Does the FIFA 11+ Injury Prevention Program Reduce the Incidence of ACL Injury in Male Soccer Players?
Level 2 - randomized trial
Individual cluster randomized controlled trial
PubMed 28389864 · doi:10.1007/s11999-017-5342-5
What was done
A prospective cluster randomized controlled trial evaluated the FIFA 11+ dynamic warm-up program (15–20 minutes before training and games) over one competitive season across NCAA Division I and Division II men's soccer teams. Sixty-five teams were randomized: 34 control teams (850 players) and 31 intervention teams (675 players). Four intervention teams did not complete the study due to time constraints, leaving 61 teams for per-protocol analysis. Compliance, athletic exposures, knee injuries, ACL injuries, and time loss were tracked via an internet surveillance system and verified by certified athletic trainers.
What was found
Athletes in the intervention group had significantly fewer knee injuries (25% [34/136]) compared with the control group (75% [102/136]; RR 0.42; 95% CI, 0.29–0.61; p < 0.001). For ACL injuries specifically, fewer occurred in the intervention group (16% [3/19]) than the control group (84% [16/19]), representing a 4.25-fold reduction (RR 0.236; 95% CI, 0.193–0.93; NNT = 70; p < 0.001). Subgroup analyses showed no significant differences for game vs. practice settings (games: RR 0.31; 95% CI, 0.09–1.11; p = 0.073; practices: RR 0.14; 95% CI, 0.01–2.59; p = 0.186), player position (p = 0.327), Division I play (RR 0.30; 95% CI, 0.06–1.45; p = 0.136), or overall grass vs. turf interaction (p = 0.492). However, significant reductions were observed in Division II play (RR 0.12; 95% CI, 0.02–0.93; p = 0.042) and specifically on artificial turf (RR 0.14; 95% CI, 0.02–1.10; p = 0.049).
Why it matters
This study demonstrates that consistent implementation of the FIFA 11+ warm-up routine can substantially lower knee and ACL injury incidence in competitive male collegiate soccer players.
Limits
Four intervention teams dropped out due to time constraints, resulting in a per-protocol rather than intention-to-treat analysis. The absolute number of ACL events was small (19 total injuries across all cohorts), leaving subgroup analyses underpowered with wide confidence intervals. Findings are restricted to male collegiate athletes followed over a single season.
Cited by
- supports FIFA developed a validated neuromuscular warmup and hopping program that significantly reduces lower extremity and ACL injuries in soccer players.