How do soccer players handle injuries during the World Cup?

It is difficult to go anywhere these days without seeing people walking around in soccer jerseys, flags from different countries, people enjoying watching the game. And also difficult, I think, to hear about the games without hearing about injuries, whether it's a hamstring, a broken leg, we have seen a few of those as FIFA is continuing. So how do the athletes deal with these injuries and what can we learn from that? Joining me now to talk more about this is Ali Masumi, sports fellow chiropractor 4, the Vancouver Football Club. But Ali, thank you for taking some time and being with us. Thank you for having me. Before we get into the specifics and about these injuries, what exactly does a sports fellow chiropractor do? A sports fellow is basically the fellowship that we do is another four years post chiropractic degree. And we basically specialize in sports medicine, sports injuries, and most sports fellow chiropractor they work with some of the professional teams in Vancouver or in Canada. All right, so when you're watching the athletes and you see injuries, that must get such a reaction from you. Yeah, I mean, I don't deal with injuries every single day, but since I work with the Vancouver FC, I am the customer to a lot of these different types of injuries. And sometimes you have a good idea of what's going on based on what you see on the field. And when we look at things such as a broken leg, and unfortunately we've seen a couple of those in recent days, but a broken leg is one thing I think when a crash happens, something happens in a bone breaks. But when you look at other injuries, whether it's muscle strains or other parts of the body, how much of it is preventable or how much does prevention weigh in on that? I mean, some of the broken bones are usually due to trauma, right? So you can't really prevent that, but also the science of prevention is a billion dollar topic basically. Even with ACL injuries that happens with lots of soccer players, we actually see the rate of ACL injuries actually increasing for the past 10 years. So I mean, prevention is such a wide topic, but I must say we're not really good at it, to be honest. As far as muscle injuries and tears, there are some programs through FIFA, they're called FIFA 11 Plus. Basically that they try to come up with proper warmups and proper nutrition and psychological treatments for players that can hopefully minimize it. But I mean, injury prevention is a billion dollar topic and I don't think we're really good at it to be honest. I saw a story the other day that I mean, it seems every day there's a different study out to a different story, but I saw a couple of news outlets talking about this particular study that said taking calcium and vitamin D maybe isn't this great thing to stop fractures or to prevent fractures. I'm sure another study will come out saying something different, but when you say we're really bad at prevention, is it mainly diet and keeping ourselves fit and strong or where do we really fall short? I mean, if I knew the answer to that, I would be a billionaire by now. But as far as vitamin C's and D obviously they're very important for bone health, but as far as athletes goes, these are sometimes in traumatic events and it's really hard to prevent it. But also the game is fast, and athletes are getting more athletic, there's a lot more pivoting and speed in the game. If we go back to ACL injuries, there were talks about angles, different hip angles and different morphology, the way the bones sit in the pelvis versus the ratios between hamstrings and quads and all that things. But again, the rates are always increasing for the past few years. I don't have a perfect answer for you, but every time we deal with athletes, we want to look at them as holistically as possible. Nutrition, psychological factors, proper warm ups, proper training loads, which is something that basically many athletes and may professional teams actually deal with. If you have a game, basically the day before you're not putting that much pressure on the athlete, the day before that you might be doing a little bit more. Load management is a big topic in sports medicine right now, and that's what most teams actually focus on, but again, I don't have a perfect answer for you. No, and that's like you said, if we knew that answer, things would be very, very different. But when you talk about the ACL injuries, do we know why there's such an increase? No, we don't, we really don't. And people talk about the turf versus the regular grass, obviously the load that it puts on through your body, different ratios as far as the strength of the muscles and whatnot, but no, we really don't. There are always studies, as you said, that come out every time. And most of us that we follow evidence-based studies, we just mostly start focusing on those studies, but then science is always improving. And sometimes you might have a study that comes as ice is great for this, and a year says ice is horrible for that, that's simple to that. So we're always improving, trying to our best, but again, injury prevention is a trailing dollar question, you know. And I wouldn't be in business basically if I could do that. If we only knew, when you talk about elite athletes, though, is it different dealing with athletes because of the wear and tear on their bodies, it being so much more than somebody that's recreational or maybe just doesn't do a whole lot of physical activity, what do you see that's different with the elite athletes? I talked more like the injury or the recovery or sending it back to you. Both, both kind of the injury and the recovery period. Well, I think the biggest thing, the difference between professional athletes and many of us is as far as the return to sport goes, is most, when I work in a clinic, if you have a hamstring, it's injury, for example. Once the pain is under control, you can walk and do your normal tasks, you're usually kind of clear to do whatever you want to do slowly. But with professional athletes, usually that's actually where the return to sport comes, right? So we've seen a good example with Alfonso Davis, obviously I don't know the details of that injury, but you know, he has hamstrings injury that he's slowly gradually coming back into the team and all their staff, which are amazing, actually the Canadian national team staff are amazing, I don't know most of them. They want to make sure that they gradually introduce him into training and then if it comes to a game, it might be 10 minutes and then 45 minutes and next game is a full game or whatnot. But also another big factor is the psychological part with athletes. And when they're injured, we don't necessarily want to say, hey, you know, you have a tear in the muscle, you might want to say, you know, you have irritation in the muscle because they really need to trust you and they need to trust the process. And if you freak them out from the beginning, they will, you know, take longer for them to heal basically because, you know, they make money from their bodies, right? Right. So yeah. And with FIFA here, I know there's been some talk of people getting more excited about this sport. Maybe more people will be encouraged to take up soccer, whether it's kids or people who have just haven't done it before. What do you say to people doing that? The importance of or how to kind of protect yourself as best you can and or at least go into it knowing what's at stake, what the most common injuries are things, things like stretching and such. What kind of advice do you give people? I think one of the main thing is dynamic warm up. So, you know, when you're about to play any sports, you don't want to just like stretch and hold a muscle at tension. You want to actually actively warm your muscles up by going through those ranges of motion. So depending on your sport, if you're, you know, if you're, if it's a kicking sport like soccer, you might want to, you know, open up your hip by actively moving those through full ranges of motion. Hydration, obviously, is big. Having good night's sleep. There's a lot of very good studies with athletes or just regular people that have proper sleep and that's about eight hours, eight to ten hours. You know, the risk of injury drops. One big thing is that we see even in the clinic is about load management. So, you know, if you want to do a marathon, you don't want to start by running off as a marathon right? You want to just gradually do maybe like 10 minutes run and then go to 15 and go to 20 and go to 30 and listen to your body and just slowly increase the load. So you allow your muscles to adapt and increase the tolerance for that load basically. So I think load management, proper warm up nutrition, proper sleep. Those are all obviously and having a team, you know, as far as like, you know, physiotherapist, chiropractor, whoever, whoever you trust as a part of your team. So when you have injuries, go see someone, you know, the worst thing is they say, hey, you know, this is good. You'll be fine. Here's a couple of advice. and you're going to be able to do it. you'll be okay, but sometimes the sooner you seek treatment, sometimes the better it is for you. That is good advice. We will leave it there for today. Thank you for joining us and for talking more about this. Awesome. Thanks for having me.