Soccer demands a myriad of physical attributes, including speed, dexterity, and endurance—players run an average of seven miles per game. As the tournament intensifies and nagging injuries and fatigue become an issue, Dr. John Gallucci, Major League Soccer's medical coordinator, discusses how teams use training, diet, and rehab to give themselves the best shot to win it all.
MEN'S FITNESS: How do players’ training programs change to accommodate the more frequent playing and more intense matches?
John Galucci: Their strength and conditioning coaches grade them on a process to peak aerobically and strength-wise during the World Cup. They decrease their protocols in the last week going into the tournament. In the two weeks before the tournament, you saw a lot of players decreasing their playing time to save their legs.
MF: So injury prevention takes precedent over strength and conditioning?
JG: Correct. You go from guys who are used to normally playing 90 minutes a game, 75 minutes a game, to only really playing 30 or 45 minutes. The other thing they need to manage is the heat component; Brazil is a very humid, hot country, and there is a lot of concern about hydration among the athletes. There is going to be a huge emphasis on recuperation factors as the tournament goes on.
MF: How would an athlete's diet change going into the World Cup, or does it have to change at all?
JG: All of these guys are playing on professional clubs. Their nutrition and hydration, including their weight loss during games, all of that is calibrated. So now when you go into the World Cup, your medical staff will have all of that information of what normal losses are. We are a large running sport, so carbohydrates play a factor, but of course lean protein plays a huge factor in the recuperation of muscles. So when you see these guys right now in Brazil, all of their trainers and nutritionists have spoken to the hotels they are staying in—and this is done months in advance—so that teams can meet the dietary needs of each player while they are in the country.
MF: In this tournament what, in your opinion, is going to make or break a team?
JG: The U.S. team, for years in the last three World Cups, has been [one of] the fittest and strongest teams, yet we haven’t had the greatest results. But we have competed at a much higher level than we ever have before. The most important thing coaches are focusing on is “Where is the health of my team going in? Where are my forwards? Where are my midfielders?” And what a lot of spectators don’t realize is how much time and how much concern goes into how many minutes a player can give you in a game. Coaches will have those statistics to know which players have a quick turnaround time.
MF: Do you see more overuse injuries because these young guys have been playing for so long?
JG: There is no professional athlete who isn’t nursing some kind of injury that they have had in the last six months. Overuse injuries, which as we know are tendonitis—Achilles tendonitis, and patellar tendonitis—or a muscle strain because of fatigue, managing these becomes extremely important. The really good thing, though, is because they are professional athletes, they have the nutritionists, physiologists, and certified athletic trainers around them. When a staff of professionals communicates well and can modify a player’s training schedule, that’s where they’re able to keep them healthy and peaking for each game.
MF: There are new head trauma studies coming out all the time. Is this something to pay attention to in soccer or is this a bit overblown?
JG: Concussions in sport are prevalent. We are seeing a larger incident of concussion, and statistics are showing that. The really good—not that there is anything good about a concussion—but the really great thing is that research has shown us a true opportunity on how to treat a concussion and how to make sure an athlete goes back in the game, and back to practice in a more safe and efficient manner. Another thing research has taught us is that you don’t need to get hit in the head to get a concussion. We have learned that the velocity of the brain, if suddenly stopped, is going to hit off of the skull, which would cause a person to be concussed.
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MF: A lot of our readers—athletes or not—have knee injuries. What are some of the best rehab exercises for the knee?
JG: A standing squat is a great starting point for injuries to the knee and hip. You are basically increasing the strength of not only the hip musculature but also your knee musculature—your quads and your hamstrings. So when you look at a true functional athlete, a squat, and a split squat are two very functional activities that you can do to strengthen your lower body from your hip all the way down to your ankle. Plus there is a balance component to it, which is fantastic.
Dr. John Gallucci is the author of Soccer Injury Prevention and Treatment, available now on Amazon.