boys.

There’s also growing, very solid evidence that shows that girls respond differently to a concussion than a boy does. Girls tend to have symptoms that last longer and perhaps are a little more severe than one would see in a boy. There’s some strong scientific evidence of that coming out of the University of Pittsburgh.

SA: For years there have been reports of higher rates of ACL injuries in females. What should coaches do with this in mind?

DR. MISHRA:
There’s a lot of effort in trying to improve training for girls to reduce ACL injuries.

Dr. Bert Mandelbaum’s group has been key in developing some of those methods. He and physiotherapist Holly Silvers have done a great job of identifying a simple warm-up that helps to improve the landing characteristics when you’re landing from a jump, and improving the mechanical ability to cut and pivot.

And they’ve shown that they do have reductions in ACL injury rates for teams that follow these protocols.

(Editor’s note: For more on the Prevent injury, Enhance Performance (PEP) Program, click HERE.)


SA: What else can coaches do to help prevent injuries?

DR. MISHRA:
Good training courses should include in their training age-specific methods that help coaches recognize and provide basic management for injuries.

As the kids get older and into adolescence there’s more of an emphasis on proper warm-up, flexibility, jump training, and other preventive measures.

Early on, the game should really be about fun and less about tactical awareness. It’s amazing that when we take tactical awareness and that type of thing out of the game -- and it becomes more play than game -- we see far fewer injuries than we do otherwise in a structured environment.

SA: How can coaches prepare to respond when injuries do happen?

DR. MISHRA:
Coaches should use whatever resources are available to educate themselves about injury management .

Our premise, with SidelineSportsDoc.com, is to teach people a method they can use every time. Learn how to take care of the six to eight key injuries that happen. They’re going to be a little different for soccer than they are for baseball and hockey.

If you have resources available in your local community, take advantage of them. Perhaps your club has an injury management curriculum as part of your coaching certification course. Make yourself aware of a method and make yourself aware of the most common injuries, how to look for the red flags and manage that properly on the sidelines. Knowing those basic things will allow a coach to respond with confidence when an injury occurs.

(Dev K. Mishra, the founder of SidelineSportsDoc.com, is an orthopedic surgeon in private practice, Burlingame, Calif. He is a member of the team physician pool with the U.S. Soccer Federation and has served as team physician at the University of California, Berkeley.)

(Mike Woitalla, the executive editor of Soccer America, coaches youth soccer for Rockridge SC/East Bay United in Oakland, Calif. His youth soccer articles are archived at YouthSoccerFun.com.)

December 06, 2010
They scored -- now what?

Goalkeepers react in various ways after they get scored on. Some keepers whack the ball in anger. Some fall to their knees, head in hands. Some scream at their teammates. And some hang forlornly on the net. Whether the keepers realize it or not, these immediate, emotional responses are more than personal reactions. These actions speak loudly to the keepers' own teammates and to their opponents.

By Tim Mulqueen with Mike Woitalla



So what’s the best way to react? Keep your composure. Your teammates don’t want to see you falling apart as if you’ve lost all confidence. They certainly don’t want to be berated. If they were at fault, they most likely already know it. If they weren’t, they’ll resent being blamed. If something needs to be discussed, it should be discussed concisely and without drama.

What should you do with the ball in the net behind you? Don’t embark on a long sprint, carrying the ball to midfield to speed up the kickoff. That implies panic. Don’t boot the ball like a madman. If there’s no defender around to grab the ball out of the net, calmly retrieve it yourself and pass or toss it upfield.

Body language that conveys a negative frame of mind -- such as a slouch or a sulky grimace -- sends a depressing message to teammates and an inspiring one to opponents. And such gestures only delay the keeper’s own recovery.

Keepers need to assume a poker face after conceding a goal -- and they must put the setback out of their mind, whether or not the goal was scored because of their own error.

However, the keeper who has given up a goal should not become shy and stop communicating with his teammates to help them organize the defense. The team still needs the direction of the keeper. In addition, focusing on the upcoming play will help the keeper put the conceded goal out of his mind.

Bouncing Back

During a game, the goalkeeper coach can play an important role in helping the keeper bounce back from a setback. One approach is to point out the positive: “You let that goal through, but you did save two point-blank shots.”

Another approach is to remind the keeper that errors are a part of the game at every level. Struggling keepers need to put out of their mind what they did wrong. They should think about what they did well and how they can continue to help their team.

Afterward, the keeper coach will have a chance to address the errors and the good plays with the keeper. Keepers need to learn from their mistakes, and they can build confidence from recalling what they did well. When a keeper has just had a tough outing, I often tell the keeper to look at the overall performance:

“You didn’t play your best game, but you gave your team a chance to win when you stopped that breakaway and kept the score within reach.”

Sometimes I don’t even bring up the mistakes. If the keeper made errors but we’ve recently had some really good training, I leave it alone. There’s no sense in bringing up errors if the keeper is training well. I may just touch on it and say, “Hey look, you know what? That mess is behind you. Look how good you’ve been at training.” And I leave it at that.

Goalkeepers have to develop a short and somewhat selective memory, and the keeper coach can help them do that.

The time and place to examine and correct errors and to rebuild confidence is in training. Good training instills confidence. It’s the best way to get the keeper sharp again.

(Excerpted from “The Complete Soccer Goalkeeper” by Tim Mulqueen with Mike Woitalla courtesy of Human Kinetics.)


U.S. Soccer Federation coach and instructor Tim Mulqueen has been goalkeeper coach for U.S. national teams at the U-17 World Cup, U-20 World Cup and at the 2008 Olympic Games. He’s been a goalkeeper coach in MLS, for the MetroStars, and the Kansas City Wizards when they lifted the 2000 league title.



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