Five-a-Side First Aid: Beyond the Magic Sponge

First Aid
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Nearly two million people in the UK play football at least once a week. For some, it’s the only chance to exercise and offset dietary excess, but it’s often the cause of injuries – up to between nine and 35 of them per 1,000 hours of football in adults, estimates, which can mean a hamstring popped or ankle rolled every 29 games.

In most cases, first aid by a team-mate offers your best hope of recovery, but 43% wouldn’t be confident enough to perform it. Tracey Taylor from the British Red Cross explains what you should and shouldn’t do. Grab the magic sponge, it’s time to play doctor…


A headache, cramp and dizziness are tell-tale signs. If you manage to catch it early, you can carry on after isotonic refreshment with fluids, electrolytes and salts. But if your body overheats to dangerous levels, your organs will start to shut down, you’ll stop sweating and become unresponsive.

Taylor says: If it’s progressed to heat exhaustion, headaches will be severe, they may be dizzy, confused, very pale and sweaty. Move them into shade and get them to replenish fluids – isotonic drinks are best but water, tea or milk are better than nothing. Any concerns, call the NHS non-emergency number 111.


These aren’t life-threatening, but could cost you at the end of a tight match. A stitch is cramp of the diaphragm. If your player pulls up with a tight calf don’t get them to tense the muscle. It’ll go into spasm; you’ll chuckle, they’ll curse you.

Taylor says: Help them stretch the muscle and massage it gently.

Ankle Sprain

Despite the bowling green surfaces of modern five-a-side pitches, rolling, turning or twisting an ankle is still the second-most common football injury. They can balloon up in seconds like something out of The Elephant Man. Try not to gasp in horror. If they’re not in too much pain, help them to the sidelines.

Taylor says: Get ice on it to reduce swelling and pain. Don’t make them play on or take their shoes and socks off to examine it. If you think it might be broken, keep it still and supported.

Dead Leg

Impact, typically from the knee of an overzealous opponent, has probably crushed the muscle against the bone, causing a tear in it or the sheath surrounding it. Mobilising the muscle will bring more blood to the area, more swelling and often more pain.

Taylor says: If it’s too painful to run on, get them off the pitch. Apply ice and compression.

Broken Bone

Compound fractures, where the skin is pierced, can be nightmares. There’s a risk of medical shock, which can happen in thigh-bone breaks when a lot of blood can be lost, depriving organs of oxygen. In severe cases paramedics may give them “gas and air” that includes Entonox, a painkiller used for women in labour.

Taylor says: Keep the limb still and supported. If necessary, call for an ambulance. If it’s a bad break they might be cold, so keep them warm. Get them to lie down and raise the uninjured leg to redirect blood to their organs. Don’t give them food or drink – their stomach will be doing somersaults, and if they need surgery later, this isn’t wise.

Twisted Knee

Knee cartilage or meniscus tears are the third-most common injury, regardless of pitch surface or if you’re playing in astros, moulds or studs. In the worst case, it’s ligaments. If the latter, don’t let them drive home. Their leg might function as normal – until they need to brake.

Taylor says: Ask them how it happened. If – between yelps – they describe a popping or snapping sensation while the knee swivelled, they’ve probably damaged the ligaments. Get ice on it quickly to ease the pain and take them to hospital.

Hamstring Strain

The most common injury in the game, there were 185 in the 2015-16 season of the Premier League. If a player on your pitch pulls up as if they’ve been shot (and you’re sure they’re not trying to con a referee) there’s a chance that it could be a grade-three tear. The muscle is completely torn and there might be a large lump of muscle tissue bunched
up above the rupture.

Taylor says: Follow the RICE protocol. Rest, ice, comfortable support and elevate. Help the player off the field, apply ice wrapped in a T-shirt to protect the skin from ice burn, for 10-20 minutes spells to reduce swelling and raise the leg above heart level.

Head Impact

The no-overhead height rule should limit the risk of a clash of heads, but a player could be just as vulnerable to an elbow.

Taylor says: Apply something cold to the bump to reduce swelling. Press on a cut with a T-shirt to stem the bleeding. Ask them how it happened; if they’re drowsy, dizzy, confused or vomiting it could be a brain injury. Ring for an ambulance. Avoid painkillers – they can sometimes mask a serious head injury.


No matter how many episodes of Casualty you’ve watched, resist the urge to pop it back in yourself, or you could trap nerves, cause more damage, resentment and the long-term loss of a five-a-side regular.

Taylor says: Keep them still and the limb supported until an ambulance arrives. If the shoulder, fold up their shirt to act as an impromptu sling.


When Fabrice Muamba collapsed in 2012, his heart stopped for 78 minutes. He was kept alive by paramedics and a consultant cardiologist in the crowd.

Taylor says: The first few moments are crucial. If they’re unresponsive, tilt their head back and look, listen and feel for signs of breathing. If none, get someone to call an ambulance and fetch an automated external defibrillator (AED). Start chest compressions: push up and down on the middle of their chest at roughly two per second until the AED or paramedics arrive. Don’t worry about breathing; adults should have a residual amount of oxygen in their bodies to supply their organs.

If they’re breathing, put them in the recovery position on their side with their head tilted back so they won’t choke on vomit or saliva.

The British Red Cross is calling on footballers to watch and share the #UpYourGame first aid video. For more information, visit and download the First Aid by British Red Cross app (iOSAndroidWindows).

Sam Rider

Sam Rider is an experienced freelance journalist, specialising in health, fitness and wellness. For over a decade he's reported on Olympic Games, CrossFit Games and World Cups, and quizzed luminaries of elite sport, nutrition and strength and conditioning. Sam is also a REPS level 3 qualified personal trainer, online coach and founder of Your Daily Fix. Sam is also Coach’s designated reviewer of massage guns and fitness mirrors.