Football injuries

A hamstring goes on a sprint, a stretch-out tackle, or a hard cut. It heals. You get cleared. Six weeks later it goes again, usually worse.

That is not bad luck. Reinjury rates run over 30 percent, and studies that followed athletes into later seasons have found rates as high as 60 to 70 percent. The muscle heals long before the thing that tore it gets fixed.

Here is what changes it. Athletes rehabbed with stretching and hamstring strengthening reinjured at about 70 percent within a year. Athletes rehabbed with progressive agility and trunk stabilisation work instead came in under 8 percent. Same injury, same muscle, completely different outcome — because the second group trained the way a hamstring actually gets loaded when you run.

So we do not spend six weeks on a hamstring curl machine. We build the hip and trunk control that lets you decelerate, then put speed back in on purpose, at measured distances, before you go back. And I test you before I clear you, rather than asking how it feels.

Not a normal ankle sprain. Not a normal timeline either.

A normal ankle sprain rolls the foot inward and damages ligaments on the outside. A high ankle sprain is a different injury: the foot gets planted, the leg twists over it, and the damage is to the ligaments holding your two shin bones together, above the joint.

It swells less. It bruises less. It often looks like the milder one. It is not. Handled without surgery, most athletes need roughly four to six weeks before return to sport. If it needs surgical fixation, high school and college athletes are usually looking at six to eight weeks after the operation.

The tell is where it hurts — above the ankle rather than below it, and worse when you push off or get twisted than when you roll it.

If you have an ankle sprain that is not behaving like your last ankle sprain by week two, get it looked at. Playing on a missed high ankle sprain is how a four-week problem turns into a season.

You take a hit, your head snaps sideways, and a hot electric line runs from your neck down one arm. It goes dead or weak for a few seconds, then clears, and you go back in. Almost every defensive back and lineman has had one.

Most of the time that is exactly what it is — nerves at the base of the neck got stretched, and they recover in seconds to minutes. But three things change the answer, and coaches and parents should know them cold.

Both arms. A stinger is a one-arm injury. Symptoms in both arms is a spinal cord sign, and that athlete comes off the field and gets evaluated the same day.

Neck pain. A stinger does not hurt the neck. If the neck hurts, something else is going on.

Weakness that stays. Seconds to minutes is a stinger. Weakness still there days later is a nerve injury that needs looking at.

Nobody goes back with weakness or neck pain. And if you are getting them repeatedly, that is a pattern worth fixing — usually neck and shoulder-girdle strength, sometimes equipment fit — rather than something to keep absorbing.

You land on the point of the shoulder, or get driven into the turf on it. The ligaments holding your collarbone to your shoulder blade get sprained or torn, and depending on how bad, you end up with a visible bump on top of the shoulder.

This is not a dislocated shoulder and it is not a broken collarbone, though on the day it can feel worse than both. Most of them never need surgery. Timelines run from around a couple of weeks for a mild sprain to roughly twelve weeks when both ligament sets are torn.

What decides how well it goes is weeks two through six. The shoulder blade stops moving properly while you are guarding the arm, and if nobody retrains that, you get back on the field with a shoulder that hurts overhead and a bench press that never comes back.

So we work the shoulder blade and the rotator cuff before we work the arm. The bump, if you have one, usually stays. It is cosmetic. It is not the problem.

An adult with back pain usually has a disc or a joint that is irritated. A fifteen-year-old with back pain is a different question, and this is the one most often missed.

In adults, a stress fracture in the back accounts for maybe 6 to 8 percent of back pain. In young athletes with back pain, that figure is 14 to 30 percent. The cause is repeated arching and twisting — which describes a lineman coming out of a stance, a quarterback throwing, and anyone doing heavy overhead work in the weight room all winter.

The pattern to watch for is a dull ache that turns sharp with movement, worse when the back arches, better with rest, and no pain down the leg.

If a teenage athlete has back pain lasting more than two weeks, they need imaging, not a foam roller. Caught properly, about 92 percent are back to sport within six months — but it usually means real time out of the sport first, and that is a conversation better had in September than in March.

Guidance on this has changed, and a lot of what parents were told five years ago is out of date.

Current international consensus is relative rest for the first 24 to 48 hours, including limited screen time, and then a return to light activity such as walking as tolerated. Light aerobic exercise is recommended within the first two to ten days, at an intensity that does not spike symptoms. Most people recover within four weeks, though 20 to 30 percent of youth and adults take longer.

Where physical therapy comes in is specific. If dizziness, neck pain or headaches are still there past about ten days, individualised neck and balance rehabilitation is recommended, and that is work I do.

What I do not do is clear anyone to play. Return to contact runs through a physician and the school protocol, in steps, and I work alongside that rather than around it.

If your player is three weeks out and still getting headaches in class, that is not something to wait out.