The over-35s soccer player

AFTER many years of treating injuries sustained by soccer players falling into the over-35s age group, it has become clear that they are a significant injury demographic in their own right.

The Scenario

Mario, aged 36, has a daughter who has just signed up to play with the local under?6s soccer team. While Mario has a soccer background, his family has kept him off the pitch for a few years. He keeps fit by going to the gym 2–3 times a week but has put on 10kg. He hasn’t performed 90 minutes of aerobic activity with repeat sprint efforts for some time. 

It is suggested that the over-35s are looking for some more players and he thinks, ‘Why not, I love playing soccer!’ 

This scenario is something heard commonly from the patient who has limped into the consulting room with either an acute knee injury, or a hamstring or calf tear. Injury appears to be less common in players who have continued to play year in and out, than in those who have had a break, even for a year or two. 

Resolving the Problem

The first step is to improve general conditioning. The most common mistake made is to train once or twice and then get straight in and play a game. 

Realistically the decision to play should be made early, at least three months before the season starts. A running-based conditioning program should be undertaken for at least six weeks prior to even starting football activity.

This initially needs to include slower conditioning work, but should be upgraded to include both high intensity and direction change running. 

As a football code in particular, soccer involves a combination of both continuous low intensity running and repeat sprint efforts. 

Most people haven’t trained with that degree of endurance or intensity since they were younger, and to try to reproduce it on aging hamstrings for 90 minutes is a recipe for injury.

Once the six-week conditioning program is complete, then a period of six weeks of soccer-specific practice, involving a continuation of speed and endurance conditioning, should be performed before playing games. 

This will hopefully provide a more ‘soccer hardened’ body, able to withstand traumatic muscle strains and injuries to the knee and ankle, as well as one more able to recover after games. 

‘Prehabilitation’ and Recovery

The last component of a successful training program includes addressing ‘prehabilitation’ exercises and recovery techniques. 

The majority of players who are able to complete a conditioning program as described above would be ahead of the pack, but these last components are the ‘extras’ that may prevent injury. 

This would include a flexibility program, particularly for the glutes, hamstrings, quadriceps, hip flexors and calves.

These should be performed on most days, and especially on days after training and games. Exercise should involve strengthening for the thighs and buttocks (squats, lunges), core strength and proprioception or balance exercises. 

Core strength is a fashionable term for the deep muscles supporting the spine and pelvis. It is excellent for treating patients with back problems, but also helpful in preventing hamstring tears and injury around the groin. 

Proprioceptive exercises involve using devices like a ‘wobble board’ to improve balance sense. This has been shown to reduce the incidence of injury to the knee and ankle. 

Post game recovery techniques should also be considered. A post-game warm down and stretch is recommended. Low intensity exercise the day after a game such as a walk, a swim or a light bike ride will aid muscle recovery and reduce delayed onset muscle soreness. A massage 1–2 days after the game will also facilitate muscle recovery. 

Be careful not to neglect post-game hydration, ideally not just with alcohol! 

Key points: Older athletes

• Older athletes are more prone to injury, especially if participating in a new sport
• Common injuries in older athletes include hamstring and calf tears, as well as knee and ankle ligament tears
• A pre-participation fitness program is an important factor in injury prevention. This should include graded aerobic exercise, flexibility and core strength
• Appropriate post activity management can improve recovery and reduce subsequent risk of injury.