Taking the strain out of the game

The football season is upon us once again and for many this means it's time to get into shape. But it's also the busiest period for sports injury specialists. Michael Durham explains how to get fit without getting hurt

It's that time of year again – only August but already the football season is under way. The boots have come out of the cupboard, the shirts been retrieved from the bottom of the laundry basket, and, for the keenest among us, it's back to those weekly amateur matches in the local league.

After a holiday season spent on the beach recliner, it is not only Sunday-afternoon footballers who will be dusting off their kit and persuading forgotten muscles to function again this autumn. Running, swimming, cycling, tennis – all our favourite sports beckon. And it is also the busiest time of year for sports-injury specialists. This is the period, just after the summer holidays, when injuries associated with amateur sports peak, as bodies out of condition are pressed into service again.

Sports injury is a growing industry. With the burgeoning fashion for fitness and active lifestyles, sports-injury clinics have mushroomed and sports physiotherapists are so thick on the ground they could fill an entire football stadium. Every reputable gym has its sports-injury specialist waiting in the wings to sort you out when things go wrong.

So what keeps them in business? Lynda Daley, a physiotherapist with the British Olympic Association who has travelled to Sydney and Atlanta to press the flesh of gold-medallist hopefuls, says the single underlying cause of injuries on the playing field is poor training.

"Really acute injuries are usually the result of a tackle or a fall," Daley says. "But often there is a combination of things – chronic overuse of muscles, doing too much of one particular activity, not warming up, wearing the wrong footwear. The most important thing is not training enough or doing the wrong sort [of training]. Even if you are only going out once a week to play for the local pub league and then going for a pint afterwards, you have to be fit for what you are doing."

Daley recommends a basic cross-training routine of two 25-minute runs a week on grass (or the equivalent of between four to five miles), with a mixture of speed runs, interval work and muscle stretching; swimming is also good for general fitness. Individual sports require special training, depending on the level at which you are going to play.

The right combination of general fitness and special training gives even the most amateur sportsman a huge lead in the injury-avoidance stakes. Warming up before the game is the next most vital measure. Physiotherapists recommend stretching and bending for 15 to 20 minutes before vigorous exercise – recommended stretching routines are available at every gym and sports club.

"Do a few stretches first. Quite simply, it will reduce the incidence of injury, because it prepares your body for what is coming to it. Think of your muscles as Plasticine – if you take Plasticine and roll it between your fingers to warm it up you can stretch it, knead it and play with it and it'll stay in one piece. Cold Plasticine tends to fracture and break. It's just the same with muscles. If you start cold, when you put stress on your muscles you are much more likely to stretch or tear something." Physiotherapists also recommend "warming down" afterwards.

Football is only the most popular of many sports where the same rules apply, especially at any kind of competitive level. Running, swimming, cycling, tennis, basketball and rugby are all activities that can put serious strains on the body, and each has its specific danger points.

Alan Hodson, head of sports medicine for the Football Association, whose hands have soothed many a highly-insured limb, tends to talk technically of "eccentric" and "concentric" limb movements in football, but his message is the same – train for the sport and the level at which you will play.

"Lots of people doing it for a bit of fun aren't very active during the week and then wonder why they get injured when they have a go at the weekend. The key thing is to be fit to play and the training should fit the demands of the game," he says. "You don't have to be in the first division to come under real stress on the pitch."

Hodson says 37 per cent of football injuries are muscular strain and 19 per cent are torn ligaments. Every sport has its particular dangers, and in football it is the combination of sudden sprinting, slowing down and twisting movements that is most likely to put you in hospital.

"A lot of these strains happen when you are accelerating away, or suddenly slowing down, with a change of direction at the same time," says Hodson. "It's a pattern that is very similar in amateur and professional football – it's just part of the game."

Players who have done their stretches and the right cross-training are more likely to survive these stresses and strains on the pitch, but there are other factors that can lead to serious sports injuries, including sheer exhaustion. Studies of professional matches show that most of the injuries happen in the minutes before the half-time and full-time whistles – when players are at their most tired.

Diet is also a factor: players can boost their chances of getting through a match unscathed by eating sensibly before a match and drinking enough fluid to top up their endurance levels. But football, of course, is a contact sport where injury can be a matter of sheer bad luck. Nobody comes out of a head-on collision at speed with a 15-stone striker without a few bruises.

As for eccentric muscle activity, technically that means the stretching and lengthening motion in a muscle (for example, stopping suddenly or fending off another player in a tackle), this is the single biggest cause of leg injuries of all among footballers. It is going from stretching to pulling motions that does the damage.

Footballers run between five and seven miles during a game, apparently, but running five miles twice a week will not be enough to prepare your legs for the bashing they can expect on a football pitch. Even amateurs need to build in stopping-and-starting exercises to mimic the real thing, says Hodson.

Other contact sports have similar danger areas. Softball damages shoulders and arms, since throwing the ball puts a tremendous strain on these areas. Chucking a ball about should help, together with weights in the gym twice a week to strengthen the wrists, biceps and triceps. Basketball players are prone to ankle strains – for which calf and ankle stretches are particularly recommended.

Cycling, while excellent exercise, can damage the knees, back and hips. One way to keep in shape for that charity bike ride across Tibet is to do abdominal and lower back exercises in the gym. Another is to make sure your bike's frame size, seat and handlebar height are right for your build.

Tennis, of course, is famous for tennis elbow, but budding Wimbledon champions should also beware of shoulder and calf injuries. The peculiar move of the over-arm serve, coupled with the shock as the racket whacks the ball, can produce tendonitis, while calf muscles are at risk from all that stopping and starting. Stretching and rotating exercises at the gym should reduce the risks.

Finally, that old favourite jogging – such a basic form of exercise but one that produces a surprising number of casualties. Calf stretches and ankle exercises should give your lower the limbs the best possible chance of surviving a pounding across the pavements. Sports medics also recommend training with a mixture of fast and slow running, to maximise your stamina and reduce the risk of injury from sheer tiredness.

And if you are injured? Don't soak the offending limb in a hot bath, don't use a heat lamp and above all don't ask the goalkeeper to do a bit of amateur massage. Stop exercising and seek professional help, say the experts. Most gyms have a qualified sports-injury specialist and there are plenty of sports-injury physiotherapists in the Yellow Pages.

National Sports Medicine Institute: 020-7486 3974 ( enquiry@nsmi.org.uk). The institute is building a sports-injury dedicated website ( www.rescu.org.uk) that will include a list of qualified sports-medicine practitioners