It’s soccer season!

For most of us this means grabbing our cleats, jerseys and water bottles and heading out to the field. Unfortunately, for many it also means a new batch of injuries.

The most common soccer injuries occur in the lower extremities the ankles and knees. One of the more common and serious injuries is the dreaded ACL tear, or anterior cruciate ligament tear. A recent study found that ACL tears have an incidenceof 0.06 /1h of play (1)! When you extrapolate that into a whole season and the amount of people that play soccer that’s a lot of ACL tears occurring in this sport!

Good thing for us, the wise people at FIFA and their Medical Assessment and Research Center (F-MARC) have recognized this issue. In an attempt to prevent ACL injuries (and other lower extremity soccer injuries) FIFA designed a warm up prevention program (2).

Prior to 2010, the F-MARC noted that there was over 300 million people playing, refereeing, and staffing organized soccer worldwide (2). They noted that this number was growing annually and included over 40 million females, making it by far the most commonly played sport worldwide (2).  They also noted that soccer injuries could occur commonly both with and without contact (2). FIFA recognizing the sports growing popularity worldwide and its prevalence of injuries felt the social responsibility to try to keep the health and safety of all involved in the game (2).

These lead to the design of the injury prevention program FIFA 11+. This program was officially rolled out with the 2010 FIFA World Cup throughout all of the worldwide FIFA associations (2). A development program was used to educate coaches, trainers, referees and technical staff about the statistics, including what and how exercises should be done to prevent injuries.  The learning and development tools are still available today for free at FIFA’s official website.

The FIFA 11+ program consists of three parts Running Exercises 1 (focus on slow warm up), and Strength / Plyometrics / Balance and Running Exercises 2 (focus on high speed agility and cutting) (2).

The entire program should be incorporated into all warm ups and is approximately 20 minutes in length (2).  The program should be used prior to matches (Parts 1 and 3 only) (2). The downloadable PDF and video program breaks down the form and common errors of each exercise (2). The program has been validated in all players 14 years of age and older (1,2,3). FIFA 11+ has gained so much popularity in the last 8 years that most soccer association websites have links to this program directly.

A main reason for its gain in popularity is FIFA’s published data suggesting that their FIFA 11 + program could prevent the worst soccer injuries by 30-50% (50% reduction seen in injuries considered to be severe, 30% for all other injuries) (2).

Furthermore, many other scientific studies (with no affiliation to FIFA or F-MARC) found very similar results (1,3). Below is a chart from FIFA showing the prevalence of injuries with and without the FIFA11+ program:

With all this in mind May is a great month to start implementing some change in your warm up routines! Ask your coaches and makes sure an injury prevention program is in place! This will help keep you on the field and off the treatment tables!

If you have more specific questions or require help with certain parts of the FIFA11+ program, all SEMI physiotherapists and chiropractors are familiar with this program and we can assist you and even make the program more specific to your individual needs. Feel free to ask us we are here to help keep you well!

Valerie Naccarato Sp. Hons B.Sc M.Sc PT

1. G. Biscotti, K. Chamari, E. Cena, G. Carimati, P. Volpi  (2016). ACL injury in football: A literature overview of the prevention programs. Muscles Ligaments Tendons J, 6(4), 473-479. doi:: 10.11138/mltj/2016.6.4.473
2. M. Bizzini, A. Junge, J.Dvorak.  The 11+ Manual: A complete warm up program to prevent injuries. FIFA Medical Assessment and Research Centre.
3. D. Sadigursky, J. Braid, D.De Lira, B.Machado, R. Carneiro, P Colavolpe.  (2017) The FIFA 11+ injury prevention program for soccer players: a systematic review. BCM Sports Sci Med Rehabil, 9:18 doi::  10.1186/s13102-017-0083-z