Rehab for RC Tears: Optimizing Recovery in Soccer Goalkeepers

USA goalkeeper Mandy McGlynn makes a save during the first half against Australia in the SheBelieves Cup at State Farm Stadium. Mandatory Credit: Mark J. Rebilas-Imagn Images

Soccer goalkeepers (GKs) occupy a unique physical role on the field, performing frequent overhead reaches, rapid dives, high-velocity arm actions when catching or parrying shots, and abrupt deceleration or impact on landing. These high-intensity actions repeatedly subject the glenohumeral joint and surrounding musculotendinous structures, particularly the rotator cuff (RC), to substantial mechanical stress. Goalkeepers experience a disproportionately larger burden of shoulder and elbow injuries compared with field players. In a National Collegiate Athletic Association cohort from 2009–2014, goalkeepers had a 4.6-fold higher incidence of shoulder and elbow injuries than field players, including RC tears and sprains (see figure 1)⁽¹⁾. Furthermore, researchers from the University of Barcelona found that upper-extremity injuries, including RC pathology, account for up to 20% of all goalkeeper time-loss injuries and are often linked to repetitive eccentric loading during dives and saves⁽²⁾.

“…a 4.6-fold higher incidence of shoulder and elbow injuries…”

Despite this elevated risk, rehabilitation recommendations for RC tears in soccer goalkeepers remain limited. Clinicians derive rehabilitation protocols from general shoulder injury research or from studies of overhead athletes, such as swimmers or throwers. Position-specific preventive and rehabilitative strategies, including adaptations of the FIFA 11+S shoulder program, primarily focus on prevention rather than on the treatment of established cuff tears^(3,4). Consequently, clinicians must integrate general evidence with goalkeeper-specific biomechanical demands to design effective rehabilitation programs.