Footballer's injuries and osteopathy
Introduction to pathologies in soccer players
Injuries in soccer remain a major challenge for players, whether amateur or professional. According to recent data from studies on sports injuries in 2025, there are on average around 15 to 16 injuries per 1,000 athletic exposures (AEs), with a marked distinction between training and matches. The risks are 10 to 12 times higher during competitions than during training sessions, due to the increased intensity and physical contact.
These injuries are varied and affect different body tissues. According to updated analyses of common pathologies in soccer players, the typical distribution includes:
- Muscle injuries: approximately 40-45% of cases, often without direct contact.
- Ligament injuries: 20-25%, such as sprains.
- Direct trauma (bruises, hematomas): 10-15%.
- Tendinopathies: 10-12%.
- Joint problems: 8-10%.
- Bone injuries: 4-6%, including fractures and growth disorders.
Among the new developments in 2025, studies highlight an increase in injuries among midfielders (up to 43% of total cases), due to their versatile role involving frequent changes of direction. In addition, post-COVID research indicates a 46% increase in injuries in this position. Among young people, lower extremity injuries are declining slightly thanks to prevention programs, but remain prevalent with more than 500,000 annual emergency room visits in the United States.
This article aims to become a comprehensive reference on these pathologies, covering muscular, tendon, ligament, bone, and growth aspects. We incorporate modern treatment approaches, such as the PEACE & LOVE protocol recommended by the Clinique du Coureur, which replaces traditional methods based on icing (RICE) for more optimal healing. We will also discuss the key role of osteopathy, as well as updated prevention strategies, including programs such as FIFA 11+ and its developments.
Muscle disorders in soccer players
Frequency and location
Muscle injuries dominate the landscape of football injuries, accounting for nearly 41% of incidents, with 90% occurring without external contact. The thigh is particularly vulnerable: the hamstrings (back of the thigh) are affected in 60% of cases, the quadriceps (front) in 23%, and the adductors (inside) in 17%. In 2025, data confirms an increased prevalence of hamstring tears among forwards and midfielders, linked to explosive sprints.
Types of muscle injuries
Muscle damage varies in intensity:
- Muscle soreness: Diffuse post-exercise pain caused by unusual overexertion, disappearing within 3-7 days.
- Cramps: Sudden, intense contractions, relieved by stretching, often linked to dehydration or fatigue.
- Contractures: Prolonged protective reactions without actual fibrous lesions.
For more serious injuries:
- Stretching: Micro-tears in fibers with moderate swelling.
- Tears: Partial rupture of muscle bundles, causing hematoma and functional impairment.
- Complete tears: Total separation of the muscle, often requiring surgery.
Prevention of muscle injuries
The key lies in striking a balance between strength and flexibility. Muscle strengthening through exercises such as core training or specific protocols is essential. The FIFA 11+ program, updated in versions such as Football Australia Perform+, reduces injuries by 30-50% with 15-20 minute exercises, 2-3 times per week. It includes routines for adults and children (FIFA 11+ Kids), with visuals for easy application.
For flexibility, prioritize cold stretches, 2-3 hours after exercise or in the morning, for 5-10 minutes daily. Avoid stretching immediately before or after activity so as not to weaken the tissues, and avoid stretching for too long. You need to have a minimum level of flexibility as a soccer player, but you don't need to be extremely flexible to be more explosive.
Treatment of muscle injuries
Adopt the PEACE & LOVE protocol for optimal management:
- PEACE (acute phase) :
- Protection: Avoid painful activities during the first few days.
- Elevation: Raise the limb above the heart.
- Avoid anti-inflammatories: Avoid anti-inflammatories and ice, as they slow down natural healing.
- Compression: Apply an elastic bandage to limit swelling.
- Education: Learn about the healing process; let the body do its work without unnecessary interventions.
- LOVE (recovery phase) :
- Load: Gradually reintroduce guided loads based on pain.
- Optimism: Adopt a positive attitude to promote healing.
- Vascularization: Stimulate circulation through pain-free cardio activities.
- Exercise: Restore mobility, strength, and proprioception through active exercises.
Osteopathy is used to release compensatory tension and optimize recovery. Avoid deep massages initially, corticosteroid injections, and rehabilitation too early on.
Tendon disorders in soccer players
Tendons connect muscles and bones, and damage to them (tendinopathies) results from fibrous remodeling rather than pure inflammation. In soccer players, the most common tendinopathies are patellar, Achilles, tensor fascia lata (iliotibial band syndrome), and certain types of groin pain.
Prevention
- Hydration and alkaline diet to reduce acidity.
- Cold stretches and gradual warm-ups.
- Gradual recovery after a pause.
- Shoes suitable for the terrain.
Treatment
Apply PEACE & LOVE adapted to tendinopathies: no total rest, but controlled stimulation of the tendon. Combine transverse massage, kinesio taping, shock waves, and eccentric work in physical therapy. Osteopathy corrects overall dysfunctions, while podiatry treats postural imbalances. A multidisciplinary approach is crucial for a complete resolution.
Ligament disorders in soccer players
Ligaments stabilize joints; injuries range from sprains (partial stretching/tearing) to complete tears, sometimes with bone avulsion. Main areas: ankle and knee (e.g., ACL, with a 46% reduction via FIFA 11+).
Prevention
Strengthen muscles and proprioception with FIFA 11+: exercises on one foot, with eyes closed, or on unstable boards to develop anti-imbalance reflexes.
Treatment
PEACE & LOVE: avoid anti-inflammatory drugs; rest without excessive immobilization (except in cases of suspected fracture in children). Osteopathy tests and releases blockages, promotes drainage; physical therapy drains and rehabilitates; podiatry stabilizes chronic cases.
Specific addition: ACL (anterior cruciate ligament) tears often affect women (2-8 times greater risk) and require surgical reconstruction followed by 6-12 months of rehabilitation.
Bone disorders in soccer players
Fractures
Bone can withstand up to 1,000 kg/cm², but fractures require 40 days of consolidation and 8-10 months of total remodeling. Treatment: immobilization (cast), except for ribs or toes (strapping). Osteopathy after 3 months for sequelae.
Periostitis
Inflammation of the periosteum (outer layer of bone), often in the tibia in soccer players. Prevention: soft playing fields, appropriate footwear, alkaline diet, gradual training progression, osteopathic/podiatric consultations.
Treatment via PEACE & LOVE: ice avoided, but massages, taping, compression, physical therapy for drainage.
Concussions
Concussions represent a major risk, with a 25% reduction through head restrictions among young people.
Symptoms: headache, confusion.
Protocol: cognitive/physical rest, gradual return. Cranial osteopathy for residual tension, as well as osteopathy to treat cervical joint and muscle tension.
Growth disorders in soccer players
In young people, asynchronous growth (bones before muscles) causes excessive pulling.
Sever's disease (heel)
Due to Achilles tendon strain or microtrauma. Prevention: hydration, stretching, osteopathy/podiatry for balance.
Treatment: relative rest, gentle stretching, temporary heel lifts (2-3 days), shock-absorbing insoles. PEACE & LOVE adapted.
Osgood-Schlatter disease (knee)
Patellar traction on the tibia. Prevention: hydration, quadriceps stretching, osteopathic/podiatric corrections (e.g., genu valgum).
Treatment: rest (up to 6 months if advanced), stretching, correction of dysfunctions. Multidisciplinary approach to prevent permanent deformities.
Conclusion: Towards safer practices
To make soccer a sustainable sport, incorporate prevention (FIFA 11+), nutrition, hydration, and regular monitoring. Osteopathy plays a pivotal role in restoring bodily balance, reducing risks, and accelerating healing. Consult professionals for a personalized plan, and remember: patience and optimism (LOVE) are key to an optimal return. This guide, updated with 2025 data, aims to educate and protect soccer players of all levels.
