Soccer Medicine Program

Over the last 10 years, the Emory Sport Medicine team under the Department of Orthopaedics has established itself as one of the national experts in sports concussion education and treatment. While it has proven difficult to “prevent” concussions, Emory Sports Concussion program has dedicated itself to enhancing the diagnosis and recognition of concussion signs and symptoms within the sports community to better equip athletes, parents, coaches, organizations, and the community to seek treatment to prevent the short and long term consequences related to sports concussions. The Emory Sports Concussion Program has collaborated with key departments within the Emory Healthcare system to establish the Emory Concussion Specialty Clinic within Emory’s nationally acclaimed Brain Health Initiative that is a multidisciplinary team of Neurologists, Neurosurgeons, Neuropsychologists, Physical Therapists, Vestibular Therapist, Neuro-radiologists, and Neuro-optometrists that provide a targeted evidence-based approach in the active management of concussions and their signs and symptoms. Emory Sports Concussion Program has been instrumental in forming Georgia legislature and laws that regulate an athlete’s return to play and requires the involvement of a certified healthcare provider in return to play decisions regarding a concussed athlete. With soccer being the #2 and #4 most common sports associated with concussions in women and men, respectively, we have focused on education in the soccer community with free baseline neurocognitive and vestibular testing in all preseason soccer, football, basketball, and other contact sports for our soccer partners, high school, collegiate, and professional athletes. Emory also partners with several organizations to provide an education platform for coaches that updates them annually on concussion recognition and treatment to better help sports organizations understand the current treatment algorithms and goals for prevention of short and long term concussion complications.

Emory Healthcare’s Soccer Medicine conferences are a series of conferences that occur annually for local soccer academies as part of our football team medical services. The conferences are geared to US national licensed coaches, parents, and the soccer community. At each of these conferences we certify all coaches in Basic cardiac life support/CPR. Our conference is based on FIFA principles of injury prevention. Topics have included Sports Specialization and mental health, Common Soccer Injuries and prevention programs, Soccer conditioning and nutrition, Injury prevention and treatment options, soccer science through performance analytics and workload monitoring, as well as concussions in soccer. In addition to the conference we provide on field instruction to all coaches at partner soccer academies on best practices and implementation of FIFA 11+ and FIFA 11+ kids programs to prevent injury. Emory Soccer Medicine has each partnered soccer academy as well as every soccer athlete that is seen in clinic enrolled into our ongoing soccer specific research study that looks at the incidence of soccer-related injury across all levels of youth soccer to track injury and identify risk factors.

The ACL injury prevention program at Emory Sports Medicine utilizes certified Physical Therapists and Athletic Trainers to provide baseline screening in soccer athletes with prior history of injury. Screening currently includes evidence based tests of kinematics during sports specific tasks (Tuck jump and Drop Vertical Jump test; Hewitt et al 2005 and Paterno et al. 2010), isokinetic strength testing, patient specific subjective scales (IKDC, KOS-ADL) and psychological questionnaires (ACL-RSI scale; Webster et al 2008). Through the expanding partnership with the Peak Performance Project at the Emory Sports Medicine Complex, a state of the art laboratory will allow intricate baseline neuromuscular and motion analysis to track injury risks and the ability to modify them. A 2015 systematic review (Pappas et al, BJSM) revealed exercises were effective in decreasing neuromuscular deficits associated with ACL rupture. A collaborative effort between our sports surgeons and physical therapists also focuses on secondary ACL tear injury prevention through a data driven objective return to play protocol of athletes after ACL surgery. Emory Sports Medicine has integrated computerized outcomes tracking software that follows patients longitudinally through their return to play after ACL surgery to help validate and improve on secondary ACL tear prevention protocols in sport.

Emory Soccer Medicine Program under the division of Sports Medicine is focused on driving home evidence-based soccer player injury prevention initiatives. Over the last couple of years, it has become evident that most recreational and academy soccer clubs are not well-versed in the FIFA 11+ or FIFA 11+ kid’s programs. One of Emory Soccer Medicine’s main initiatives over the last year has been to have every club implement the FIFA 11+ or FIFA 11+ kid’s dynamic warmup at a minimum of two practice sessions a week for prevention of injuries in soccer. Prior to each season we have provided on-field instruction at local soccer clubs, academies, and high schools to ensure coaches and teams are well informed and educated on the steps of the program. We also educate coaches and players on best practice of eccentric training for myotendinous injury prevention and that proper healing time for injured muscles is essential given that most re-injuries occur at the same location (50% in first 25 days after return to sport, and 25% in first week per Wangenstein, et. al. 2016).

It has been well reported in the literature that the most common sports-related and soccer-related injury is an ankle sprain. At Emory Sports Medicine, we provide screening at PPE’s, in athletic training rooms, as well in our clinics for patients with history of prior ankle sprain injury. Peters et al 1991, estimated that 10-30% of ankle sprains could evolve into chronic ankle instability so we have implemented an evidence-based approach in our Physical Therapy clinics that targets a home exercise program with balance, proprioceptive, perturbation and strength training. The results in the current literature have been shown that a successful program leads to reduced injury rates in ankles (Verhagen 2004, Valvolich 2008, Tropp 1985, Konradsen 2002, and Loudon 20008). Through Emory Sports Medicine sports specific computerized outcome measures we can follow surgical and nonsurgical patient reported outcomes of treatment to track recovery and intervention.

Emory Soccer Medicine is committed to implementing FIFA injury prevention principles through the FIFA 11+ and FIFA 11+ kid’s programs. The 11+ program is a dynamic warm up program aimed at reducing injuries in players aged 14 and older while the 11+ kids program is aimed at players 13 and younger. Many different research programs have demonstrated injury reduction levels of up to 30-50% if the program is utilized at least 2x a week. Injury reduction levels increased with higher compliance to the program.

The 11+ program consists of three parts with all three parts being utilized in practice and parts one and three on match days:

• Part 1 – Running Exercises- 8 Minutes
• Part 2 – Plyometrics And Balance-10 Minutes
• Part 3 – Running Exercises- 2 Minutes