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Soccer's growing pains

THE BALTIMORE SUN

With the whomp and grunt of soccer matches echoing in the autumn air, coaches and doctors say they've seen a rise in the number of young players benched by contusions, sprained knees and broken bones.

Soccer enthusiasts blame a number of factors, but two stand out. First, until the past couple of weeks, the mid-Atlantic's drought had turned the soft turf of many soccer fields into surfaces about as soft and spongy as a concrete slab, many coaches say. Others point to the rising popularity of the sport.

Not only is the sheer number of young players surging, they say, but the players also tend to be larger, more aggressive athletes than in the past.

"Every year, because of the interest in world soccer, high school teams are attracting better athletes," said Dr. Bill Howard, an orthopedist and sports medicine specialist at Union Memorial Hospital. "Better athletes have more speed, and they're more aggressive."

These husky competitors, coaches and others suggest, are capable of inflicting more damage on others and, perhaps, themselves.

Wendell Thomas, coach of the junior varsity boys team at Atholton High in Howard County, said that in the first few weeks of the season, half of his 22 players suffered minor mishaps -- the highest rate he could recall in his 18 years of coaching. "My kids have complained about a lot of leg and foot injuries," he said.

Nancy Ferguson, coach of the varsity girls team at Fallston in Harford County, said her team has stayed healthy, but she has noticed an increase of injuries on other teams. "In talking with other coaches, we think it might be the lack of rain and harder playing surfaces," she said.

Dr. Allan Lanzo, an orthopedic surgeon at the Greater Baltimore Medical Center in Towson, estimates that the number of his young patients with soccer-related injuries has jumped 20 percent in the past year.

The federal Consumer Product Safety Commission reports a 1percent rise in the number of soccer injuries to players of all ages in this country between 1990 and 1994.

Union Memorial's Howard is not alarmed.

"The increase is nothing spooky, and there's nothing inherently dangerous to the sport," he said. "Part of playing sports is injuries. It happens. That's the deal. The more kids play, the more kids are going to get hurt."

Nationwide, about 2.9 million youths are soccer players, up 44 percent since 1990, according to a sports equipment manufacturing group.

In Maryland, the soccer boom is even bigger. The number of youth players has more than doubled in the past four years -- from 18,000 to 40,000, according to state youth soccer officials.

Of course, as more children play soccer, more are likely to get hurt. But many coaches suspect the rate of soccer mishaps may be rising, as well.

If there's one thing coaches agree on, it's that this summer's drought made playing more perilous. Studies have shown that up to 25 percent of soccer injuries are related to field conditions. And many practice and playing fields this fall were in terrible shape: flinty, scarred and rutted.

"The fields cause a lot of the injuries," said Reginald Hahne, a computer science teacher and varsity soccer coach at Atholton. "Nature hasn't been kind to us this year, with the hard fields." However, Hahne said, the recent weather has led to kinder playing conditions.

"The rain has really helped things," he said. "It has softened up the fields, and there's not as many injuries."

As for the trend of bigger athletes gravitating to soccer, it was first noted in a 1985 study in the journal Physician and Sports Medicine. Though better nutrition and health care may be pumping children up generally, several coaches said many of the bigger athletes who once might have gone out for football in the autumn are showing up for soccer practice.

No one knows if these huskier soccer players are getting hurt more often, or if they're injuring others. But researchers have looked at the issue among young football players.

"It's the more mature, larger athletes in American youth footbalthat seem to get injured more than the more immature or smaller athletes," said Dr. John Leddy of the University of Buffalo's Sports Medicine Institute. "That may hold true in soccer, as well."

Overall, he said, soccer injury rates "go up with increasing agepresumably because the players are bigger, faster, more aggressive as they get older."

The increasing popularity of winter soccer may add to the annual toll of injuries.

Some studies have found that players get hurt more often indoors than outdoors, Leddy said. Howard blames indoor soccer's hard, artificial turf for many "big-time" injuries, such as torn knee ligaments.

"I think AstroTurf ought to be put in the offices of the athletic directors of the world only," he said.

Some physicians deplore the trend toward all-year soccerStressing the same muscles and bones repeatedly, they say, doesn't give minor injuries time to heal.

"Here are kids, 8 to 12 years old, playing year-round soccer,said Lanzo. "I think there ought to be a season where you take a break, do something different."

Traditionally, soccer has been seen as safer than most other field sports. But some physicians dispute this. "Injuries in soccer can be as severe as football," Lanzo said.

The Consumer Product Safety Commission reports, for example, that 1.3 percent of the 162,115 soccer players treated at hospital emergency rooms in 1994 had to be hospitalized.

Almost 425,000 football players went to the emergency room that year, more than double the number of soccer players. But that just may reflect the fact that more youths still play football. The same proportion of injured football players -- 1.3 percent -- was hurt badly enough to be admitted.

Female soccer players have suffered a steep rise in one type of severe injury: the tearing of the anterior cruciate ligament in the knee. In fact, for undetermined reasons, women suffer this injury far more frequently than men.

Not everyone thinks that more soccer players are getting hurt.

Helen Houser, administrator of the Maryland State Youth Soccer Association, said the number of insurance claims against her organization for injuries has held steady at about five each year over the past several years.

More players, more injuries

Popularity of soccer

Growth in the number of those 19 and under playing soccer in the United States and registered with three major organizations:

Year .. .. .. .. .. .. No. (in millions)

1980 .. .. .. .. .. .. 889

.. .. .. .. .. .. 2.023

.. .. .. .. .. .. 2.281

.. .. .. .. .. .. 2.434

.. .. .. .. .. .. 2.631

.. .. .. .. .. .. 2.895

Source: Soccer Industry Council of America

Estimated U.S. soccer injuries

F: Number of players treated in hospital emergency rooms:

Year .. .. .. .. .. .. No. .. .. .. .. .. % admitted to hospital

1990 .. .. .. .. .. .. 139,702 ... ... .. 0.8

1991 .. .. .. .. .. .. 150,860 ... ... .. 1.2

1992 .. .. .. .. .. .. 160,228 ... ... .. 1.5

1993 .. .. .. .. .. .. 146,409 ... ... .. 1.9

1994 .. .. .. .. .. .. 162,115 ... ... .. 1.3

Source: Estimates based on data from National Electronic Injury Surveillance System, U.S. Consumer Product Safety Commission. Data based on treatments at hospital emergency rooms. Numbers do not include injuries treated at home or in a doctor's office.

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