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Nationwide Children's Sports Medicine

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Fifty percent of injuries sustained by younger athletes playing organized sports can be avoided if the athlete was properly conditioned to play his or her game. As competitive levels increase in younger age groups it is the responsibility of parents and coaches to be knowledgeable in proper conditioning programs and to know when to rest athletes to prevent unnecessary and avoidable injuries. Coaches, athletes, and parents must remember that being physically fit for one sport or position does not necessarily mean an athlete is adequately prepared for soccer.


Ideally, male and female high school soccer players should participate in a year round conditioning program that varies in frequency and intensity. Today’s high school athletes are, on average, less active outside of their sport’s regular season and are less prepared for vigorous participation in their sport. 


Training Seasons


To become better prepared, athletes should know there are four training seasons for a high school sport. The first is the post season, which is 1-3 months following the regular season. Athletes should take this time away from soccer to rest and recuperate both mentally and physically. It is very important to take this time off so the body can heal itself and so the athlete can avoid burn out.


The next season is the off-season, which lasts 4-6 months after the post season. This is where intensive conditioning takes place 3-5 times a week, focusing on improving strength, flexibility, and endurance. Many experts believe flexibility and strength training enhances physical performance and reduces the risk of injury.


The third season is the preseason, which begins 1-2 months prior to the start of the season. Workouts should now shift to assure the athlete will peak out at the start of the season. Properly conditioned soccer players will be ready to enter the regular season and have a lower risk for injury.


For younger children, below high school age, preseason conditioning is the most important. This age should not be made to participate in structured year round conditioning programs like older athletes; instead they should be encouraged to stay active when not in season, and have fun being a kid. Many children at younger ages are being expected to train harder and longer in order to excel in sports. Proper preseason conditioning will not only help the young athlete excel by improving their soccer abilities, but will also help decrease his risk for injury by easing him back into the sport. The goal of preseason conditioning is to improve athletic performance and prevent injury. The American College of Sports Medicine suggests that preseason conditioning begin six weeks prior to the start of the regular season and should have a frequency of three to five times a week. 


Proper preseason conditioning should focus on two general components. The first consists of enhancing strength, flexibility, and endurance, and the second is to improve natural soccer specific movements and agility. Preseason exercising should begin with more emphasis on stretching while the athlete attempts to get into playing condition. This will help improve flexibility and decrease the risk of injury including sprains/strains, and tendonitis. 


Lastly, there is the regular season.  It is recommended to continue to train 4-6 days a week anaerobicly and aerobically to prevent de-conditioning, and for high school athletes to continue lifting weights 2 times a week to maintain muscular strength.   


10 Principles of Conditioning


The 10 principles of conditioning that your workout should be designed around include:

1.  Warm up/cool down- warm up with a light jog or swim a few easy laps to get blood flowing into the muscles to warm them up.  It is easier to stretch a warm muscle than a cold muscle. After warming up, stretch the appropriate muscle groups, perform the activity, and then cool down with stretching.

2.  Motivation- coaches should be creative with workouts and practices to keep the athlete interested and keep them from getting bored. Training is allowed to be fun!

3.  Overload- work harder than normal to place a stress on your body, within limits, and your body will adapt and improve to those levels as long as they are not too difficult.

4.  Consistency- workouts must have a regular set schedule to be effective.

5.  Progression- like overload, this is done by increasing the intensity of a workout (more reps or weight) gradually and within the athlete’s ability over a period of time.

6.  Intensity- quality instead of quantity. Work hard for shorter periods of time, rather than for longer periods of time.

7.       Specificity- be specific in your drills to match the skill the athlete requires for soccer.

8.  Individuality- every athlete is an individual and will need individual attention.

9.  Minimize stress- push athletes, but give them time to rest and be away from conditioning during the week (at least one to two days off).

10. Safety- make sure the environment where the athlete is training is safe, and teach proper techniques.


Remember there are many soccer players who do not train appropriately and are inactive in the off season. Punishing them by overworking their body the first week or two can lead to a nagging or serious injury, with the possibility of having to sit out part of, or the entire, season. By training properly, athletes can be prepared for the start of the season both mentally and physically, decreasing their risk of injury and allowing them to have fun while participating in their sport.  


Consult your primary care physician for more serious injuries that do not respond to basic first aid.  As an added resource, the staff at Nationwide Children’s Sports Medicine is available to diagnose and treat sports-related injuries for youth or adolescent athletes. To make an appointment, call 614-355-6000.






By: Lisa Kluchurosky, ATC

Program Manager, Nationwide Children’s Sports Medicine


Sprains and strains are some of the most common types of injuries in any sport. They involve the stretching or tearing of tissue. Sprains occur to ligaments, while strains involve muscles or tendons.




Sprains and strains are placed into three categories according to severity. They are classified as follows:

v     First Degree (Mild) – tissue is only stretched

      Slight swelling (hardly noticeable)

      Mild loss of range of motion (ability to move in various directions) and strength (0 – 25%)

      No decrease in stability

v     Second Degree (Moderate) – involves stretching and some tearing of tissue

      Moderate swelling (may look “baseball” size)

      Usually includes some bruising

      Moderate loss of range of motion and strength (25 – 75%)

      Some decrease in stability

v     Third Degree (Severe) – complete tearing of tissue

      Significant swelling and bruising

      Near complete loss of range of motion and strength (75 – 100%)

      Marked decrease in stability


Range of motion and strength percentages are determined by comparing the injured body part to the uninjured side. Severity of injury is best determined by a physician or licensed athletic trainer. Immediate first aid for all sprains and strains is Rest, Ice, Compression, and Elevation (described in detail in the May 2002 SportsPage article “The Numbers Are Impressive”). After initial first aid is administered, prompt referral to an appropriate medical professional should be sought to ensure proper injury treatment.




Sprains and strains can be a big deal. Athletes who are still growing often encounter other types of injuries. The most common is a fracture – specifically a Salter-Harris or growth plate fracture.


“Growth plates are located near the ends of long, growing bones in children and gradually close as a child reaches skeletal maturity,” explains John Kean, M.D., Chief of Orthopedics at Children’s Hospital. “The growth plate in growing children is weaker than the nearby ligaments and tendons. Therefore, the growth plate will become injured under lower forces than those that would injure a tendon or ligament.” 


Young athletes with Salter-Harris fractures will be very tender, typically over the growth plate. They may have bruising, are often reluctant to bear weight and, if initially missed, will not respond to rehabilitation as expected. A x-ray is the best way to confirm this diagnosis. Even if the initial x-rays are negative, repeat studies will sometimes reveal the fracture.


There are complications of growth plate injuries that go undiagnosed, untreated, or treated incorrectly. This confirms the importance of seeking the advice of a qualified medical professional with experience in dealing with these injuries even when it looks like it is “just a sprain.”




Initially, the inability to bear weight (about 4 steps) after the injury or tenderness over any bone should prompt an evaluation that includes x-rays.


“Within a few days, any continued significant pain, continued reluctance to bear weight, significant swelling and/or bruising may warrant re-evaluation and possibly an x-ray.  Any other unusual symptoms such as numbness, loss of pulses near the injured area, discoloration, out of proportion pain, or rashes would indicate the need for further evaluation,” states Dr. Kean.


As this fall approaches, enjoy the whistles blowing and the drills being run.  If your child is unfortunate enough to sustain an injury, remember that quick and proper treatment is the key to limiting the time on the sideline.


Consult your primary care physician for more serious injuries that do not respond to basic first aid. As an added resource, the staff at Nationwide Children’s Sports Medicine is available to diagnose and treat sports-related injuries for youth or adolescent athletes. To make an appointment, call 614-355-6000.





Click here to go to the Nationwide Children's site:
The site includes sports health articles and tips, the current Personal Best injury prevention program schedule and online registration, patient stories, bios about our sports medicine staff, and maps and directions to each of our four locations, including the new Sports Medicine and Orthopedic Center in Westerville.

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