Futbol Fever and Other Soccer Ailments

Futbol Fever :\ˈft-ˌbl ˈfē-vər\ a malady which consists of a constellation of unusual behaviors which occur in a regular, four-year cycle.

Signs and symptoms include:

  • Colorful rashes on the face and body- often corresponding to the national colors of the victim’s country
  • High anxiety, often followed by periods of mania and/or depression
  • The urge to congregate in large crowds, particularly in places which serve alchohol
  • The desire to see how long you can scream the word “Gooooooaalllll!” before you run out of breath (this seems to be especially prevalent among newscasters)

Complications can include:

  • Sore/raspy throat
  • Hangover symptoms- headache, nausea and vomiting
  • Musculoskeletal aches and pains from excessive jumping up and down

Futbol fever seems to be reaching epidemic proportions as the FIFA World Cup event takes place this month in Brazil. The World Cup is the most widely viewed and followed sporting event in the world, exceeding even the Olympic Games; the cumulative audience of all matches of the 2010 FIFA World Cup was estimated to be 3.2 billion with an estimated 909.6 million people watching the final match.

This year, the US, which still calls the sport soccer, is showing more than its usual interest in the event. The US team, considered an underdog (even by its own team coach, German Jürgen Klinsmann) beat Ghana in its first match, and last night drew a last minute tie at the end of overtime with Team Portuguese. They now will play to win against Germany in their final Group G match on Thursday.

Have you caught Futbol Fever?

Besides “Futbol Fever” soccer/football* has its own unique series of common injuries:

Ankle injuries

An ankle sprain is the single most common injury in football.

The ankle joint is made up of 3 bones, ligaments and a joint capsule:

  • The tibia, sometimes called the shin bone, is the main bone of the lower leg, and makes up the inside of the ankle joint.
  • The fibula is a smaller bone that lays next to the tibia on the outside of the lower leg and makes up the outer side of the ankle joint.
  • The talus is a odd hump shaped bone of the foot that the tibia and fibula arch over to form the ankle. Those bumps that stick out from the sides of your ankles are called malleoli (singular is malleolus). They are the end parts of the tibia and fibula that surround the talus.
  • A fibrous membrane called the joint capsule,lined with a smooth layer called the synovium, encases the bony joint structure. The joint capsule contains synovial fluid produced by the synovium which allows for smooth movement of the joint surfaces.
  • The ankle joint is stabilized by 3 groups of ligaments, which are fibers that hold these bones in place.

A sprain is an injury to the ligaments (thick bands of cartilage that connect bone to bone) caused by a fall or outside force that pulls the surrounding joint beyond its normal range of movement. The degree of sprain can range from a stretched ligament to a completely torn ligament. Symptoms include pain with movement,  swelling, bruising, and joint instability. The only way to know for sure whether an injury is a fracture or a sprain is by taking an x-ray of the ankle. Mild injuries of either type are treated with RICE therapy– rest, ice, compression and elevation. More severe injuries may require immobilization or possibly surgery to restore function.

Knee injuries

One of the most severe injuries in football is an anterior cruciate ligament tear of the knee. But there are further structures that can be affected.

The knee is essentially a modified hinge joint located where the end of the thigh bone (femur) meets the top of the shin bone (tibia). Four main ligaments connect these two bones:

  • Medial collateral ligament (MCL) — runs along the inner part of the knee and prevents the knee from bending inward.
  • Lateral collateral ligament (LCL) — runs along the outer part of the knee and prevents the knee from bending outward.
  • Anterior cruciate ligament (ACL) — lies in the middle of the knee. It prevents the tibia from sliding out in front of the femur, and provides rotational stability to the knee.
  • Posterior cruciate ligament (PCL) — works with the ACL. It prevents the tibia from sliding backwards under the femur.

The ACL and PCL cross each other inside the knee, forming an “X.”


The ACL is the most commonly injured ligament in the knee. It can be torn when a twisting force is applied to the knee while the foot is firmly planted on the ground or upon landing, or from a direct blow to the knee, usually to the outside of the knee, as may occur during a football tackle. The most common sports where ACL injuries occur are soccer, basketball, tennis, volleyball and skiing. ACL injuries are more common in women for a variety of reasons including anatomical difference and the effect of female hormones on the joints.

Hamstring injuries


Anatomy Chart courtesy of FCIT

The hamstrings are the muscles at the back of your thigh. There are three hamstring muscles:

  1.  Semitendinosus
  2.  Semimembranosus
  3.  Biceps femoris

The hamstring muscles allow you to extend your leg straight back and also to bend your knee. They can get rather injured during sprinting or sudden moves. A strain of the hamstring, also known as a pulled hamstring, is defined as an excessive stretch or tear of muscle fibers and related tissues.

Straining the hamstring while running results in  a sudden, sharp pain at the back of the thigh, forcing you to come to a quick stop. You may fall down and only be able to hop on your good leg.

Additional symptoms may include swelling of the leg and bruising of the back of the leg above or below the knee. The bruising may increase over the first few days post-injury. Some may also notice a weakness of the hamstrings, which can persist for several weeks.

Head injuries

The most important issue in a head injury is to exclude a concussion. Football players often use a header (the striking of a ball in the air by a player’s forehead) to a make a clearance (away from the goal), a pass, or a shot at goal.

A concussion is a traumatic brain injury (TBI) that may result in a bad headache, altered levels of alertness, or unconsciousness.

It temporarily interferes with the way your brain works, and it can affect memory, judgment, reflexes, speech, balance, coordination, and sleep patterns.

Symptoms of a concussion can range from mild to severe. They can include:

  • Altered level of consciousness (drowsy, hard to arouse, or similar changes)
  • Confusion, feeling spacey, or not thinking straight
  •  Headache
  • Loss of consciousness
  • Memory loss (amnesia) of events before the injury or immediately after
  • Nausea and vomiting
  • Seeing flashing lights
  • Feeling like you have “lost time”

Healing or recovering from a concussion takes time. It may take days, weeks, or even months. You may be irritable, have trouble concentrating, be unable to remember things, have headaches, dizziness, and blurry vision. These problems will probably go away slowly.

Coaches need to be able to assess whether a player has suffered a concussion and to remove that player from the rest of the game, and assure that the player is then properly assessed by a health professional before returning to play.


*Whenever I refer to football from now on, I am speaking about soccer.

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

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