Injury Preventing Warm-Up for Soccer Players
In 2006, FIFA undertook the ‘big count’ and determined that 265 million people play soccer worldwide! In my opinion, the beautiful game is the BESTsport in the world! That being said, the incidence of injury is quite high among soccer players, in particular lower extremity injuries such as ankle sprains, hamstring and groin strains, and of course ligament injuries in the knee (Junge, A. et al., 2010). These injuries are not just seen in the short term, but can lead to serious long term health consequences, such as osteoarthritis (Solgard, T. et al., 2008). Further, 70% of these injuries occur without contact to another player (Junge, A. et al., 2010).
In May of 2014, the Canadian Academy Of Sport and Exercise Medicine (CASEM) released a position statement illustrating the importance of neuromuscular training programs in reducing anterior cruciate ligament (ACL) injuries among youth soccer players (Campbell, C. et al., 2014). Within the position statement, CASEM refers specifically to a program created by the FIFA-Medical Assessment and Research Centre (F-MARC) in 2003, called ‘The 11+’ (Campbell, C. et al., 2014). This program includes a complete dynamic warm up for boys and girls aged 14 and older composed of 10 evidence based exercises and the promotion of fair play (Junge, A. et al., 2010). The implementation of ‘The 11+’ in Switzerland lead to a 34% reduction of injuries on average, when performed twice per week during training sessions and prior to games (Junge, A. et al., 2010). Further, individual players with the highest rates of compliance had the lowest risk of injury, 45% reduction in overall risk of injury, and teams with coaches who had undertaken this training before, had an additional decrease in risk of injury (Soligard, T. et al., 2010). Additionally, coaches served as role models, and their attitude toward injury prevention significantly influenced their team’s participation in ‘The 11+’ (Sorgard, T. et al., 2010).
In order to reduce and prevent injuries incurred on the pitch, specifically non-contact injuries, our main focus must be improving awareness and neuromuscular control during standing, running, planting, jumping, and landing (Sorgard, T. et al., 2008). By implementing ‘The 11+’ program into our warm ups twice per week and prior to games, starting with young players, we hope to achieve improved strength, awareness, and neuromuscular control throughout static and dynamic movements and therefore decrease and prevent injury among our athletes (Sorgard, T., et al., 2008).
‘The 11+’ program can be found online at http://f-marc.com/11plus/home/ including instructional videos and handouts. Recent literature has found however, that there was a positive affect in the execution of ‘The 11+’ among coaches who undertook an educational workshop and had follow-up supervision of the delivery of the warm up program (Steffen, K., et al., 2013). CASEM advises that a ‘train the trainer’ model should be undertaken whereby a qualified health care professional delivers this information as part of the coaching program (Campbell, C. et al., 2014). CASEM further recommends that soccer teams collaborate with a qualified health care professional in the institution and monitoring of an injury-preventing program (Campbell, C. et al., 2014).
That being said, if you are interested in implementing ‘The 11+’ warm up with your team, please don’t hesitate to contact me, or another health professional who can happily ensure its proper execution!
Dr. Julia Callaghan, BSc (Hons), DC, ART®,
CSCS, Contemporary Medical Acupuncture
Campbell, C., et al. (2014). Canadian Academy of Sport and Exercise Medicine Position Statement: Neuromuscular Training Programs Can Decrease Anterior Cruciate Ligament Injuries in Youth Soccer Players. Clinical Journal of Sports Medicine, 24, 263-267.
FIFA. (2011). FIFA 11+ a complete warm up programme. Retrieved from: http://f-marc.com/11plus/11plus/
Junge, A. et al. (2010). Countrywide Campaign to Prevent Soccer Injuries in Swiss Amateur Players. American Journal of Sports Medicine, XX, (X, XXXX). Retrieved from: http://f-marc.com/11plus/downloads/
Soligard, T. et al. (2008). Comprehensive warm-up programme to prevent injuries in young female footballers: cluster randomized controlled trial. British Medical Journal, 337, (a2469). Retrieved from: http://f-marc.com/11plus/downloads/
Soligard, T. et al. (2010). Compliance with a comprehensive warm-up programme to prevent injuries in youth football. British Journal of Sports Medicine. Retrieved from: http://f-marc.com/11plus/downloads/
Steffen, K. et al. (2013). High adherence to a neuromuscular injury prevention programme (FIFA 11+) improves functional balance and reduces injury risk in Canadian youth female football players: a cluster randomised trial. British Journal of Sports Medicine 00. Retrieved from: http://www.ostrc.no/upload/Publication/Steffen_2013_BJSM_High%20adherence%20to%2011+%20improves%20functional%20balance%20and%20reduces%20injury%20risk%20in%20Canadian%20youth%20football%20players.pdf