9 Common American Football injuries (Prevention & Treatment)

The 9 most common American football injuries: concussions, knee ligament damage, ankle and hamstring sprains, shoulder trouble and groin strain.

Each one gets a section on how the hit or the movement causes it and what the warning signs are, followed by fractures, dislocations, neck pain and heat injury, plus prevention advice and an FAQ.

Injury Rates and Numbers

The figures below come from injury surveillance data and peer reviewed studies. Each row names the population it was measured in, because rates from elite athletes and from recreational players are not comparable.

Finding	Measured in	Source
College football players had an injury rate of 7.29 per 1,000 athlete-exposures, versus 4.01 per 1,000 for high school football players.	US high school and NCAA college football players (athletic trainer reported data), NCAA 2004-05 through 2013-14; high school 2005-06 through 2013-14 (published 2018)	Kerr et al., Journal of Athletic Training (NCAA Injury Surveillance Program and High School RIO)
Men’s football had the highest average annual injury count of any NCAA sport, an estimated 47,199 injuries per year.	NCAA student-athletes across 25 championship sports, 2009-10 through 2013-14 academic years (published 2015)	Kerr et al., MMWR / CDC (NCAA Injury Surveillance Program)
NCAA football had the highest competition injury rate of any college sport, at 39.9 injuries per 1,000 athlete-exposures.	NCAA football student-athletes, 2009-10 through 2013-14 academic years	Kerr et al., MMWR / CDC (NCAA Injury Surveillance Program)
Concussion was a common injury during football competitions across most playing positions at both high school and college level.	US high school and NCAA college football players, high school 2005-06 to 2013-14; NCAA 2004-05 to 2013-14	Kerr et al., Journal of Athletic Training (NCAA Injury Surveillance Program and High School RIO)
Football injuries occurring during NCAA competition were more likely to require 7 or more days before athletes returned to full play than practice injuries.	NCAA student-athletes, 25 championship sports (context includes football), 2009-10 through 2013-14 academic years	Kerr et al., MMWR / CDC (NCAA Injury Surveillance Program)

Overview

Injury	Body area	Typical time out
Sprains and Strains (ankles, knees, hamstrings)	Ankle, knee and thigh	1 to 8 weeks, 3 months if ruptured
Concussion	Head and brain	2 to 4 weeks, longer if repeated
Knee Injuries (including knee ligament injuries)	Knee	2 weeks to 12 months by structure
Shoulder Injuries	Shoulder	1 week to 6 months by injury type
Fractures and Dislocations (including general dislocations)	Bones and joints	4 weeks to 6 months, more if operated
Groin Strain	Groin and hip	1 to 8 weeks, 3 months if avulsed
Overuse Injuries	Tendons and bone	6 weeks to 6 months, often modified
Neck Pain	Neck	Days to 2 weeks, longer if recurring
Heat Injury	Whole body	1 to 2 days, weeks after heat stroke
Lumbar Facet Joint and Muscle Strain of the Lower Back	Lower back	1 to 4 weeks, 3 months if bone stress
Anterior Cruciate Ligament (ACL) Tear	Knee	9 to 12 months after reconstruction
Thumb Ulnar Collateral Ligament Sprain	Hand and wrist	3 to 6 weeks, 3 months if repaired

Sprains and Strains (ankles, knees, hamstrings)

A sprain damages a ligament, the short band that holds two bones together, while a strain damages muscle fibers or the tendon that anchors them to bone. In football the classic patterns are the lateral ankle ligaments giving way when a foot rolls inward on planted turf, the medial collateral ligament of the knee taking a hit from the outside, and the hamstring tearing at the muscle tendon junction during a sprint or a long stride in coverage. All three fail when the tissue is stretched faster than it can lengthen, usually with the athlete already at speed.

Symptoms

• A pop, snap or tearing sensation at the moment of injury
• Pain that comes on instantly rather than building up over the drive
• Swelling within the first few hours, sometimes with bruising a day or two later
• Trouble putting full weight on the leg or pushing off to sprint
• A feeling that the joint is loose or that the muscle will not fire

How serious it is: Both injuries are graded 1 to 3: grade 1 is a stretch with a few torn fibers, grade 2 a partial tear with clear weakness and swelling, grade 3 a complete rupture with an unstable joint or a muscle that cannot contract. Grade 3 injuries and any ankle sprain with bone tenderness need imaging.

Typical time out: One to three weeks for a grade 1 ankle sprain or a mild hamstring strain, four to eight weeks for a grade 2 injury, and three months or more when a ligament is completely torn or repaired surgically. Hamstrings vary most: a tear close to the sitting bone heals far slower than one in the muscle belly, which is why two players with the same grade can return months apart.

See a doctor if: See a clinician the same day if you cannot take four steps on the leg, if the joint looks crooked, or if the pain sits directly on bone rather than on soft tissue.

What helps

• Load the limb early within a pain limit rather than waiting for it to feel normal; protected walking beats several days of couch time
• Short cooling in the first hours for pain only, not as a long treatment plan
• Progressive strength work: calf raises and balance drills for the ankle, and lengthened position hamstring work such as Nordic curls and single leg deadlifts
• A brace or tape for the first weeks back in contact, which lowers the chance of a second ankle sprain
• Physical therapy if you still limp after a week, and imaging if the joint stays unstable or swelling returns each time you run

Concussion

A concussion is a functional injury to the brain caused by rapid acceleration of the head, either from a direct blow or from a hit to the body that whips the head around. The brain tissue is stretched and its cells briefly lose their normal chemical balance, which is why scans usually look normal even when the athlete clearly is not. In football the common mechanisms are helmet to helmet contact, a head striking the ground on a tackle, and a knee or shoulder to the head of a player already going down.

Symptoms

• Headache or a feeling of pressure in the head
• Dizziness, feeling slowed down, or in a fog
• Blurred or double vision and sensitivity to light and noise
• Trouble remembering the play, the score or the moments before the hit
• Nausea, irritability or sleep that changes over the next nights

How serious it is: Concussion is no longer graded on the field by number of symptoms or by whether the player blacked out; loss of consciousness happens in a minority of cases and its absence proves nothing. What matters more is how many symptoms there are, how long they last, and whether the athlete has had concussions before.

Typical time out: Most symptoms settle within two to four weeks, and a graded return to contact usually takes at least one to two weeks after the last symptom is gone. Recovery runs longer for athletes with previous concussions, with migraine history, or with dizziness and vision symptoms early on, and a small group needs months of guided rehabilitation.

See a doctor if: Go to an emergency department for a headache that keeps worsening, repeated vomiting, one pupil larger than the other, a seizure, weakness or numbness in an arm or leg, or a player who cannot be roused.

What helps

• Come out of the game immediately and do not return the same day, whatever the score
• One to two days of relative rest, then light aerobic activity below the symptom threshold; complete darkened room rest for a week makes recovery slower, not faster
• A stepwise return to play supervised by a clinician, with each step held for at least a day and repeated if symptoms come back
• Screen and school or work load reduced at first and increased in small steps rather than all at once
• Referral to a concussion clinic if symptoms are still there after four weeks, since neck, balance and vision problems can be treated directly

Knee Injuries (including knee ligament injuries)

The knee is held together by four ligaments and cushioned by two crescent shaped menisci, and football loads all of them. The medial collateral ligament tears when a block or tackle drives the knee inward, the anterior cruciate ligament tears most often without any contact at all, during a cut or a landing where the foot is planted and the body rotates over it, and the meniscus is crushed or split when a loaded knee twists. Cartilage and cruciate injuries hurt long term because those tissues have a poor blood supply and heal badly on their own.

Symptoms

• A loud pop at the moment of the cut or the hit
• Swelling that fills the knee within the first hours, which suggests bleeding inside the joint
• The knee giving way when you try to change direction
• Locking or catching so the knee will not fully straighten
• Pain on the joint line when you squat or twist

How serious it is: Collateral ligament injuries are graded 1 to 3 by how far the joint opens under stress, and most grade 1 and 2 medial injuries heal without surgery. A complete cruciate tear, a locked knee from a displaced meniscus, or several structures torn at once is a different category and belongs with a knee surgeon.

Typical time out: Two to six weeks for a grade 1 or 2 medial collateral injury, six weeks to three months after a meniscus trim, and nine to twelve months after cruciate reconstruction before contact football is sensible. Returning before nine months clearly raises the chance of tearing it again, which is why the range is so wide.

See a doctor if: Get checked promptly if the knee swells within an hour, locks so it cannot be straightened, or buckles when you walk on level ground.

What helps

• Early assessment by a clinician who can test the ligaments, since a swollen knee hides a lot and MRI is worth it when instability is suspected
• Quadriceps and hamstring strengthening started as soon as swelling allows, because thigh strength drives every later stage
• Neuromuscular training for landing and cutting technique, which lowers cruciate injury rates in field sport athletes
• Criteria based return to play, that is strength and hop symmetry compared with the other leg rather than a date in the calendar
• Surgery discussed early for a completely torn cruciate in a player who wants to keep taking contact, and for a meniscus that keeps locking the knee

Shoulder Injuries

The shoulder is a shallow ball and socket joint held in place by the labrum, the capsule and the four rotator cuff tendons, and the collarbone connects to the shoulder blade through the acromioclavicular joint on top. Falling on the point of the shoulder sprains that top joint, landing on an outstretched arm or getting the arm forced backward pushes the ball out of the socket and tears the labrum, and repeated tackling with the arm out irritates the cuff tendons. Linemen and tacklers take these loads on almost every snap.

Symptoms

• Immediate pain and a sense that the arm is dead or will not lift
• A visible bump or step on top of the shoulder after a fall on it
• The feeling that the shoulder slipped out and went back in
• Weakness reaching overhead or across the body
• Pain at night when lying on that side

How serious it is: Acromioclavicular separations are graded from type I, a sprain with no visible change, through type III, where the collarbone clearly sits high, up to the rarer high grade types that usually need surgery. A first dislocation in a young athlete carries a high chance of it happening again, and that risk, not the pain, drives the decision to operate.

Typical time out: One to three weeks for a type I or II separation, six weeks to three months for a type III depending on position and symptoms, and four to six months after stabilization surgery or a cuff repair. Contact positions wait longer than skill positions with the same injury because the shoulder has to survive impact, not just movement.

See a doctor if: Seek care the same day if the shoulder stays visibly out of place, if the arm is numb or cold, or if you cannot lift it at all after the first hours.

What helps

• A sling for comfort in the first days only, with gentle movement started early so the joint does not stiffen
• Rotator cuff and scapular strengthening under guidance, progressing to loads in the tackling position
• A shoulder harness or spica taping for contact once strength is back, which limits the range where the joint is most vulnerable
• Imaging after a first dislocation or when weakness lasts beyond a couple of weeks, to look for a labral or cuff tear
• A surgical opinion for repeated dislocations, since each one damages more of the rim of the socket

Fractures and Dislocations (including general dislocations)

A fracture is a break in the bone itself, a dislocation is a joint whose surfaces have been forced apart, and football produces both through direct collision and through limbs being twisted while a player is pinned in a pile. The clavicle, the small bones of the hand, the fibula at the ankle and the ribs break most often, while fingers, shoulders and occasionally the kneecap dislocate. Both injuries can also damage the nerves and blood vessels running beside the joint, which is what makes them urgent rather than merely painful.

Symptoms

• Pain that stays severe and does not ease when you stop moving
• A limb or finger that looks bent, shortened or out of line
• Rapid swelling and deep bruising over a bone
• Complete inability to use the limb or bear weight
• Pins and needles, numbness or a cold hand or foot beyond the injury

How serious it is: The simple end is a hairline crack in a finger or a rib that heals in a cast, tape or nothing at all. The serious end is a bone that has moved out of position, one that breaks through the skin, or a dislocation that will not go back in, and all of those are hospital problems from the first minute.

Typical time out: Four to eight weeks for most simple hand or rib fractures, six to twelve weeks for a collarbone or ankle fracture, and three to six months when a plate, screws or a joint repair are involved. Bone in the foot with a poor blood supply, such as the fifth metatarsal, heals slower and re-breaks more often, so those timelines run longer.

See a doctor if: Call for emergency help if the limb is deformed, if bone has broken the skin, or if the area beyond the injury is numb, pale or cold.

What helps

• Splint the limb in the position you found it and get medical assessment; do not try to pull a joint back in on the sideline
• X-ray rather than guesswork, since a nondisplaced fracture can feel like a bad sprain for the first day
• Movement of the joints above and below the cast during immobilization, and structured rehabilitation once it comes off, because stiffness costs more time than the bone does
• Enough pain control to sleep and to do the rehabilitation, agreed with a clinician
• A protective cast, brace or padded splint for return to play where the rules allow it, especially for hand and forearm injuries

Groin Strain

A groin strain is a tear in the adductor muscles that run from the pubic bone down the inner thigh, most often the adductor longus at the point where the muscle becomes tendon. It happens when the leg is forced outward while the muscle is contracting, for example when a defensive back opens the hips to turn and run, or when a lineman braces sideways against a push. Related pain can also come from the tendon attachment itself or from the pubic bone, which changes the treatment.

Symptoms

• Sharp pain in the inner thigh or at the crease of the groin during a change of direction
• Pain when squeezing the knees together or bringing the leg across the body
• Tenderness you can find with a finger along the inner thigh
• Bruising on the inner thigh a few days later in bigger tears
• Stiffness and pain on the first steps after sitting

How serious it is: Grades 1 to 3 apply as with any muscle strain: a grade 1 lets you keep walking normally, a grade 2 produces clear weakness on squeezing, a grade 3 is a full tear or a tendon pulled off the bone and usually needs a surgical opinion. Pain that has crept in over weeks rather than appearing in one moment points to a tendon or pubic bone problem instead.

Typical time out: One to three weeks for a mild strain, four to eight weeks for a clear partial tear, and three months or more for a tendon avulsion or a long standing groin pain that has been ignored for a season. The range is wide because groin injuries recur easily when players return while the adductor squeeze is still weak.

See a doctor if: Get it looked at if you felt a sudden give with immediate bruising, if you cannot lift the leg while lying down, or if groin pain has been present for more than a few weeks without improving.

What helps

• Isometric adductor squeezes started within pain limits in the first days, then progressive loading such as the Copenhagen adduction exercise
• Strength measured before return, since the injured side should squeeze close to the healthy side, not merely feel fine
• Gradual reintroduction of cutting, sprinting and lateral work in that order rather than all in one session
• Hip and trunk strengthening, because weak adductors relative to the abductors is a known risk pattern in field sports
• Imaging and a specialist opinion when pain sits on the pubic bone or has lasted more than six weeks

Overuse Injuries

Overuse injuries are failures of tissue that has been loaded repeatedly without enough recovery between sessions, so the repair process never catches up. In football that shows up as patellar and Achilles tendinopathy from constant acceleration and jumping, stress reactions in the shin and foot bones from running volume on hard surfaces, and shoulder tendon irritation in quarterbacks from throwing. The tissue is not inflamed in the classic sense; the tendon fibers become disorganized and the bone develops microscopic damage faster than it rebuilds.

Symptoms

• Pain that starts at the beginning of a session, eases when warm and returns worse afterward
• Localized soreness you can point to with one finger
• Stiffness in the tendon in the first minutes after getting up
• Pain that has grown over weeks rather than appearing in a single play
• Bone pain that worsens with each running session and starts hurting during ordinary walking

How serious it is: Mild cases hurt at the start of activity and settle; the concerning form hurts during and after every session and eventually at rest. Bone stress injuries are the ones to catch early, because a stress reaction that is managed heals in weeks while a completed stress fracture takes months.

Typical time out: Tendinopathy usually keeps a player limited rather than out, with three to six months of loading work before the tendon is reliable. Bone stress injuries need six to twelve weeks of reduced impact, and high risk sites such as the front of the shin or the navicular in the foot take longer and sometimes need surgery.

See a doctor if: Have it assessed if the pain wakes you at night, if it hurts while simply walking, or if a specific point on a bone stays tender to touch.

What helps

• Load management first: cut the volume of the aggravating drill rather than stopping everything, and build back in weekly steps of roughly ten percent
• Slow heavy resistance and eccentric work for tendinopathy, for example slow calf raises for the Achilles or decline squats for the patellar tendon
• Strength of the whole chain, since a weak calf or glute pushes load onto the painful tendon
• Imaging when bone stress is suspected, because X-rays often look normal early and an MRI changes the plan
• Corticosteroid injection only as an exception for a short term problem; it can ease pain quickly but tends to leave tendons worse over the longer run

Neck Pain

Neck pain in football usually comes from the muscles and small facet joints of the cervical spine being loaded suddenly when the head is thrown forward or sideways in a tackle. A separate and more distinct injury is the stinger, where the nerves of the brachial plexus are stretched or compressed as the head bends one way and the shoulder is pushed the other, producing a burning line down one arm. Both differ from a spinal cord injury, which involves symptoms in more than one limb.

Symptoms

• Stiffness and pain turning the head after a collision
• Muscle spasm along the side or back of the neck
• A burning or electric feeling running down one arm, usually lasting seconds to minutes
• Temporary weakness in the shoulder or grip on one side
• Headache starting at the base of the skull

How serious it is: Most cases are a muscular strain that settles within days, and a stinger that clears within minutes is common and usually benign. Symptoms in both arms, in a leg, or in the trunk are a different matter entirely and mean the spinal cord may be involved.

Typical time out: A few days to two weeks for a simple neck strain, and return the same day is only reasonable after a stinger when strength and sensation are fully normal on examination. Repeated stingers or weakness that lasts beyond a few days mean weeks out and a full workup, including imaging of the neck.

See a doctor if: Treat it as an emergency if there is numbness, tingling or weakness in both arms or in the legs, if there is midline pain over the spine bones, or if the neck cannot be moved at all after a heavy collision.

What helps

• Keep the neck moving gently within a comfortable range from the first days; collars and immobilization prolong stiffness once a serious injury has been excluded
• Progressive neck and upper back strengthening, which also builds tolerance for future impacts
• Technique coaching so contact is taken with the head up and never with the crown of the helmet
• Correctly fitted helmet and shoulder pads, checked through the season rather than once in August
• Medical assessment before returning after any stinger, and imaging if symptoms repeat or last

Heat Injury

Heat illness happens when the body produces more heat than it can shed, which is easy in football because helmets and pads cover most of the skin and block evaporation. Heat exhaustion is the stage where the circulation struggles and the athlete feels weak and sick but the brain still works normally. Exertional heat stroke is the emergency: core temperature climbs high enough to disturb brain function, and the mechanisms that protect organs begin to fail.

Symptoms

• Heavy fatigue out of proportion to the drill and a sense of not keeping up
• Headache, nausea, dizziness or muscle cramps
• Skin that is flushed and either soaking wet or oddly dry
• A racing pulse and rapid breathing that do not settle in the break
• Confusion, stumbling, aggression or strange behavior, which is the danger sign

How serious it is: Heat cramps and heat exhaustion resolve with cooling and fluids; the athlete stays lucid throughout. Any change in behavior, coordination or awareness during heat means exertional heat stroke until proved otherwise, and that is a life threatening condition where minutes matter.

Typical time out: A day or two of easy activity after heat exhaustion, provided the athlete rehydrates and feels normal. After exertional heat stroke, return is medically supervised and takes at least one to several weeks, longer if blood tests showed organ or muscle damage, since heat tolerance stays reduced for a while.

See a doctor if: Call emergency services immediately for any confusion, collapse, seizure or unusual behavior in the heat, and start cooling before the ambulance arrives.

What helps

• Get the athlete out of the gear and into shade or air conditioning at the first sign, rather than waiting to see if it passes
• Cool first, transport second in a suspected heat stroke: cold water immersion is the fastest method and ice packs to the neck, armpits and groin come next
• Cool fluids with electrolytes for heat exhaustion, taken steadily rather than a large volume at once
• Heat acclimatization over the first one to two weeks of camp, with pads added gradually instead of on day one
• Practice scheduling and work to rest ratios adjusted to humidity, not only to air temperature

Lumbar Facet Joint and Muscle Strain of the Lower Back

The lower back takes load through the small paired facet joints at the back of each vertebra and through the deep muscles that hold the spine steady. In football these are strained by repeated blocking from a bent forward position, by extending and twisting the trunk to make a tackle, and by heavy squatting and Olympic lifting in the weight room. Linemen firing out of a three point stance load these joints hundreds of times a week, which is why the complaint is common in that group.

Symptoms

• Pain across one side of the lower back that worsens when you arch backward or twist
• Stiffness that is worst on waking and after long sitting
• A catch or spasm when getting out of a stance
• Pain that stays in the back and buttock rather than running past the knee
• Difficulty holding a braced position under load

How serious it is: Most low back pain in football is mechanical and settles within weeks. Pain that runs down the leg past the knee suggests nerve involvement from a disc, and pain in a young athlete that is worse on arching backward and stays on one side can be a stress injury of the pars interarticularis, which needs imaging rather than more rehabilitation.

Typical time out: One to four weeks for a simple facet or muscle strain with graded return to lifting. A pars stress injury takes three months or more of restricted loading, and disc related nerve pain varies from a few weeks to several months depending on how the symptoms in the leg behave.

See a doctor if: Seek care promptly for numbness in the groin or saddle area, loss of bladder or bowel control, weakness in a leg, or back pain following a heavy collision with midline bone tenderness.

What helps

• Keep moving and return to light activity within days; bed rest makes low back pain last longer
• Progressive trunk and hip strengthening, including hip hinge patterns retrained under supervision before heavy lifting resumes
• Technique review of squat, deadlift and blocking stance, since most recurrences trace back to position under load
• Manual therapy or dry needling as a short term aid for pain, combined with exercise rather than used alone
• MRI or a bone specific scan if one sided pain on extension persists beyond a few weeks in a young player

Anterior Cruciate Ligament (ACL) Tear

The anterior cruciate ligament runs diagonally inside the knee and stops the shin bone sliding forward and rotating under the thigh bone. In football it usually tears without contact, when a player plants a foot, decelerates and turns while the knee falls inward and the body rotates over a nearly straight leg. It can also tear from a hit to the outside of the knee, and in that case the medial collateral ligament and the meniscus are often torn with it.

Symptoms

• A distinct pop felt or heard at the moment of the cut or landing
• The knee swelling markedly within the first hours
• A sense that the knee shifted out of place and then relocated
• Being unable to continue playing despite the pain settling somewhat
• The knee giving way later on turns and stairs

How serious it is: An ACL injury is either a partial tear, where some fibers remain and the knee may stay stable, or a complete rupture, where it does not. What decides the course is less the ligament alone and more whether the meniscus and other ligaments went with it, since a repairable meniscus tear changes both the surgery and the timeline.

Typical time out: Nine to twelve months from reconstruction to full contact football, and often longer for defensive and skill positions who cut at speed. Athletes who return before nine months, or before they reach strength and hop symmetry with the other leg, tear the graft again at a clearly higher rate.

See a doctor if: Have the knee examined the same week if it swelled within hours of a twisting injury, and urgently if it locks in a bent position or will not bear weight at all.

What helps

• Prehabilitation before surgery to regain full extension and quadriceps control, which improves the result afterward
• A rehabilitation plan measured in milestones, including single leg strength and hop tests compared with the healthy side
• Neuromuscular and landing retraining continued after return, because the untorn knee is also at raised risk
• An honest discussion about surgery: a player who wants to keep cutting and taking contact almost always needs the ligament reconstructed
• Screening the whole chain, since hip and calf strength and trunk control all influence how the knee is loaded

Thumb Ulnar Collateral Ligament Sprain

The ulnar collateral ligament sits on the inner side of the base of the thumb and keeps the thumb from bending away from the hand when you grip. It sprains or tears when the thumb is forced outward, which happens when a hand catches in a jersey during a tackle, gets caught in a facemask, or is jammed into the ground or a helmet on a fall. A complete tear can slip out of position under a nearby tendon, in which case it will not heal without surgery.

Symptoms

• Pain and swelling at the web between thumb and index finger
• Weak or painful pinch grip, for example turning a key or holding a ball
• A sense that the thumb bends too far sideways
• Bruising over the base of the thumb after a day or two
• Pain when gripping a jersey or making a tackle

How serious it is: A partial tear leaves the joint stable when tested and heals in a splint. A complete tear leaves the thumb opening up on the inner side and often requires surgical repair, which is why the difference matters more here than the level of pain.

Typical time out: Three to six weeks in a thumb spica splint or cast for a partial tear, often with play continuing in a protective cast where the rules allow it. Six weeks to three months after surgical repair of a complete tear, with grip strength the limiting factor at the end.

See a doctor if: Get it assessed within days if pinch grip is clearly weak or the thumb feels unstable when pushed sideways, since a fully torn ligament rarely heals once displaced.

What helps

• Early examination by a clinician who can test the joint stability, ideally before swelling makes the test unreliable
• Thumb spica splinting for a stable partial tear, with the other fingers left free to move
• X-ray to check for a small piece of bone pulled off the base of the thumb
• Grip and pinch strengthening once the splint comes off, progressing to sport specific gripping
• Protective taping or a padded playing cast for the remainder of the season after return

First Aid for Soft Tissue Injuries: PEACE and LOVE

Sports medicine has moved on from RICE. The current guidance, published in the British Journal of Sports Medicine in 2019, splits care into the first days after the injury and everything that follows.

PEACE, the first two to three days

• Protect: unload the area and limit movement that hurts, but only briefly.
• Elevate: keep the limb above heart level when you can.
• Avoid anti-inflammatories: they may blunt the healing you need.
• Compress: a bandage or taping limits swelling.
• Educate: your body heals this on its own; passive treatments rarely speed it up.

LOVE, from day three onward

• Load: return to movement as pain allows, early loading builds tissue.
• Optimism: expectations shape recovery more than most people assume.
• Vascularization: easy cardio that does not hurt brings blood to the area.
• Exercise: restore strength, mobility and balance before returning to play.

Ice still helps with pain in the first hours. What changed is the evidence that long icing and routine anti-inflammatory drugs slow tissue repair.

How to Lower Your Risk in American Football

• Build heat acclimatization into the first one to two weeks of camp, adding pads and practice length gradually and adjusting work to rest ratios to humidity rather than air temperature alone
• Run a season long neuromuscular program covering landing, deceleration and cutting mechanics, since most cruciate ligament injuries in football happen without contact
• Train the hamstrings in a lengthened position with exercises such as Nordic curls and single leg deadlifts, because sprinting positions expose them at long muscle lengths
• Coach and rehearse tackling with the head out of contact and follow limits on full contact practice, which reduces both head and neck loading across the week
• Strengthen the neck and upper back through the season, so the head is decelerated by muscle rather than by the cervical spine
• Complete rehabilitation of the previous injury to measured strength targets before returning to contact, and keep helmets, shoulder pads and mouthguards fitted and checked as the season goes on

When to Stop and Get Medical Help

Most of the injuries on this page are treated at home. These signs are not.

• Any confusion, memory gap, loss of consciousness, seizure or a headache that keeps getting worse after a head impact
• Numbness, tingling or weakness in both arms, in a leg, or across the trunk after a collision, or midline pain over the bones of the neck or back
• A limb, joint or finger that looks deformed, or bone visible through the skin
• Inability to bear weight for four steps, or a joint that cannot be moved at all
• Skin beyond the injury that is numb, pale or cold, which suggests nerve or blood vessel involvement
• Disorientation, stumbling or strange behavior during heat, which is treated as exertional heat stroke until proved otherwise

Sources

• Kerr et al., Journal of Athletic Training (NCAA Injury Surveillance Program and High School RIO)
• Kerr et al., MMWR / CDC (NCAA Injury Surveillance Program)

This article is general information, not medical advice. If you are hurt, a doctor or physiotherapist who can examine you is worth more than any web page. Last reviewed: August 2026.

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