Upper Extremity Injuries in Soccer
TAKE-HOME POINTS
- Upper extremity injuries in soccer are not common, however they can reach up to 18% of all injuries in professional goalkeepers.
- Common injury locations in the upper extremity in soccer are the shoulder/clavicle, hand/finger/thumb, the elbow, and the wrist and most of these injuries are traumatic injuries.
- Mechanism of injury, players’ complaints and presentation, physical examination, and imaging features are all important for a proper evaluation and optimal management.
- Position of play is an important consideration in the management of upper extremity injuries in soccer. Outfield players may be able to return to play before a complete resolution of their injury, with protective accessories.
- Prompt and accurate diagnosis and appropriate management are essential for improved outcomes and timely return to play.
Upper limb injuries in association with soccer have been reported to represent only 3% of all time-loss injuries in professional soccer players1. However, they are considered an increasing problem in recent years2-4 and have been reported in high proportions in children under the age of 15 years.5 Some of the reasons for the increase in upper extremity injuries may be explained by modern soccer tactics that have been characterized by high speed, pressing, and marking.2 Furthermore, upper extremity injuries may still be underestimated in soccer, mainly because outfield players are sometimes able to train and play even when they suffer from an upper extremity injury.
Unsurprisingly, upper extremity injuries are reported to be up to 5 times more common in goalkeepers than in outfield players,1,2 reaching a high rate of up to 18% of all injuries among professional goalkeepers. The usage of upper extremities to stop the ball and repeated reaching to the ball and landing on the ground with changing upper extremity positions are some of the contributors to the increased upper extremity injury risk in goalkeepers.
Following 57 male professional European soccer teams from 16 countries between the years 2001 and 2011, Ekstrand and colleagues1 showed that 90% of upper extremity injuries are traumatic, and only 10% are related to overuse. They also reported that the most common upper extremity injury location is the shoulder/clavicle (56%), followed by the hand/finger/thumb (24%), elbow (10%), wrist (5%), forearm (4%), and upper arm (1%). Specifically, the 6 most common injuries are acromioclavicular joint (ACJ) sprain (13%), shoulder dislocation (12%), hand metacarpal fracture (8%), shoulder rotator cuff tendinopathy (6%), hand phalanx fracture (6%), and shoulder ACJ dislocation (5%).
This article will discuss common upper extremity injuries observed in soccer players, focusing on proper diagnosis and optimal management.
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