If you could increase your soccer skill level efficiency, drastically reduce your chance of injury, and help your body feel better before and after soccer, would you want to know how?

Warming up is one of the most forgotten, overlooked and neglected parts of a soccer training program. It’s not everyone’s favorite, improperly warming up or even altogether skipping it can be detrimental to your practice. In my years as a soccer athletic trainer, here are some reasons and some of the poorest  excuses I have heard for not doing a warm up:

  • “It’s boring”
  • “Stretching is uncomfortable”
  • “I just want to play soccer”
  • Laziness
  • Misinformed and uneducated on adequate warm-up techniques
  • Coaches have limited time with players and want to utilize that for soccer only

You read that correctly – sometimes even coaches skip the warm up!

These are NOT acceptable excuses.

Unfortunately, most players don’t care until they’ve experienced the pain of having to watch their team play from the sidelines with an ice bag strapped onto them. Read on to find out how you can keep the ice in the cooler and focus on how you’re going to score that next goal, not on how bad your hamstring hurts.

What is a warm-up? A warm-up is elevating your core temperature, increasing blood flow to the working muscles, and dynamically stretching the body in functional ways that mimic movements you will perform on the field. A warm-up is NOT static stretching and kicking the ball around for a few minutes. But the first thing I see players do when they get to the field is open up the ball bag.

Here’s a new rule to live by: Nobody touches a ball for the first 10 minutes of practice. Start a stopwatch when you get to the field and begin your warm-up. Let’s go over a few key warm-up movements you can begin to incorporate in your routine.

  • Jog two full laps (gradually increasing pace)
  • Perform skips, side shuffle, carioca, butt kicks, high knees
  • Perform calf raises, toe walks, heel walks, inchworms
  • Perform hamstring sweeps, leg swings, forward leg kicks (Frankensteins)
  • Perform squats, walking lunges (forward, backward, side)
  • Perform hip circles (open/close the gate)
  • Work on quick feet/change of direction drills
  • Do mini hops, controlled jumps for height, squat jumps
  • Focus on gradual build up sprints – Jog to Stride to Sprint

These are just a few of the many dynamic movements used by soccer teams around the world to prepare for training. A good rule of thumb is you should have at least two exercises for each body part/muscle group. I suggest you learn as many warm-up exercises you can and find which ones make you feel the best. Then you can create a routine that best prepares you.

An effective warm-up routine at the pro level is planned with just as much detail as the practice itself. Many professional athletes get on the field early to go through their own personal routines before the organized warm-up begins. This not only prepares you physically but gets you mentally ready to train as well.

Pro tip: Next time you’re watching a professional sporting event, take some time to observe what each player is doing during pre-game. The best athletes in any sport have extremely detailed preparation plans, and they become obsessed with it.

All in all, implementing a great warm-up routine is absolutely crucial for both injury prevention and performance enhancement. Don’t wait until you’re injured to start taking it seriously. Once you experience the boost it can give your training and performance, you’ll become addicted. While it may not be as glamorous or exciting as scoring a goal, it will help you keep scoring goals for a long, long time.

Kevin Thornton, M.AT, LAT, ATC is an athletic trainer with OrthoCarolina Randolph Sports Physical Therapy.  He is an avid soccer fan and has worked with several college and professional soccer teams. 


Jennifer DeRosa knows all too well about soccer injuries. Jennifer started playing soccer at four years old and battled through injuries from a young age through college, playing Division 1 Soccer at UNC Asheville. Injuries included knee and neck strains, and she even needed anterior compartment surgery to bilateral lower legs.

From experience, Jennifer also knows that sometimes players play through the pain and may downplay just how injured they are in order to continue playing. Jennifer did this, and despite getting treatment when she was not playing, suffered damage and injury that made the recovery process last longer.

Since becoming a physical therapist, she’s had two meniscal tears that likely stem from years of playing soccer. “I don’t think until now, I realized how important the weight training and off-season workouts were to not only making your stronger in order to compete and be a better soccer player but also injury prevention for during the soccer season, as well as later in life.”

For soccer players in high school that are thinking about playing in college, Jennifer stresses that strength, endurance, agility, flexibility, and balance workouts are worth the effort now. To start, here are two areas that Jennifer suggests soccer players focus on:

  • Single leg activities to activities to allow for decreased compensation and bring out any imbalances that may be present already. This includes single-legged deadlifts and single-legged sit to stands
  • Upper-body exercises, like push-ups and dumbbell rows, as soccer mainly focuses on leg strength, but it is important to be well-rounded all over

Between taking the time to let injuries heal and working on building up overall fitness, soccer players can better prepare themselves for a longer soccer career.


Soccer is not only one of the fastest growing sports, but it’s also one of the most fast-paced. Like any contact sport there is always a potential for injury, but during the juvenile and teenage years, those chances are higher simply due to growth patterns and growing bodies. The game generally gets progressively more aggressive as children get older, and sprains, strains, and fractures are some of the most common acute injuries on the pitch. Sometimes the biggest danger simply comes from literally playing soccer too much. Overuse injuries can keep kids sidelined and also mean eager young players are suddenly quite unhappy.  Dr. Barrett Little, with OrthoCarolina Rock Hill shares some ways parents, can help deflect the risk.

1. What type of stretches are important for young athletes after training sessions and games?

The main muscles to stretch after training sessions are hamstrings, quadriceps, and gastroc-soleus(calf). These are big lower extremity muscles that have to do a lot of work during games, so it’s important to give them attention.

2. Are there guidelines for a recommended amount of training time for young athletes?

As you might imagine, it’s generally best to progress into more training time with older age. Here are some recommended guidelines:

  • Ages 8 to 11: 20 games per year with two to three practices per game and two days of rest per week. *Practice no more than 60 minutes
  • Ages 12 to 18: 30 games per year with two to three practices per game and two days of rest per week. *Practice 75-90 minutes
  • *Ages 15 to 16: No more than 160 game minutes per 72 hour period.
  • *Ages 17 to 18: No more than 180 game minutes per 72 hour period.

3. Is there injury prevention warm up exercises or stretches that soccer players can participate in?

The Fédération Internationale de Football Association (FIFA) is a well-respected international soccer organization that has suggested guidelines for soccer players called the FIFA 11. These injury prevention exercises are recommended by consensus opinion of expert healthcare providers and backed by research. They include running exercises, strength, plyometrics and balance exercises specially geared towards soccer players. You can find them here.

4. What are the industry recommendations to prevent overuse injuries?

One of the top things we stress to parents and players is that off-time and cross-training are critical to recovery and injury prevention. Encouraging players to participate in a variety of sports during the year is the most important thing a young player can do to avoid overuse and burnout. It can be hard sometimes especially when a child is laser focused on developing skills in one particular sport, but young athletes’ growing bodies are different than those of adults and are more prone to certain injuries. Cross-training allows them to develop other skills which can translate onto the soccer field and increase their performance.

5. How important is proper equipment (cleats, shin guards) to injury prevention?

Proper shin guards are very important to prevent tibia and fibular injuries as well as soft tissue injuries from cleats. They should fit snuggly and comfortably. You should look for shin guards that hit just at the prominent bone below the knee, or the tibial tubercle.Cleats are important for different play surfaces.  Shorter cleats are recommended for artificial playing surfaces whereas standard cleats are recommended for natural surfaces.  Data suggest injuries to knees and feet may be increased when playing on artificial turf.  Round cleats versus blade cleats have shown no difference with regard to knee injuries.

6. What are the obvious and hidden signs of concussions?

Concussions can be difficult to spot which is why it is very important to monitor young athletes both on and off the field for symptoms. If a child seems to have a loss of consciousness or is confused, these are obvious signs he or she could have a concussion. If a child is sensitive to light, has headaches, unable to focus, have irritability, insomnia or fatigue, these are potential hidden signs of concussion and the child should be seen by a medical provider. The mainstay of treatment for concussions is mental and physical rest.

7. Is there a game to rest ratio that should be followed to prevent injuries?

Rest is so important to allow optimal recovery, not only for health but for performance in the next game. There should be between 48-72 hours of rest between games for young athletes.

8. What type of aches and pains should not be ignored and what are those to seek medical attention for?

Kids are bound to have minor scrapes and pains, but there are more serious injuries to watch for. The first tip for pain care is R-I-C-E (rest, ice, compression, elevation). If pain does not improve with this technique and over-the-counter ibuprofen the child should be evaluated by a healthcare professional. Aches and pains that wake an athlete up from sleep certainly merit seeing a medical professional.

9. How does proper nutrition come into play for injury prevention?

Proper nutrition and hydration are important for all young athletes. Calcium and Vitamin D are vital to bone health.  Peak bone density occurs between the ages of 16-22 in females and 18-26 in males so adequate nutrition is important for long term bone health.

Here are some general guidelines for calcium and Vitamin D:


  • Ages 4 to 8: 400 mg per day
  • Ages 8 to19: 1300 mg per day

Vitamin D:

  • 1000 IU per day after age 5

Balanced nutrition will also help the body recover more quickly after competition.  Poor nutrition can lead to earlier fatigue of muscles and therefore increase the chances of musculoskeletal injury. If you are unsure if your child’s diet is adequate you should see his or her doctor.

10. What is the number one piece of advice you would give parents to help prevent injuries in young athletes?

Expose young athletes to and encourage participation in a variety of sports. Not only is a variety of activities important to help children decide what they love but it is one of the best things parents can do to prevent injuries.  Sports specialization should not occur until the young skeleton has nearly fully developed, age 13-14 in girls and age 14-15 in boys.

Download a PDF version of the FAQ here.


Dr. Barrett Little, MD is a Sports Medicine Physician at the OrthoCarolina Rock Hill location.


The impact of a soccer ball to the face can cause minor or sometimes potentially serious eye health injuries. These include bleeding, inflammation, retinal tears or detachment and can be especially dangerous for youth soccer players.

Few soccer players are seen wearing protective eye gear when playing on the field, despite soccer making up one of the highest percentages of sport related injuries.

Andy Hylton, OrthoCarolina physician assistant and former professional soccer player says direct blows to the eyes generally result in temporary blurry vision and can result in a “black eye”, but occasionally a more serious eye injury can occur.

Three main eye injury concerns are:

  1. Blow out fracture – pain, double vision, decreased range of motion of the eye (look for the player to have limited ability to look up)
  2. Retinal detachment – shadow forming at the periphery of vision, flashing lights
  3. Globe rupture – decreased eye mobility, extruded eye contents, foreign body

Hylton says an urgent medical evaluation by an ophthalmologist is important if any these signs or symptoms are present.

Eye injuries do not necessarily mean that a player will have to be out of athletic competition. Many companies make protective eyewear for games and practices that may be recommended until an injury heals.  However, the majority of protective eyewear does have thicker rims and can subsequently result in decreased peripheral vision for players.

Despite the current lack of popularity and protective eye gear options for soccer players, there are signs this may change in the future.  Research continues to show a strong case for why both children and adult soccer players would benefit from added protection.

Andy Hylton is a physician assistant with OrthoCarolina Pineville and also has a degree in athletic training. He has played professional soccer in the U.S. and England, and also played for Great Britain’s soccer team at the World University Games (Olympics for students) in Beijing, China. Andy treats all ages and orthopedics needs, particularly sports medicine injuries and conditions.


Injuries to the face are common in soccer, most often occurring though direct impact with either a soccer ball or collision between players. When there is trauma to the face a nosebleed can occur. Knowing how to properly treat a nosebleed can help minimize disruption and anxiety. When managed appropriately players can often return to the field with peace of mind.

Andy Hylton, physician assistant and former professional soccer player, says there are two types of nosebleeds – ones that disrupt the anterior chamber of the nose, and others that affect the posterior. The nose is filled with many small blood vessels that can be disrupted or break after exposure to excessive force.

90 percent of trauma based nosebleeds occur in the anterior chamber, according to Andy. These accidents should not alarm parents and coaches, however it is important to be proactive and minimize blood loss.

To properly treat a nosebleed, step one is to slow down the bleeding. Despite what players, parents or coaches may think, it is okay and expected for the blood to drain temporarily after impact.

Andy recommends the following treatment steps for a nosebleed:

  1. Have the player bend forward at the waist.
  2. Squeeze the bridge of the nose, applying pressure.
  3. Apply ice to the bridge of the nose while squeezing the area.
  4. Gauze packets can be placed inside the nose if needed.

In most cases, the nosebleed will stop within a couple minutes. If the bleeding does not slow down and is not improving, Andy says it may be sign of something more serious and should be evaluated by a medical provider.

Andy Hylton is a physician assistant with OrthoCarolina Pineville and a former professional soccer player. His suggestions are guidelines and treatment steps for some of the most common soccer injuries. In case of an emergency you should always call 911.


A former professional soccer player’s perspective on playing the sport

Is it time for your child (or you) to head to the soccer field and join in the frenzy around the most popular sport in the world? What is it that makes the sport so appealing, even though some games end in a draw, and occasionally no goals are scored at all. How does such a sport continue to grow in popularity?  Like it, hate it or completely indifferent, soccer is in the U.S. to stay.

The expectation is that the game will continue to grow over the next five to 10 years, as the country strives to be recognized (and respected) on nnternational level. The presence of globally known players such as Schweinsteiger (former German national team captain and player for Manchester United, Bayern Munich) and David Beckham (former England captain and also Manchester United player), and others who have played in the MLS (Major League Soccer) have helped increase soccer’s profile and popularity.

Personally, I have been playing the game for nearly 40 years, and there are many reasons why I have enjoyed the game and continue to play today. If you are thinking about getting your child involved, or even start playing yourself as you watch you child run around the field, here are a few reasons why it would be a great idea.

Exercise: Playing the game requires constant movement. The size of the field in combination with the speed that the ball travels and changes direction requires the players to continually be active. It really is a great way to exercise and stay in shape.

Teamwork: The success of the team is dependent upon working together and functioning as a unit.  You have to learn to be dependent on other people (and help them to be successful), as well as being expected to perform your own duties/roles. This will even prepare you for life in the ‘real world’!

Free/recreational play: To play organized soccer primarily just requires soccer cleats, soccer ball and shin guards, all of which generally can be purchased at a reasonable price. The game can be played on a field, in a street or on your driveway. In my house that sometimes means the family room! You do not even need a soccer ball, any ball will do. Playing for a club or in a recreational program often will incur costs, but to just play with friends on a field somewhere is very inexpensive.

Lifetime: To me, this is one of the most important aspects.  20 years on from playing in college, I will still go out and play during the week with other friends who also enjoy its benefits.

If you are on the fence, I would recommend getting out there and giving it a try…..you may just be the next Messi……

Andy Hylton is a physician assistant with OrthoCarolina Pineville and a former professional soccer player. His suggestions are guidelines and treatment steps for some of the most common soccer injuries. In case of an emergency you should always call 911.


Not too long ago I was working with the U.S. Men’s National Beach Soccer team in their Beach World Cup qualifier tournament. On a daily basis, half of the team would use the foam roller in the training room.

(Side note:  I’m a former professional soccer player, both in the United States and England, and  I can tell you this: beach soccer is a totally different style of play than my traditional “football”.)

These seasoned players were not weak and did not have a muscle imbalance, but the demands of playing soccer on the sand put excessive stress on the core stabilizers and in particular the hips. The foam roller was, for them, a critical tool in their war chest to play their sport and stay healthy between matches. They are seasoned athletes but diligence with the foam roller kept them loose and stretched out.

Performing just about any athletic or recreational activity requires activation of the core muscles: not just abs but pelvic floor muscles, obliques, rectus abdominous, transversus abdominous multifidus, sacrospinal muscles, diaphragm and more…! These core muscles help to maintain stability and balance. Any type of imbalance, weakness or increased load (demand) can result in one or more of these muscles becoming strained.  The goal is not only to maintain the strength of these muscles but also, when necessary, the flexibility.

When we use the foam roller, we are able to massage the muscles of the lower extremity. Most commonly we find that runners develop tightness and pain in the IT band. This is due in part to the fact that at every point during the impact phase of running the hip (and lower extremity) is stabilizing the whole body. This increased load and stress makes the stabilizers work hard and can expose some hip weakness of inflexibility. The foam roller historically was used for the IT band, but more and more people are seeing the value in massaging out the hamstrings, quadriceps and calf muscles as the pressure helps to stimulate blood flow, massage out knots and loosen tight muscles.


See also: Foam Rolling Guide for Runners

Andy Hylton is a P.A. (Physician Assistant) in OrthoCarolina’s Pineville office and also has a degree in Athletic Training. He has played professional soccer in the U.S. and England, and also played for Great Britain’s soccer team at the World University Games (Olympics for students) in Beijing, China. Andy treats all ages and orthopedic needs, particularly sports medicine injuries and conditions.


Soccer players combine speed, strength and agility to compete on the field.  Ball handling, sprint work and shooting drills are typically incorporated into practices… but developing core strength may not be.

OrthoCarolina Pineville physical therapist Jillian Maguire treats many ACL and knee soccer injuries. These injuries can be caused by a lack of core strength and weakened hip and glute muscles.  By strengthening core muscles, soccer players can improve performance on the field and reduce their risk of injury.

Maguire shares her favorite strength building exercises for soccer players to incorporate into their training program.

Soccer Ball – Wall Squat (Photo 1)

  1. Place your back against a wall, with your shoulders and upper back against the wall.
  2. Slowly squat down the wall walking your legs slightly forward.
  3. Place a soccer ball between your knees, squeeze and hold for 10 seconds. Keep legs parallel to the floor.
  4. Return to standing position.

Complete 2 – 3 sets.

Gliding Disc – Single Leg Rotation (Photo 2)

  1. Use a gliding disc for this exercise (a Frisbee, paper plate or furniture moving disc can substitute).  Place the disc under one leg and stand tall on the other leg. Imagine a clock around you with.  Slowly slide the leg with the disc forward to the top of the clock (12 position) and pull back to meet the standing leg.
  2. Next, slide the leg with the disc to the right and pull back to meet the standing leg.
  3. Continue moving around the clock. Switch directions, moving around the clock the other way. After you’ve completed a circle in each direction switch legs.

Complete 2 sets on each leg.

Resistance Band – Side Step (Photo 3)

  1. Use a theraband or theratube for this exercise. Depending on equipment, either wrap the band around both legs slightly above your ankles or step on the band, pulling tight with your arms.
  2. Tighten your core and squat slightly.
  3. Shift your weight to one leg and take a step sideways with the other leg. Keep your hips level and try not to bounce. Walk side to side about 10 times in one direction.
  4. Shift your weight to the other side and switch directions.

Complete 2 – 3 sets.


Growing up in England, soccer was everywhere. From school playgrounds to streets to weekend parks, there was no lack of opportunities to play the sport. However, despite the love for soccer, the majority of players in England, still played multiple sports.

My goal growing up was to play professional soccer. However, I would still regularly play cricket, tennis, badminton and basketball. Playing multiple sports aided my overall athleticism and motor development.  It also kept me motivated and interested when playing soccer.

There is a trend of players focusing solely on one sport. However, recent studies have supported playing multiple sports and cross-training to increase speed, agility and build a more well-rounded athlete. Although the idea of playing a sport other than soccer may seem counterintuitive to your game, there are reasons it could improve it.

I’m not the only player who benefited from playing more than one sport. Most of the 2015 Women’s World Cup champion players were multi-sport athletes and multiple current English Premier League Soccer players excelled in other sports : Wayne Rooney (boxing), Zlatan Ibrahimović (taekwondo) and Joe Hart (cricket).

Here are a few skills that can be improved by incorporating additional sports into your soccer game.

  • Unique movement patternsYouth soccer primarily functions in a horizontal plane in a larger area. Complementing that with sports that require a vertical plane (jumping) in a tighter area (such as basketball) can enhance athleticism and even decrease the risk of injury.
  • Forms of coordinationControlling a soccer ball and changing direction at a high speed takes coordination.  Tennis and lacrosse can improve hand-eye coordination skills, which translate to the foot movement patterns required in soccer.
  • Team vs individual mentality: Soccer is a team sport, so players rely on other teammates for success. Individual sports like tennis and golf, build mental toughness since the outcome is dependent solely on a player’s output. Mental toughness and accountability are valuable skills as soccer players move into higher levels of competition.
  • Unique coaching styles A new sport will often mean a new coach and teammates. These new coaches and teammates will approach the game differently and give you different approaches and tips for improving your game.

Whatever you play it is important to have fun. Play hard, play with passion and success will be a natural byproduct.

Andy Hylton is a physician assistant with OrthoCarolina Pineville and also has a degree in athletic training. He has played professional soccer in the U.S. and England, and also played for Great Britain’s soccer team in the World University Games (Olympics for students) in Beijing, China. Andy treats all ages and orthopedics needs, particularly sports medicine injuries and conditions.