Injury prevention programming, consistency is key!

Effect of the FIFA 11+ injury prevention program in collegiate female soccer players over three consecutive seasons.

Magoshi H, Hoshiba T, Tohyama M, Hirose N, Fukubayashi T. Scand J Med Sci Sports. May 21, 2023. doi: 10.1111/sms.14379. E-publishing prior to printing.

https://pubmed.ncbi.nlm.nih.gov/37211876/

Take home message

Over three seasons, injury prevention programs effectively reduce lower extremity injuries, especially those considered non-contact or moderate-severe.

Background

Injury prevention programs reduce the risk of lower extremity injuries. However, most studies have only examined the effectiveness of these programs over one season. It would be useful to verify whether these benefits persist if a team continues to implement an injury prevention program for multiple seasons.

Study aim

The authors conducted a non-randomized controlled trial to investigate the effectiveness of an injury prevention program (FIFA 11+) to reduce the risk of injury for up to three seasons among football teams in the Kanto University Women Football Association Division 1 (similar to NCAA Division 1).

Methods

Four teams agreed to run the FIFA 11+ program for 20 minutes before practicing 2-3 times a week. Three teams refused to agree to the program and represented the control group. Each team’s athletic trainer or physiotherapist recorded sports-related injuries, participation in training/matches and how often a team completed FIFA 11+. The authors defined a sports injury as an injury that causes a player to miss at least one day of training or competition.

Results

Adherence to the FIFA 11+ program was high (~88%). Compared to the other teams, the teams implementing the FIFA 11+ program have reduced the number of new injuries in a season by 36 to 61% – especially for non-contact, moderate or lower extremity injuries. Teams running FIFA 11+ may achieve better results each subsequent season (e.g. lower rate of new injuries in Season 2 versus Season 1), but this may be mainly due to the athletes who were on each team all three years.

Viewpoints

This study adds to the many previous randomized clinical trials showing that injury prevention programs reduce the risk of lower extremity injuries within a single season. This study provides good evidence that injury prevention programs can be effective over three seasons, especially for athletes who complete the program for all three years. It would be interesting to see the incidence of injuries in male football players and other sports associated with lower extremity injuries. Furthermore, it would be useful to confirm these results with a cluster-randomized clinical trial with a larger sample size to verify that athletes who perform FIFA 11+ continuously over multiple seasons experience greater protective benefits each year. Based on this research, it is unclear whether the benefits are due to the very high compliance rates (~88%), which is likely because teams actively decided to start the FIFA 11+ program rather than being randomly assigned to complete it program to execute. This highlights a major benefit of convincing a team to implement these programs.

Clinical implications

Clinicians should recommend that teams incorporate injury prevention programs into weekly team activities.

Questions for discussion

1. We often hear that a lack of time or coaching support for these programs is a barrier. WWhat are some strategies we can implement to combat this problem?
2. Would incidence remain low with a once-a-week approach if maintained during the off-season?

related posts

Coach the coach, make ACL injury prevention programs stick!
Injury prevention warm-up programs, one size fits some?
Back-to-school injury prevention programs
Forget about 7 minutes of Abs. What about the 10-minute lower extremity injury prevention program?

Written by Shelly Fetchen DiCesaro
Reviewed by Jeffrey Driban