Author: Kevin B. Freedman, M.D. Sports Medicine Surgeon, Professor of Orthopaedic Surgery
Injuries Are Part of the Game
Rothman Orthopedics is proud to serve as the Official Orthopedic Partner for Eastern Pennsylvania Youth Soccer and is here to provide tips to coaches, parents, and young athletes when an injury occurs.
Soccer is fast, physical, and exciting, which is exactly why athletes love it. But with quick changes of direction, contact between players, and high levels of activity, injuries are an inevitable part of the game. The good news? How coaches, parents, and athletes respond in the first moments after an injury can make a meaningful difference in recovery and long-term health. Preparedness — not panic — leads to the best outcomes.
Whether you are a coach on the sideline, a parent in the stands, or a player on the field, understanding what to do when an injury occurs helps everyone respond with confidence and care. The goal of this article is to know:
- What to do immediately when an injury occurs
- Understand red flags that require urgent medical attention
- Recognize the difference between contact and non-contact injuries
- Know when and how to access follow-up care for safely returning to play
When a player goes down, safety is always the priority.
First Steps When an Injury Happens on the Field
1. Stop play and assess the situation:
If a coach, referee, or medical professional is present, one person should take the lead to avoid confusion. The athlete should remain still until a basic assessment is made. Parents should avoid rushing onto the field unless requested, as this can increase anxiety and disrupt evaluation.
2. Perform a quick on-field check:
Address the following questions to get a high-level assessment of the situation:
• What is the athlete’s pain level?
• Can they move the injured area?
• Is there visible swelling or deformity?
• Was the head or neck involved?
Severe injuries are uncommon. If there is concern for a severe injury due to extreme pain, deformity, or a head and neck injury, an ambulance can be called. If that is the case, the athlete should be left on their back and have their spine stabilized.
Contact vs. Non-Contact Injuries: Why It Matters
Understanding how an injury occurs can provide important clues about its severity.
Contact injuries happen when a player collides with another player, falls, or is struck by the ball or an opponent. Common examples include bruises, sprains, fractures, and concussions. When a more severe injury occurs that requires immediate attention, it is usually due to contact or collision.
Non-contact injuries occur without a collision, often during sudden stops, pivots, or sprints. These injuries are common in soccer and can be significant injuries, such as an ACL, LCL or MCL tear in the knee. Ligament tears should be taken seriously, and athletes should never be rushed back in to play. A key takeaway for athletes and parents: pain that appears suddenly without contact should never be ignored.
Head Injuries and Concussions: A Special Concern
Head injuries require immediate attention and caution. If a concussion is suspected, the athlete must be removed from play right away and should not return the same day.
Common concussion symptoms to watch for include headache, dizziness, nausea, sensitivity to light or noise, and confusion or difficulty concentrating.
Even subtle symptoms should be taken seriously. Proper medical evaluation is essential before returning to sports to protect the athlete’s short- and long-term brain health.
The following guidelines are designed to help determine safe return to play on the day an injury occurs. They are based on functional tests commonly performed on the sidelines by Certified Athletic Trainers. These guidelines differ based upon the type of injury: head, lower extremity, or upper extremity.
For concussions, it is recommended that in any suspicious case, a Certified Athletic Trainer should evaluate the athlete to determine when the athlete should return to play. If no Athletic Trainer is available, the athlete should NOT be allowed to return-to-play.
However, the following are some key signs and symptoms of concussion that parents should be aware of if their child has suffered a head injury:
- Headache
- Dizziness
- Nausea
- Sensitivity to light or noise
- Problems with balance
- Fuzzy or blurred vision
- Changes in emotion or irritability
- Trouble concentrating or remembering
If any of these signs or symptoms are present, the child should NOT be allowed to return to play on the day of injury.
Return to Play from Lower Extremity Injuries
For lower extremity injuries, such as knee, ankle, or foot injuries, there are a variety of tests to determine whether the athlete is safe to return to play. Athletes should be able to perform all of the following exercises with ease and without pain before returning to play:
- Hop on both legs
- Hop on one leg
- Deep squat keeping both heels on the ground
- Jog in a straight line
- Sprint in a straight line
- Diagonal cuts
- Carioca: crossovers in both directions
- Jog backwards
If any of these actions cause pain, the athlete should not be allowed to return to play.
Return to Play from Upper Extremity Injuries
For upper extremity injuries, such as shoulder, elbow, or wrist, the following tests should be performed without pain by the athlete after an injury before returning to play. Upper extremity tests are as follows:
- Complete range of motion: starting with arms by your side, lift arms forward and up until they are overhead; again, starting with arms by your side, lift arms out to the side and continuing until they are overhead
- Doing the same motion as above at full strength
- Resisted belly press: resisting movement with hand on belly
- Resisted bear hug: resisting movement with arms crossed on chest
- 3-5 push-ups
- Any other sports specific drills (ex. throwing)
If any of these actions cause pain, the athlete should not be allowed to return to play.
Overall, our policy is, “When in doubt, keep them out!” Safety is our #1 priority, and if there is any concern over a more serious injury, professional medical evaluation should be performed.
Where to Go for Care: Immediate vs. Non-Immediate Needs
Not every injury requires a trip to the emergency department, but some situations demand urgent care.
Seek immediate medical attention if there is:
- Severe pain or obvious deformity
- Inability to bear weight
- Head or neck injury
- Numbness, tingling, or loss of consciousness
Prompt but non-emergency evaluation is appropriate for:
- Persistent swelling or pain
- Limping or limited motion
- Symptoms that worsen over 24–48 hours
- Suspected overuse injuries
If you’re unsure about whether to go to an emergency department or an urgent care/walk-in center, check with an orthopedic specialist 24/7/365 with RothmanNow to get injury insights.
Accessing Sports Medicine Care
When an injury needs medical evaluation, timely access to the right specialist can streamline recovery and reduce uncertainty. Sports medicine providers who regularly treat youth athletes understand the unique demands of growing bodies and developing athletes.
Early evaluation supports accurate diagnosis, appropriate treatment, and a safe plan for return to activity.
Safe return-to-play decisions should be based on:
- Resolution of pain and swelling
- Full strength and range of motion
- Ability to perform sport-specific movements without discomfort
- Medical clearance when appropriate
Bottom line: When an athlete gets injured, proper assessment that allows a safe return, and protects long-term health, must be priority for everyone – coaches, parents, and the athlete. Once again, when in doubt, keep them out!
For members of the Eastern Pennsylvania Youth Soccer community who wish to make an appointment with a member of the Rothman Orthopaedics Sports Medicine team, you can use our Fast Scheduler Program to get quick access to expert care.