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When is More Too Much?: Part 2 By Michael Golisano, PT, DPT, FAFS As we had mentioned in part one of this article, no one can go 100% in a single sport year round without risking significant injury. When you hear your kids complaining of pain in their shoulder, knee, ankle, etc. after playing sports do not expect this pain to get better over time, especially when there is no rest period! These acute injuries can quickly become chronic problems that may lead to decreased playing time, further injury, injury in another area, or even surgery. That being said professional soccer players are also seeing a significant rise in overuse injury as a result of athletes trying to perform in too many games in a short span of time. There have been several studies that have focused on fatigue and chronic injury during soccer matches. One such recent study published in The American Journal of Sports Medicine looks at the recovery duration, physical performance, and injury rate in male elite soccer players. Elite soccer players participate in national cup matches, UEFA (Union of European Football Association) Champions League and/or UEFA Cup matches, and international cup matches. For these players it is common to play 2 matches per week over several weeks. The study showed that the recovery time between 2 matches, 72 to 96 hours apart, appears to be sufficient to maintain the level of physical performance but is not long enough to maintain a low injury rate. In fact late September during a Series A league match, Lazio lost to AC Milan 2-0 primarily because they had to play with 10 men for thirty minutes. In FIFA regulated soccer matches, the coach is only allowed three substitutes per match. Lazio witnessed four men limp off the field with a variety of pulled or strained thigh muscles after the club played their third game in eight days. So not only are we seeing increased chronic pain/injury in our young athletes but even the pros, who have round-the-clock elite care, are beginning to run into the same types of issues.