By Peter H. Edwards, Jr., M.D.

Overuse injuries are very common in all athletes, but especially among soccer players. Soccer combines both endurance and collision elements that predispose athletes to repetitive stress type injuries. These injuries happen as a result of an accumulation of small or micro injuries that athletes don’t often noticed when they occur. Over time, injuries worsen and symptoms develop.

Training patterns often influence the onset of overuse injuries. Hard training over several

consecutive days is not recommended. To minimize the risk of overuse injury, athletes should

remember the 24-hour recovery rule: intense training sessions should never occur within 24

hours of each other. This equates to a hard-easy-hard-easy pattern. Coaches often can balance

intense fitness training with tactical or skill work, allowing athletes adequate recovery after high

levels of physical stress.

For well-conditioned athletes, progression of the 24-hour rule is usual. The pattern allows for

vigorous training on a daily basis, as long as maximal intensity and maximal duration workouts do

not occur on consecutive days. For example, an elite marathon runner may run seven to ten miles

daily, but by varying the pace from five-minute to seven-minute miles, the workout’s intensity still

adheres to the hard-easy pattern.

When matches are added into the training equation, another variable must be considered. To

optimize play, athletes should never engage in high intensity and duration training in the 24 hours

before a match. Similarly, the day after a match, training should allow for muscular recovery. In

peak play periods when multiple match weekend tournaments are the norm, adhering to the 24-hour

recovery rule often is modified. However, recognizing athletes’ need for recovery time is still


As with all injury situations, early recoginition and treatment of overuse injuries reduces time lost

to play. Stiffness or pain that worsens over three to four days of training is significant. At first, ice

and rest is recommended. If the condition does not improve, see your athletic trainier or a sports

medicine orthopedist to prevent more serious problems.