Category Archives: medical

Subbing strategies in football

Throughout the years, I have witnessed nearly every type of substitution strategy there is in the book of football (aka soccer). One doesn’t have to be a referee to experience these ceremonial, sometimes odd, events. I am sure others, who have been around the game in other capacities (ex. fans, pundits), have observed similar strategic behaviors and perhaps, have normalized them as part of today’s game.

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Unfortunately, these behaviors are here to stay. FIFA, far from discouraging them, does little to properly equip referees with the adequate tools to combat such time-consuming subbing strategies. Some are team and tactical oriented while others are more individual and non-tactical in nature. In the end, they are all time-consuming and serve specific purposes. FIFA has gone as far as mandating additional time be taken to to deal with specific subbing scenarios involving certain player positions (ex. Goalkeepers) or certain injuries (ex. head).

Below, I attempt to explain and classify the possible tactical, psychological, and time-management considerations rather than actual medical reasons used during player substitutions. In some cases, I even provide (and illustrate) some recent examples.

Time Management/Game Management

This strategy normally occurs by the team which is leading late in the game; players oftentimes go down to slow the game tempo and allow their team to reset. It is characterized by a player drop right after the fourth official raises the substitution board (a convenient “pause” before the next phase) and it is intended to have any (or all) the following effects:

  • Disrupting the opponent’s momentum.
  • Providing tired teammates a brief breather before a defensive stand.
  • Allowing the coach to finalize substitution instructions or delaying play strategically.

Psychological or Face-Saving Mechanism

Being subbed off can be a blow to a player’s pride, especially if they have played poorly or disagree with the decision. This strategy is characterized by the player looking disappointed or glancing at the bench, then suddenly sitting down to clutch a leg or calf. It is intended to have the following effects:

  • Going down “injured” provides a socially acceptable excuse — “I’m coming off because I’m hurt, not because I played badly.”
  • It helps them preserve face with teammates, fans, and coaches.

Cristiano Ronaldo is known to use this strategy. Moments before the substitution board goes up, he briefly gestures discomfort, touching his leg. Sometimes, there is no real injury, but going down softens the optics of being replaced for tactical reasons. It allows him to preserve ego and control the narrative: “I came off for fitness reasons, not performance.”

This strategy is normally applied when time is not of the essence and the outcome is favorable to the team subbing; however, players like Ronaldo, Vinicius, etc. apply it whenever they deem it necessary.

Masking Fatigue

Fatigue (especially in high-intensity matches) can be extreme, but players often hesitate to admit exhaustion. This strategy is characterized by a late game cramping or calf-grabbing gesture, but the player walks off fine moments later. It is more popular in games played in extreme weather (ex. hot/cold, humid, rainy, etc.), that extend to over regulation or a series of games played over a short duration (ex. tournaments). It is intended to have the following effects:

  • Falling to the ground signals to the bench: “I’m completely done” without directly saying so.
  • It gives the physio a reason to check the players (hydrate them) and the coach a window to substitute without appearing to replace a “fit” player (gives an out to the coach).

Players know their bodies best and sometimes they can plow through fatigue albeit risking a more severe injury (ex. overload) that could sideline them for a longer period of time. Therefore, players take the precautionary route, subbing themselves out and hoping to be available for the team soon. Coaches also welcome this honest strategy with open arms as fatigue is not always conspicuous. That said, if the outcome of the game does not go as intended for the team, the coach can always claim that the “unexpected” subs impacted initial technical/tactical game plans.

Tactical Reset Opportunity

A brief pause before a substitution allows a team to regroup. This strategy is characterized by the physio jogging on to the field but no treatment occurs. Since the sport is designed to have very few pauses for coaching, this brief pause provides the coach time to shout instructions from the sideline to specific players. It is intended to have the following effects:

  • The manager can use the break to relay tactical instructions to several players.
  • The incoming substitute gets more time to warm up or receive final guidance.

Pep Guardiola is the master of this strategy. In Guardiola Manchester City’s system controlled pauses are gold. Players often blatantly sit down just before a tactical substitution late in matches. It’s rarely coincidental — Guardiola uses these moments to reorganize his press or formation. The physio goes on, but the real value is the 30-second team huddle at the touchline.

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Disrupting Opponent Rhythm

If the opponent has momentum (sustained attacks or pressing high) a pause can interrupt their flow. This strategy often occurs after the opposing team has just missed a big chance or started dominating possession. It is intended to have the following effects:

  • The emotional and physical rhythm of the attacking team is broken.
  • The defending side can reset shape and composure.

This strategy is very common in competitive matches where one goal is all that is needed to achieve a milestone (ex. win, tie, advancing to next phase) and it’s exacerbated if the team needing to score is continuously applying offensive pressure. The team on the defensive stance often resorts to this strategy to defuse momentum while catching a breather. In the 2023 U20 Men’s World Cup matches, US Coach Mikey Varas instructed Goalkeeper Gaga Slonina to go down late in the second half of most games. This pause would allow Coach Varas and staff to talk to the group. A player substitution was not always conducted.

Cynical / Theatrical Gamesmanship

In some competitions or teams, it’s a deliberate part of “dark arts” (subtle manipulation of the game). This strategy is characterized by a player dramatically sitting or lying down right before their number goes up for a substitution, then sprints off the pitch seconds later. It is intended to have the following effects:

  • Delays play.
  • Allows tactical conversations.
  • Sends a message that the player gave “everything” and is being replaced only because of that “effort.”

An excellent example of this strategy is Atlético de Madrid’s Coach – Diego Simeone. When Atlético are defending a late lead, players often “cramp up” in sync. A player goes down dramatically just before being replaced burning seconds and slowing opponents’ tempo significantly. Pundits call Simenone’s strategy “masterful gamesmanship” acknowledging it as part of a systemic tactical culture which include time-wasting, tactical fouls, simulating injuries, sideline theatrics, and using psychological tactics to frustrate opponents. This approach has earned Atlético the reputation of being masters of “shithousery” and made them one of the most difficult teams to play against in Europe. Diego Simeone transferred his shithousery as a player and perfected the art as a coach.

Preemptive Injury Precaution

Sometimes a player feeling slight tightness or discomfort (ex. hamstring twinge) may go down to prevent worsening it. This scenario is common late in matches or congested fixture schedules. It is intended to have the following effect:

  • Even if it’s not a true injury, it’s a protective signal — “I felt something; better to come off now.”

It is similar to fatigue but with potential longer lasting effects. Explosive players like Kylian Mbappé who are prone to injuries have used this strategy often. At PSG, Mbappé would gesture discomfort and would sit down before being subbed off. In reality, he was not injured but felt tightness in his hamstring — later confirmed by the manager as precautionary. It’s common for players who partake in multiple matches a week to “go down” preemptively to avoid aggravating micro-injuries. Knowing your body is instrumental for a longer and healthier career in any sport.

In summary, when a player collapses before a substitution without being truly injured, it’s usually about controlling tempo, face-saving, or tactical delay — not deception in the malicious sense, but part of the gamecraft that elite players and managers use to influence moments and margins. In practice, these strategies are used widely not just by elite players but all the way down to the amateur level.

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Cryo or compression therapy for a football (soccer) player?

Cryo and compression are two popular therapies used in sports recovery. Our family uses both; however, given its portability, we have used compression therapy more frequently. We own two sets of Hyperice Normatec leg sleeves in Germany and Spain respectively. At home, we use Cryonation where both therapies are readily available for the family. While both methods have advantages beyond sports recovery, let’s compare and contrast them with respect to football players specifically.

Joana and myself doing a 20 minute session of leg compression at CryoNation

Compression therapy

Compression therapy is a common treatment to help improve blood flow in your lower legs. There are three types of compression therapy: compression stockings, bandages and wraps, and inflatable devices. Below, we will address some of the benefits of inflatable devices (leg sleeves) as those are the ones most commonly used by athletes.

Enhanced Circulation: Leg air compression devices use sequential pressure to promote blood flow and lymphatic drainage. This can help remove metabolic waste products such as lactic acid and reduce inflammation, facilitating faster recovery and reducing muscle soreness.

Reduced Muscle Fatigue: Compression helps reduce muscle vibration during physical activity, leading to decreased muscle fatigue. By stabilizing the muscles and reducing microtrauma, leg air compression can help football players maintain their performance levels for longer periods.

Quicker Recovery: The improved circulation and lymphatic drainage provided by leg air compression can accelerate the recovery process by delivering oxygen and nutrients to the muscles while removing metabolic waste. This can help football players recover from intense training sessions and matches more rapidly.

Injury Prevention: Compression garments provide a supportive effect, helping to stabilize muscles and joints. This can reduce the risk of muscle strains, sprains, and other injuries during football activities. By applying consistent pressure, leg air compression can also help prevent swelling and edema.

Travel Aid: Football players often experience long journeys for matches or tournaments (college soccer players), which can lead to swelling and discomfort in the legs. Leg air compression can improve circulation and alleviate these symptoms, making it a useful tool for travel recovery.

Cryotherapy

Cryotherapy, which involves exposing the body to extremely cold temperatures for a short duration, has gained popularity in various sports, including football. While individual experiences and opinions may vary, here are some potential benefits of cryotherapy for football players:

Jogo doing at full body Cryotherapy session

Enhanced Recovery: Cryotherapy may help accelerate the recovery process by reducing inflammation and muscle soreness. Exposure to cold temperatures can constrict blood vessels, which can help reduce swelling and promote faster healing after intense training sessions or matches.

Pain Relief: Cold therapy can act as a natural painkiller by numbing nerve endings and reducing pain sensitivity. Football players often experience muscle strains, joint soreness, and general fatigue, and cryotherapy may help alleviate these discomforts.

Improved Performance: Cryotherapy may enhance performance by increasing alertness and reducing fatigue. The sudden exposure to extreme cold stimulates the release of endorphins, which can boost mood, energy levels, and mental focus. This may be particularly beneficial before important matches or during periods of intense training.

Decreased Muscle Damage: Intense physical activity like football can cause microtrauma to muscles. Cryotherapy may help limit the extent of muscle damage by reducing metabolic activity and slowing down cell death. This could potentially lead to faster muscle repair and less severe muscle soreness.

Psychological Benefits: Cryotherapy sessions often involve brief exposure to extremely cold temperatures, which can be mentally challenging. Soccer players who incorporate cryotherapy into their routines may develop mental resilience, discipline, and a sense of accomplishment, which can be beneficial for their overall performance.

It’s important to note that while cryotherapy has potential benefits, scientific evidence supporting its effectiveness in football players is limited. Individual responses to cryotherapy may vary, and it’s always recommended to consult with a qualified healthcare professional before implementing any new treatment or therapy.

Cryotherapy vs Compression therapy

Convenience: Leg air compression devices are portable and can be used anytime, anywhere, whereas cryotherapy normally requires access to specialized equipment or facilities. This makes leg air compression more accessible and convenient for football players. However, there are now companies like TIDL which have introduced portable cryo products like the ones pictured below.

Cost: Leg air compression devices are generally more affordable than cryotherapy sessions, especially considering long-term use. Cryotherapy often involves per-session costs, making it a more expensive option. At the writing of this document, a pair of Hyperice Normatec leg sleeves costs around $700-$900 and a single session of cryo therapy costs around $15-$35 each.

Targeted Recovery: Leg air compression provides localized compression to the legs, targeting specific muscle groups. In contrast, cryotherapy involves whole-body exposure to cold temperatures. Depending on the specific needs of a football player, one method may be more suitable than the other.

Pain Relief: Cryotherapy is known for its analgesic (pain-relieving) effects, which can be beneficial for acute injuries or intense soreness. While leg air compression may alleviate muscle soreness, it may not have the same immediate pain-relieving properties as cryotherapy. Those old-timers who have been watching football for decades will remember the old times when club trainers would come onto the field to assist an injured player, they would apply a form of high-pressure, cold spray to the injured area. Suddenly, the footballer would be back on his feet as the pain was numbed momentarily allowing the footballer to proceed the match.

Personal Preference: Some athletes may have a preference for one method over the other based on personal experiences and comfort. It’s important to consider individual preferences when choosing between leg air compression and cryotherapy.

Ultimately, both leg air compression and cryotherapy have their merits. Leg air compression is particularly advantageous for improving circulation, reducing muscle fatigue, and aiding in recovery, while cryotherapy may be more suitable for pain relief and acute injury management. Football players can choose the method that aligns with their specific needs, preferences, and resources.

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