The World Cup has begun, and the US Men’s National Soccer Team (USMNT) kicks off its first game today against Wales. As a doctor for US Soccer for the past eight years, I thought I would share some insight into everything that has gone into getting these world-class athletes ready to perform at their physical peak for the biggest games of their lives.
Soccer is a demanding, physical high-intensity sport, with a lot of sprinting, cutting, jumping, and change of direction. Over the course of an average international match, soccer players can run up to 10 miles and burn up to 3,000 calories. The game requires strength, stamina, power, and quick thinking, with hundreds of decisions being made during a game that make the difference between winning and losing.
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Players put more stress and physical load on their bodies than, for example, a runner who runs at one pace in one direction. Injuries unfortunately are part of the game, and players need to prepare their bodies for these demands.
To help the players manage all of this, the US team has assembled a fantastic Sports Science/ Performance department that works with the team to optimize nutrition, fitness, training load, recovery, and sleep.
Everything the players do gets monitored through GPS units that track various parameters, including accelerations and decelerations, distance detail, velocity, and other variables to customize and enhance performance and recovery for each player in each position. This all serves to optimize performance and recovery.
This work has been building over the past four to five years when players from the overall roster came in and the expectations were set as teams went through World Cup qualifying and the final roster slowly took shape.
So, what did that preparation entail, and what have the last several weeks looked like?
Besides all of the on-field soccer work and training, our team has used multiple training and recovery modalities to provide the athletes with an opportunity to heal their bodies and freshen their minds by giving them a mental change-up from their normal sports activity.
These modalities include flushing and massage to break down muscle tension and disperse any metabolic waste caused by high-intensity exercise, as well as physical therapy, cryogenic chambers to reduce inflammation and speed healing, float tanks, yoga, mental skills/meditation, and various physio treatments by the Sports Medicine staff. These are all used to help enhance and optimize recovery and performance. In elite athletes trying to quicken recovery from muscle/tendon injuries, platelet-rich plasma (PRP) may be used to accelerate recovery and healing.
The collective goal for the Sports Science Performance staff as well as the Sports Medicine staff is that players are at their healthiest form possible, ready for peak performance of strength, power, and endurance on match day.
Players have been building a base of core and functional strength for many years. Injuries may occur, but endurance and strength training, along with optimizing recovery, can be tools to reduce the chances of injuries, such as pulled muscles or ACL tears. Fitness work may include strength and endurance exercises, followed by interval training or sprint work. Ideally, the work is done earlier in the lead-up to a match, so players can focus on recovery and optimal performance in the final lead-up to match day.
Exercises that the players focus on include building functional strength for muscles used most for soccer and putting in extra time for any deficits/ tight areas detected by the Sports Science/ Performance staff in their daily screenings. Athletes use a variety of equipment, such as bands, physio balls, ropes, weights, and machines. They are working on balance, core strength, stride, and acceleration/explosiveness.
Recovery for elite athletes includes a variety of tailored modalities, including optimal nutrition, supplements, massage therapy, muscle work and various physio treatments, pneumatic boots, and topical treatments such as Kinesiology tape. Players are looking for the best, natural options for recovery.
Elite athletes such as the USMNT players must have an excellent nutrition plan in place to succeed.
I mentioned earlier that players can burn up to 3,000 calories a game. It is important that players replace these calories after each game. Having the right mix of carbohydrates, proteins, and fats depending on whether the meal is pre-match or post-match is also critical.
A good diet and the right nutrition can support intensive training while limiting the risks of illness or injury and are also important in the preparation for games and speeding recovery afterward.
Additional supplements, including certain amino acids, vitamins, and omega-3 fatty acids may be used to provide a comprehensive approach to the total diet.
Mental Health/Proper Mindset
Soccer is challenging because it is a mental sport as well as a highly demanding physical sport. It requires concentration, quick processing of information, and agile decision-making. Making sure that the brain is functioning well is an important factor when optimizing performance, and there is increasing evidence that the brain responds to certain foods.
A dedicated team is ensuring their mental and physical health is in top form. The Sports Science/ Performance staff and Sports Medicine staff embedded with the team in Qatar are dedicated groups of elite professionals working with the same collective goal to support our country and the elite players of USMNT.
The US is coming into the World Cup fit and ready. Recent sports media has mentioned a couple of high-profile USMNT players that had to work to overcome recent muscle/soft tissue strains. They have been building their fitness and are ready to go. All players have used the last week to optimize training and tactics, as well as rest, repair, and fuel their bodies for the grind of the games to come.
The coaching staff, including Manager Gregg Berhalter, and the entire US Soccer staff have done a tremendous job preparing the team for this moment. Nothing has been left to chance, and every detail has been considered – from the quiet oasis of their hotel, the magnificent Marsa Malaz Kempinski on a man-made island off the coast of Doha, to their private training facilities nearby with a game-quality field, to bringing a hand-selected, full-time chef.
There is much curiosity about this team and what it might be able to achieve. It is the second youngest team on the field, and its full squad has not been playing together for as long as some of the other teams, but its top players are playing in top international leagues. Most people know Christian Pulisic, but I’m excited for the world to see what up-and-coming players like Weston McKennie, Tyler Adams Yunus Musah, Gio Reyna, and Brenden Aaronson can do too.
Most importantly: this team is a brotherhood that believes in one another. They’re ready for their time to shine, and fans should be ready for the exciting spectacle of the World Cup. Go USA!!
Dr. Kevin E. Elder is a SummaForte advisor, a highly regarded sports medicine specialist, and a sought-after consultant in Tampa, Florida. Dr. Elder spent five years as a team physician for the NFL’s Tampa Bay Buccaneers. Currently, he’s a team physician for the US Soccer and US Ski teams, serves as an assistant team physician for the University of South Florida (USF) Athletics, and is a sports medicine consultant for the Tampa Bay Rowdies (USL), the Tampa Bay Rays (MLB), and Tampa Bay Lightning (NHL).
Dr. Elder has been in practice for 20 years in Tampa and has extensive experience in musculoskeletal ultrasound and regenerative medicine. He is one of the most experienced practitioners of platelet-rich plasma (PRP) and stem cell treatments in the US and works with a premier medical group in the Tampa Bay region. He is an Associate Clinical Professor at the University of South Florida. Assistant Clinical Professor for Florida State University, and Clinical Professor for South University