Heat, humidity and flexibility are all risk factors for pulls and strains in top athletes.
The first week of the World Cup in Brazil has seen a rash of injuries to star players: Jozy Altidore of the United States, Brazil's "Hulk," as well as starters for Italy, Germany and Portugal. Is it the Brazilian heat and humidity, opening game nerves, or is something else going on?
Sports medicine experts say that it's likely a combination of factors including players that are adapting to a new environment for the four-week championship tournament. U.S. Soccer team physician George Chiampas said the muscle injuries Monday to Altidore and Matt Besler -- and broken nose of forward Clint Dempsey -- are part of every professional soccer game.
"That's why you have 23 players," Chiampas told Discovery News from Sao Paulo. "There are things out of your control. You have to prepare for that and it's part of the World Cup. Everybody understands that."
Chiampas said some games finish with no injuries, while others leave players bloodied with cuts and other kinds of injuries. "It's difficult to predict," he said.
Chiampas and other members of the medical staff have been preparing the U.S. Men's National Team for several months for the rigors of Brazil's climate, including training camp in Stanford, Calif., and several days in the swampy conditions of Jacksonville, Fla., right before arriving in Sao Paolo.
Still, pre-tournament fatigue could be a factor. Some players, like Altidore, have just completed eight or nine months of a brutally tough European season. Others, like Dempsey, are only a few months into their domestic Major League Soccer schedule. They might be more rested and ready.
"Every team is trying to get their athletes to ideal readiness," said Stephen Rice, director of the Jersey Shore Sports Medicine Center. "They also want to get fit and that means pushing up to the edge. The margin for stepping over the edge can get tight."