Medically reviewed by Misty Seidenburg
With quick landings, sudden sharp turns, and full-body tackles and collisions, it’s no surprise that American football has a high risk of musculoskeletal injuries. According to data from the National Safety Council, football injuries lead to more than 260,000 emergency room visits in the U.S. in a single year. However, the more we know about how and why football players get hurt, the better athletes, coaches, trainers, and physical therapists are equipped to prevent these injuries. Here, we look at best football injury prevention tips to keep players healthy and safe.
Football takes a toll on the body, even with proper training and safety gear. Here are some of the most common football injuries that keep players sidelined.
A forceful blow to the head or body can cause the brain to shift within the skull. This can cause brain bleeding, bruising, and chemical changes that cause cognitive impairments, behavioral changes, and balance and coordination problems, among other symptoms. A player who experiences multiple concussions (even mild ones) has an increased risk of permanent damage.
Signs of a concussion include confusion, headache, dizziness, and sensitivity to light and sound. Symptoms can be immediate or develop and worsen in the hours and days following the initial trauma. Any player who may have sustained a head injury should be screened for a concussion. Early treatment for concussions is associated with a faster recovery.
Broken bones can happen from trauma to the body, like a collision with another player or a hard fall. In football, fractures often involve the bones of the shoulder, ribs, ankle, wrist, and fingers. Football players are also prone to stress fractures, especially of the foot’s long, slender metatarsal bones. Repetitive stress and excessive rotation commonly cause sports-related stress fractures. A stress fracture is often described as a dull ache at the top of the foot that worsens with physical activity.
A sprain is an injury in which the ligaments connecting bones overstretch or tear completely. In football, sprains can occur when a joint is forced out of position through a fall or tackle. The ankle and knee ligaments are most often affected.
If you look at a list of NFL players on the injured list, you’ll notice several are recovering from injuries of the anterior cruciate ligament (ACL.) ACL tears are common in sports like football, which require a lot of jumping, cutting, and running.
Symptoms, treatment, and recovery from an ACL injury depend on the extent of the tear. A severe or complete tear causes considerable pain and renders the joint nonfunctional until it heals. While ACL tears do not always require surgery, most competitive athletes choose ACL reconstruction to restore mobility and function and continue playing the game they love.
Strains are injuries to muscles or the tendons that connect muscle to bone. If these tissues stretch too far, they can partially or fully tear. Football players are prone to several types of strains.
Strains of the adductor muscles located on the inside of the thigh, also known as groin pulls, are caused by direct force to the area, repetitive microtrauma, and forceful kicking, running, and changing directions. Jumper’s knee is a type of strain that involves the tendon that connects the kneecap to the shinbone.
Strains of the hamstring muscles that run from the bottom of the buttocks to the back of the knees cause sharp pain in the back of the leg, often when running or kicking. They account for more than half of lower extremity strains reported in the NFL.
Football’s repetitive throwing, pushing, and hitting motions can damage shoulder bones, cartilage, muscles, and ligaments. Shoulder pain that radiates down into the arm and difficulty raising the arm are common signs of a tear in the rotator cuff, which supports and stabilizes the shoulder joint. The rotator cuff is also susceptible to bursitis and tendinopathy, which both cause pain and impact mobility.
Twisting, falling, or colliding with another player can force the arm bone out of position. This is called dislocation. Shoulder dislocation symptoms include immediate pain, obvious deformity, and inability to move the arm. Players who dislocate their shoulder can generally return to play within 4-6 weeks, longer if they require surgery.
While high-contact sports like football have a higher risk of injuries than other non-contact sports, there are ways to make the game safer from the pee-wee level up to the NFL.
Football players should schedule a pre-season physical to determine their readiness to play. During this visit, a healthcare provider assesses the player’s overall health and fitness, reviews past injuries, and checks for heart abnormalities and other areas of concern before the player hits the field.
Without consistent exercise, the body’s ligaments and muscles become inflexible and weak, making them more prone to injury. But it’s not necessary to play football all year round. Incorporating other activities like running, swimming, and weight training is recommended. Year-round training helps football players stay strong and fit and lowers the chance of burnout and overuse injuries from playing the same sport all the time.
Players should always take time to warm up and cool down before and after practices and games, focusing on areas most prone to football injuries: thighs, calves, hips, knees, and ankles.
Stiff, cold muscles are less flexible and more susceptible to injury. Pre and post-workout stretches are essential for every athlete. Dynamic stretches are typically sports-specific movements that prepare the body for high-intensity activity.
After activity, static stretches are recommended. These are stretches where you move your body into certain positions and hold for several seconds. They improve circulation, flexibility, and range of motion—which all help with injury prevention.
A physical therapy screening at the start of each season is the foundation of sports injury prevention. Physical therapy is a proactive tool for improving form function and athletic performance by addressing underlying joint restrictions, muscle imbalances, and movement pattern issues.
Physical therapists identify areas of weakness and pre-existing issues to develop a proactive injury prevention plan. They look back at an athlete’s previous injuries to tailor an individualized program to build resilience in those areas. Sports therapy programs incorporate sport-specific exercise, focusing on the movements that are part of the game.
Physical therapists also teach and provide recovery techniques to repair hard-working muscles, tendons, and ligaments, which also help protect against injuries. They offer hands-on therapies to relieve stiff and painful joints and muscles that may keep players from performing at their best.
Rest days are essential for athletes of all skill levels and abilities. They give the mind and body time to recover and recharge after intense activity.
During exercise, tiny microtears develop in the muscles. Rest allows these tears to heal and the muscles to become stronger. Without downtime, muscles are prone to exercise-induced fatigue and soreness, negatively affecting agility and endurance.
Signs of overtraining include:
That said, a rest day doesn’t necessarily mean football players must avoid all activity. Yoga, light jogging, static stretching, and other gentle, low-impact movements are safe and effective ways to move without overworking tired muscles.
Players should always wear full safety equipment every time they are on the field. For football players, that includes:
A properly fitted helmet is the first and most crucial layer of protection against concussions and other head injuries. Players can learn more about additional head protection, such as Guardian Caps and other add-on protective shells, to choose what’s right for them.
Football is a fun way to exercise and be part of a team. But with any contact sport, injuries are possible. To learn more about how injury prevention and safe return to play with physical therapy, find a nearby clinic or request an appointment online.
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