Dr. Ayoosh Pareek is a board-certified orthopedic surgeon at Hospital for Special Surgery (HSS), specializing in sports medicine and complex joint reconstruction. His vast experience of football has won awards and involved taking care of both recreational and elite athletes, having been a team doctor for the New York Mets and New York Knicks.
Now focusing on sports injuries of the hip, knee, and shoulder, Pareek collaborates closely with strength coaches, trainers, and physical therapists to help athletes return to, and maintain peak performance safely and efficiently. M&F put the pertinent questions to him so that you can stay on the field for longer, and train off the field smarter.
Thanks for taking the time, Dr Pareek. In your experience, how do football players typically train differently during the off-season, pre-season, and in-season?
Training Evolves Significantly Across These Phases:
In the off-season, players focus on recovery and rebuilding—addressing imbalances, regaining strength, and improving mobility along with building a base for the season either focusing on strength, endurance, explosiveness, or any other goal they may have (and sometimes a combination).
Pre-season training ramps up intensity and introduces more sport-specific or football-specific drills and conditioning.
In-season training emphasizes maintenance and injury prevention more than anything—maintaining strength and conditioning without overloading the body. Recovery, injury prevention, and managing the wear-and-tear of weekly games take priority during this time.
What are some of the most common injuries sustained on the football field that require recovery in the off-season?
Football is high-impact and physically demanding, so we frequently see ACL and meniscal (knee) injuries, shoulder labral tears or dislocations, but other injuries like hamstring strains, groin injuries, and high ankle sprains aren’t uncommon. These often require either surgical intervention or dedicated rehab to allow for full recovery before the next year’s demands.
Why do these injuries tend to occur?
Even healthy athletes are at risk if their training isn’t appropriately structured but overuse injuries—such as Achilles or patellar tendinopathy—are common if there’s too much load without recovery. Stress fractures can occur with excessive volume or inadequate nutrition. Soft tissue strains and joint overload are also concerns, especially if mobility and core stability are neglected.
So, how can players strategize the right mix of training and recovery?
An effective off-season should be broken into multiple phases based on the needs of the sports and individual athlete. The recovery phase immediately post-season focuses on rest, mobility, and rehabilitation. The rebuild phase follows, targeting strength, hypertrophy, and correcting biomechanical deficits. Finally, the pre-season phase ramps up explosiveness, position-specific drills, and simulates game conditions to ensure readiness for training camp. This is of course just a general recommendation as needs can often be more granular and individualized.
What mistakes do players often make with their training?
The most common mistake is ramping up intensity, too quickly. Players may neglect foundational work in favor of heavy lifting or high-impact drills, leading to preventable injuries. Tendons and ligaments often require much more time to strengthen than muscular hypertrophy, so injuries to those soft tissue structures are still possible even if athletes feel their muscles can handle the load or fatigue. Others overtrain without enough recovery or skip mobility and stabilization exercises, creating imbalances that become problematic under the demands of the season.
Where do you stand on stretching?
Static stretching before workouts can actually reduce performance and is no longer widely recommended. Instead, a structured dynamic warm-up is key. This prepares the body by increasing blood flow, activating muscle groups, and priming the nervous system. Static stretching is more appropriate post-workout or on rest days to improve long-term flexibility.
What are some of the best recovery methods for players?
Sleep is arguably the most effective recovery tool for most athletes and still underrated, although its value is becoming more recognized. Other than that, adequate rest and nutrition/hydration remain the most important staples. Active recovery through low-impact movements, like swimming or cycling, cold therapy, and soft tissue work (massage or foam rolling) can also help.
Are there any supplements that football players should consider taking?
Some evidence-based supplements include creatine, which supports strength and power, along with why protein. Other supplements such as omega-3 fatty acids to reduce inflammation, vitamin D for bone and immune health, and addressing personal nutritional deficiencies may be important. That said, players should always consult with a healthcare professional before starting any supplements and abide by sport-specific guidelines.
How should players train in the run-up to returning to training camps?
Training should become more football-specific in the final weeks before camp, to allow the ramp up to be more gradual. That includes high-speed running, deceleration, and directional changes. Conditioning should mimic the stop-start nature of football and likely focus more on interval training. Importantly, load should be increased progressively, and players should be exposed to contact or high-intensity scenarios gradually as impact activities are particularly high risk for injury.
Once the next season begins, what further challenges do players face?
At the start of a season, we often see hamstring and groin strains, along with soft tissue injuries. These typically occur from inadequate ramp-up, fatigue, or poor movement mechanics. Proper progression, dynamic warm-ups, and individualized workload management can help reduce early-season injuries significantly.
So, what’s your take home message for longevity in football?
Longevity in football depends on training intelligently, valuing rest as much as effort, and addressing minor injuries before they escalate. It’s consistency that keeps athletes and other high achievers performing at the highest level for years!
