Ligament tear, footballer's injury

Rupture of the anterior cruciate ligament of the knee is the most feared injury in the world of soccer. However, the First Iberdrola has suffered in recent years a plague from this injury that leaves the player in the dry dock for almost a year. Why is this injury so recurrent in women's football? There are three fundamental factors: anatomical, biomechanical, and hormonal. Two specialists in this injury, Teresa Saurí and Blanca Romero, tell us how to prevent it and why there is more incidence in women

“We do not have the 'chassis' ready. It is a sport with many changes of intensity, direction, jumps … It is necessary to have a musculoskeletal system that, in addition to moving well, knows how to cushion and enhance movements,” explained Blanca Romero. , physical trainer of Madrid CFF. For Teresa Saurí, former player and coach who took a study on this type of injury in women's football, explained: “The competitive demand has increased a lot, not so much training.” Because, according to several studies, women injure up to eight times more than men ligament and they reach very young ages: 15 to 19 years. This is the time of “sexual maturation”, precisely when many of them make the leap to professionalism. Blanca Romero explained that this is due, in part, to changes in society: “Before, the children had a lot more movement. They used to climb trees and practically all day they were on the street, now they don't.”

Another factor may be grass and footwear. For Suarí it has not been shown that it influences, however Romero assured that the grass and boots with greater adherence lead to more injuries of this type. The hormonal factor is one that is most alluded to to explain this phenomenon, although it leads to controversy. They agree that there is a phase in which it is more prone to break (the ovulative phase) because there is more excess laxity, but they do not consider it decisive. “There is clear evidence that the timing of the menstrual cycle increases the risk of muscle, ligament or tendon injury. This cycle, in addition, is linked to food, which may be inadequate,” explained the Valencian. For the Madrid physical trainer: “The cycle has not been shown to be a cause of injury. There is controversy over whether there is a phase that most influences the risk of injury. Only in three of the eight works do they determine that there is a phase that there is more propensity. Diet is clearly essential. ”

An injury that, once you have it, there is more tendency to relapse. And there are many cases that corroborate it like Andrea Falcón or Paula Nicart. The recovery time is increasing: “In the American basketball league they do not let them return until the year. The longer, the fewer options there are to relapse,” said Saurí, who fully agrees with Romero: “There are biological times that exist to respect. If the return to the competition is at six months, 25 percent relapse before three months. When everything is correct and without asymmetries between the two legs, at least you have to wait nine to ten months working at stop. The more you delay the lap the lower the risk of relapse. ” Blanca, who returned to Madrid CFF after Christmas after three consecutive ligament tears in the Madrid team, warns that all factors are important, but not everything can be done to change them. However, it is not just relapse of this injury. What's more, if you have had an injury there is a 33 percent chance of having it again.

Can they be prevented or minimized?

It is clear that zero risk is impossible, but with the passing of the years and more professional work, steps are being taken so that there are fewer injuries of this type. “The figure of the readapter, so important, is new in the world of women's football. A preventive force plan is necessary to reduce the percentage of these injuries and specific work by players and field pitches. Clubs must think that, a medium and long term, investing in this figure is a money saver and benefits both the team and the player, “said Saurí that during her time at Valencia and now as a coach she is doing it. A specific training in the phase of the mestrual cycle in which strength exercises are more effective. One specific training per player. Saurí stressed: “They are women who train and compete as professionals, but that lack of strength due to the fact that they are women does not work. This injury is prevented when the player is healthy, but in the teams you do not have that preventive readapter of strength that is capable of evaluating each player. “

Romero has been doing it at Madrid CFF for years. Specific work and at key moments. But, according to her, the key is to start this work from the quarry: “The differences are accentuated during sexual maturation. Inadequate motor patterns are created and you reach the high competition and the body is not prepared for that demand. You have not worked the quality of the movements and you have not done strength exercises”. “When the players work from the beginning, in the quarry, a great physical preparation with quality of movement and strength, women's football will not take a leap. Working with force is not useless nor will it harm you more. They have benefits since they start to move, “he said. And he urged the leaders to bet on starting from the bottom with all kinds of jobs: “The day that the leaders of the quarries realize the work of strength since they join soccer when the five-year-old is feminine, she will make a leap in the medium term “. Because the physicist is, perhaps, the great debt of Spanish women's soccer, a high level of technical and tactical, but with less physical preparation than in other countries.

“In strength training, use the peak of estrogen that allows you to recover better and accentuate the load. And in phases in which it has less recovery, we lower the load. We take this into account,” Blanca said about her work with the Madrid players. CFF. “If an adequate diagnosis is made of the deficiencies that each player has and we apply specific exercises, with specific loads depending on them, the improvements achieved are significant. A preventive, multi-component program, focused on the particular deficiencies of each of the soccer players, significantly minimizes the risk of suffering this injury, “said Teresa.

There is no magic formula: “No one can assure that they will save the footballers from injuries, but there is much more that can be done to try to prevent them from appearing,” said Saurí. From the specific work, the adapters, the type of footprint, the study of hormonal cycles to the footwear and the surface in which it is played can be factors. “It is a multifactory injury,” says Blanca. The woman's anatomy is different, her pelvis and hip width, her knee, smaller ligament diameter, Q angle, ligament laxity or increased pronation. However, it is a factor in which the human being cannot change it. Neither does the hormonal aspect. So, both affect biomechanics. Teaching how to do the movements correctly, how to fall properly from the jump, the turns and the brakes so that the ligament knows how to respond is vital. Because these injuries in 80 percent of cases occur alone, without a blow or entry from an opponent. Cruciate ligament tears will continue to exist, but every day we are closer to avoiding many of them if we follow the advice of these two professionals in the field.

Of course, there are bodies more prone to this injury and once it falls there are more options to repeat.