Women’s College Soccer Injuries – Part 1: Natural Grass vs Artificial Turf

Women’s College Soccer Injuries – Part 1: Natural Grass vs Artificial Turf

A few months ago, we reported on one of our studies that examined recent research on artificial turf injuries. This remains a hot topic of discussion among coaches, players and parents. Is there greater risk of injury when playing and training on artificial turf? Given the immediate and long-term impacts injuries like an ACL tear have on the player, it’s not surprising that the soccer community wants a clear answer to this question. Dr. Michael Meyers of Idaho State University recently published a fascinating and in-depth study comparing match-related injuries in women’s college soccer. It provides a wealth of detailed information on the debate between artificial turf and grass. In Part 1 of this two-part analysis, we focus on playing surface and the risk of injury. In Part 2, we’ll examine the data more closely and look into the circumstances that lead to injuries in women’s college soccer.

The study followed 13 NCAA Division I women’s soccer teams over a 5-year period. The teams were selected based on their availability to play matches on grass and turf as well as their competitive level. Athletic trainers at each university were asked to record and describe all injuries that occurred during regular season matches played on FieldTurf and natural grass. They recorded information such as the type, location and severity of the injury, game situations, playing position as well as a host of other variables. It is important to note that in this study (as in others), an injury is defined as an acute trauma that resulted in a player missing all or part of a match or training session. Thus, chronic conditions such as overuse or minor injuries like skin abrasions are not generally considered by this definition.

In all, the 13 teams played 797 matches, 355 (45%) on FieldTurf and 442 (55%) on grass. The athletic trainers noted a total of 693 injuries (slightly less than 9 injuries per 10 matches). When looking at all injuries combined, the injury rate was nearly 20% lower for matches played on artificial turf than on grass (7.7 versus 9.5 injuries per 10 matches).

As for specific injury locations, the figure shows injuries grouped by body part and tissue type (click to enlarge). In the left panel, there tended to be more ankle and knee injuries on grass than on turf, but this difference was not statistically significant. There were however, statistically greater rates of head and shoulder injury on grass than turf (marked by the asterisk on the figure). The results also showed greater muscle injuries, ligament sprains and contusions (bruises) on turf.

There were no differences in rate of concussions on the two surfaces. However, a greater number of post traumatic headaches were reported on grass. Specific knee injuries were also similar on the two surfaces. This includes anterior cruciate ligament as well as medial and lateral collateral ligament injuries.

The study found no key differences in the mechanisms of injuries sustained on turf and grass. This includes player-to-player, player-to-surface and player-to-ball contact injuries as well as shoe-to-surface contact and non-contact injuries.

There were several interesting findings about various field conditions. Significantly fewer injuries occurred on older FieldTurf fields (≥8 years old) compared to older grass fields. The author of the study suggests that this may be due to the consistent surface of artificial turf compared with damage to older grass fields as the season progresses. The injury rate for matches played in the heat (≥70°F) was also lower on Fieldturf than on grass. This is surprising given the concerns over heat and artificial turf. However, as the college season extends into the fall months and given that many matches are often played at night, field surface temperature during a game may not be excessively high.

Overall, for the vast majority of injuries examined, none occurred more frequently on turf than on grass. In fact, some specific injury types, the rates of injury were lower on the artificial surface. Based on these results of the study, the author concludes that artificial turf is a “practical alternative to natural grass when comparing injuries in collegiate women’s soccer.”

The results of this study compare favorably with the results of two previous studies on college soccer players. In 2007, researchers from the UK examined the NCAA Injury Surveillance System and concluded that there were no differences in the “incidence, severity, nature or cause of injuries sustained on new generation artificial turf and on grass.” This held for matches and training as well as men and women.

Given these three studies, it seems reasonable to suggest that artificial turf does not raise the risk of acute injury in female college players. If one Google’s artificial turf and injuries, a host of websites can be found that promote the notion that artificial turf is inherently dangerous, especially for women. However, the scientific data simply does not support this idea. It is doubtful that anyone is willing to go so far as to conclude turf is safer than grass. Add to that, many players prefer a well groomed grass pitch over artificial turf. Nevertheless, the research certainly indicates that as far as acute injuries go, players, coaches and parents can be confident that playing on turf does not raise the risk of injury.

Next up, a look at injury causes, match situations and playing position.


Oblique & Intercostals Injuries

for link to article Oblique & Intercostals Injuries

Oblique strains and pulls and intercostals strains are injuries that you seldom saw or heard of fifteen to twenty years ago. The two injuries are different injuries; I think one mistake is to group them together. Now they are both a very common occurrence in baseball both in pitchers and hitters. If you look closely at the mechanism of the injuries based on the demands placed on the body in the activities that cause these injuries it is clear that both are force reduction injuries. They occur in deceleration of the trunk after a violent ballistic action of swinging a bat or throwing a pitch. As with any injury it is important to thoroughly assess what is being done in the training/prevention area and what is not being done. My observation is that the ratio of actually preparing to pitch and hit is out of balance. There is too much swinging of the bat with out the requisite lead up activities that prepare for the deceleration forces exerted in a diagonal rotational pattern. With pitchers they pitch more but throw less, by that I mean a structured long toss program where they have to extent themselves through ranges of motion outside of their normal pitching motion is not emphasized enough. The same would be true with striking and swinging activities to prepare for hitting. In addition there is more emphasis on weight training that is not specific enough to the demands of hitting and pitching. There are still too many traditional weight exercises with emphasis on load and force production mostly in sagittal plane. In addition the too much of the “core work” is still done in prone & supine postures and too isolated. Not enough emphasis on catching and activities that force the trunk to decelerate.

The ultimate reason for these injuries goes far back to what the current generation of players did and did not do when they were kids growing up. Most began playing baseball at an early age when they were identified as being talented and probably specialized early and prepared by pitching more and swinging the bat more. In essence accumulating stress without any preparation for the imposed stresses. Most did not have regular physical education as that has gone the way of dinosaur. The surest way to strengthen the intercostals and the oblique’s is to climb, hang, swing from overhead ladders and crawl all activities inherent in play and work in past generations. The current generation of players did not get this either in free play or in physical education. This should force us to reconsider how we train and prepare these athletes from younger ages on up to the professional level. I know this sounds old school but take a step back and think about how it can be done. It can be done, but it must be done in systematic manner beginning at the youngest ages with comprehensive preparation to play activities that are structured into the start of practices at every level. These activities should be as movement rich as possible including climbing, hanging, suspended swings and crawls. Mind you this is not to be done in a boot camp environment but in a structured playful teaching environment regardless of the level of development. It is not real complicated; it is very basic but necessary. That is both the long term and short-term solution.

Does Fascia Matter?

A great link – long but very good Does Fascia Matter?

A detailed critical analysis of the clinical relevance of fascia science and fascia properties

Does fascia — sheets and webs of connective tissue — have any properties that are relevant to healing and therapy? Are there good reasons to do manual therapy (massage particularly) that is “aimed” at fascia specifically? Fascia gets discussed in therapy offices a lot these days. It is supposedly the key to many a therapeutic puzzle, and is now routinely targeted by therapists of all kinds. Fascia is fashionable. But is fascia actually important in therapy? More than any other soft tissue?

This article questions fascia excitement from a scientific perspective.1 Fascia enthusiasts are rarely specific about why fascia matters, or how exactly “fascial work” can help people with common pain problems. They speak mainly about the complexity and ubiquity of fascia, as if those alone are good enough reasons to focus on fascia. Attempts to get more specific are usually sloppy. Poor clinical reasoning about fascia seems to be too common.

This problem was captured perfectly for me by something a massage therapist said to me on my 40th birthday. I was getting a massage (because I really do love massage). The therapist was doing fascial work, of course — you can’t get a massage in Vancouver these days without getting some. She was using some mildly uncomfortable pulling and twisting techniques, trying to “manipulate” my fascia, instead of using the more satisfying, relaxing Swedish styles I was craving. She launched into an awkward explanation of her technique, but words failed her:

Well, your problem is fascia. [I didn’t have a problem.2] The fascia is the thing you have to do something with. If you fix the fascia, everything gets more … well, the fascia will make everything better.

Somehow. I wish I could say this was an unusually murky explanation of fascial therapy, but I’ve heard explanations like that quite a few times over the years.

Walking Gait Assessment: The most functional movement assessment?

Walking Gait Assessment: The most functional movement assessment?

Whether you are a Chiropractor, Physical Therapist or Fitness Professional, one of the most important tools you have is your ability to assess human movement.   From the overhead squat to the step up, each of us probably has our favorite, or go-to, assessment techniques that we perform on all patients or clients.

As we consider the most appropriate assessment techniques for demonstrating instability or compensation patterns, how much do we consider function?

Is a double leg squat more functional that a single leg squat?  

And if you had to choose to perform only one, which would you choose? 

As we look closer at the movement assessments that we perform daily, I challenge you to consider how functional each assessment really is to your patient or client’s activities of daily living (ADLs) and/or occupation.

One movement assessment that I perform more than any other technique is the walking gait assessment.   I believe the walking gait assessment to be the most functional of all assessments – and it can reveal the instability and compensation patterns that patients and clients are performing 8,000 times a day!

A squat assessment can demonstrate dysfunction in joint mobility and stability but can it assess the way the body will react to impact forces and how efficiently load will be transferred?

Most injuries that we see, whether they are in the foot, the knee or the lower back, are related to stability and control as it relates to impact forces and energy transfer.

This means, that as we consider movement assessments, we must also consider an assessment technique that is more dynamic and transferrable to the most common activity we do everyday – walking!

Join EBFA in our newest workshop – Foot Strike & Functional Movement:  Human Gait Assessment – and learn the basics to the human gait cycle, walking gait assessment and corrective exercise programming.



We at EAP have seen different types of scar tissue, ranging from “knots” to deep kelloid scars.

“Not all scar tissue is the same”

Some scar tissue is very superficial, while others are very deep and transcend 3 dimensionally into whole distortion involving not only soft tissue, but osseous structures as well. in this post we will describe the different types of scar tissue we have encountered, and how we have dealt with it.

MUSCLE KNOT – An area of muscle tissue that has gone into spasm due to either a lack of electrolytes or an over weakness in the antagonistic muscles along with a over contraction of original muscle or a alteration in the kinetic chain (usually very distal to the site of the cramp). Note these are possible solutions from the short list! 7

TREATMENT – Positional Muscle Release (i.e. shorting the muscle belly and placing gentle but sustained pressure on the knot  – Muscle Jostling – Golgi tendon relaxation with possible Deep Soft Tissue Release on the antagonistic muscle – Strengthen  the weak muscles that are in close proximity.

BROAD FASCIAL SCAR – as a consequence of prolonged chronic overuse and the lack of lymphatic return flow from the area. Most individuals are not even aware that they have it.  This type of scar tissue can extend itself very broad, covering sometimes whole areas of the body.

TREATMENT –  Soft Tissue Release (STR) or A.R.T., Trigenics, GRASTON technique  (muscle stripping) – broad based  DEEP EFFLERLAGE over the area (i.e. “flush” massage) – Massage Stick (visit http://www.freedomfromthepain.com to purchase it) – epsom salt bath in very warm water – dry sauna – dry brushing.

SUPERFICIAL BROAD FASCIAL SCAR TISSUE – as in the previous type of scar tissue, most individuals will not even be aware they have it. Nonetheless, this type of scar tissue is very local, usually confined to inter-muscular regions (i.e. “muscles that are stuck together”).

TREATMENT – Soft Tissue Release (STR) or A.R.T.,  Trigenics, GRASTON technique  (muscle stripping) – broad based  DEEP EFFLERLAGE over the area (i.e. “flush” massage) – Massage Stick (visit http://www.freedomfromthepain.com to purchase it) – epsom salt bath in very warm water – dry sauna – dry brushing, self-directed stretching (holds of 2 to 10min. at 2 to 3 / 10 intensity). 8

SURFACE KELLOID SCAR (POST SURGICAL SCAR) – this type of scar is the consequence of some sort of surgical procedure that was done to muscle (i.e. cutting of muscle). The scar that forms is raised, but it does not penetrate too deep.  The scar maybe reddish in colour.

TREATMENT – LASER, ROSEWOOD OIL, CROSS-FRICTION, GRASTON technique  (muscle stripping). Soft Tissue Release (STR) or A.R.T. Micro-current.

DEEP KELLOID SCAR (POST SURGICAL SCAR) – this type of scaring is similar in nature to the previous on, but this time the surgen’s knife has penetrated right down, in and around the visceral organs and / or bone.

TREATMENT – LASER – ROSEWOOD OIL –  GRASTON – CROSS-FRICTION – DEEP EFFLERLAGE, Soft Tissue Release (STR) or A.R.T. Micro-current, Mechanical Link / Matrix Re-Patterning.

THREE DIMENSIONAL BROAD BASED ANATOMICAL SCAR – this type of scar tissue eludes about 99% of all practitioners who work with soft tissue. It is literally related to body contortion as a result from some sort of collision type injury and / or concussion. It has sometimes far reaching aspects to it (i.e. influenced by both emotional, physical and spiritual realms), so much so, that it can have its hand in the first three types of scars we mentioned earlier.

TREATMENT – POSITIONAL VECTORIAL TISSUE UNWINDING THAT TAKES INTO ACCOUT EYE POSITION, JAW POSITION, THOUGHT PATTERN, BODY POSITION AND / OR STAGE OF BREATH (i.e. the three phases of inhalation & exhalation- beginning – middle -end – total of 6 possible stages). The amount of force that is directed towards the source, once all the tissue vectors are located and “stacked-up”, is incredibly minimal,  no more than the weight of Canadian $2 coin! – Micro-current, Mechanical Link / Matrix Re-Patterning  – epsom salt bath in very warm water – dry sauna – dry brushing.

A Quick and Easy Way to Assess Pelvic Alignment

for full article and video click here A Quick and Easy Way to Assess Pelvic Alignment

One of the aspects of the program that I discuss is alignment.  We have really progressed our understanding of functional movement in recent years, however, you may be missing the boat if you assume that we are symmetrical and neutral.  I am a believer that we need to assess and address our alignment before we can properly look at our movement patterns and restrictions.

Some of the more basic tests for alignment, like posture assessment and pelvic palpation, have many flaws and ultimately low reliability and validity.  However, I feel that this is the case when assess in isolation.  I prefer to take clients through a detailed assessment that looks at many different aspects of alignment and mobility.  What you start to see is that patterns emerge.  When several alignment tests are all pointing in the same direction, I start to feel more comfortable about the reliability and validity of my assessment.

I talk about this a lot in FST for the Lower Body and even go through an assessment process where we put the pieces of a puzzle together for one individual.  Below is a quick clip showing a really quick and easy way to assess pelvic alignment.  Next time you assess hamstring length, look down and see what position the leg is in.  Is it rotated?  abducted or adducted?

5 Huge Lessons I Learned About Dealing With Muscle Imbalances & Overcoming Injuries

for full article click  5 Huge Lessons I Learned About Dealing With Muscle Imbalances & Overcoming Injuries

When I was starting out working with clients suffering from nagging pain and injuries due to muscle imbalances I dealt with a LOT of frustration because so many of the exercises and stretches I learned in my personal training certification courses, text books, workshops and at the physical therapy clinic where I also worked weren’t working. I’d take courses and learn all kinds of assessments for the neck, shoulders, back, hips, knees, mobility, stability and such but they didn’t teach you which ones to use in what order or when. I also learned corrective exercises and stretches to help with anterior pelvic tilt, rounded shoulders, forward head posture, medial knee rotation, foot and ankle over pronation or supination and many others only to see that they weren’t really helping. It got to the point where I nearly quit the fitness industry for good. Fortunately, I found a mentor who taught me something I had never learned in all the books, courses and experience… …He taught me the principles of correcting muscle imbalances. See, it’s one thing to learn a bunch of exercises and stretches for this and that but each client has unique needs and therefore what works for one person with an injury doesn’t work for everyone else with the same injury. Exercises and stretches don’t teach you this but principles do. And, I wanted to share some of the most valuable lessons I learned from my experience so you don’t have to go through all the same problems I did in trying to figure it all out on your own. – See more at: http://functionaltrainingcoach.com/5-huge-lessons-i-learned-about-dealing-with-muscle-imbalances-overcoming-injuries/#sthash.o2lUg1VG.dpuf