The use and modification of injury prevention exercises by professional youth soccer teams

Abstract

The efficacy of injury prevention exercise programs (IPEPs) for amateur youth soccer has been established, but little is known about their adaptability to other soccer populations. This study aimed to assess the use of individual injury prevention exercises by professional youth soccer teams, against the industry‐standard, FIFA 11+ program. Four teams' chosen IPEPs were observed across one season and documented on a standardized form. The use of each FIFA 11+ exercise was coded as “performed”, “performed modified” or “not performed”. The proportion of the 160 observed sessions containing each individual exercise was calculated. Staff provided reasons for their use and modification of FIFA 11+ exercises. On average, individual FIFA 11+ exercises were conducted in original form in 12% of the sessions (range 0–33%), and in modified form in 28% of sessions (range 2–62%). The five most frequently observed exercises, in either original or modified form, were “bench” (72%), “squats” (69%), “running straight” (68%), “single‐leg stance” (66%), and “sideways bench” (64%). Staff modified exercises to add variation, progression, and individualization, and to align with specific training formats and goals. Professional youth soccer teams often use injury prevention exercises similar to those in the FIFA 11+, but tailor them considerably to fit their implementation context.

Rescheduling Part 2 of the 11+ reduces injury burden and increases compliance in semi‐professional football

“…Despite the success of the 11+ program in reducing injury incidence in football, 11 a number of barriers exist which limit implementation of the program. 15,16 This study shows that the simple act of rescheduling Part 2 of the 11+ program to the end of training significantly improves 11+ compliance while maintaining the overall effectiveness of the 11+ program. Additionally, rescheduling appeared to impact directly upon severe injury incidence, reducing the number of days lost to injury for the most common injuries in football.…”

“…Performing the exercises contained in Part 2 of the 11+ before training is the source of most concern for practitioners and is the most modified component of the 11+. 15 As such, investigating methods to improve compliance and effectiveness of exercises in Part 2 of the 11+ program such as the Nordic Hamstring Exercise (NHE), which is known to reduce the risk of hamstring injuries, 37 is important for improving adoption. 38 Previous research has suggested that the scheduling of the NHE has no impact upon chronic strength gains, albeit the muscle architectural mechanism seems to differ.…”

“…12 However, despite the proven effectiveness of the 11+ program, only 10% of FIFA's member associations have endorsed the program and several studies highlight low 11+ program compliance. [13][14][15] Poor adoption and compliance rates of the 11+ program have been explained by (a) the time required to complete and boredom associated with the program, 10,16 (b) fatigue and soreness caused by exercises contained in Part 2, 10,[15][16][17] and (c) a lack of awareness and knowledge of how to perform the program. 16,18 Furthermore, given the importance of strengthening exercises in reducing injury risk, 19 it is concerning that research has shown that the strengthening exercises performed in Part 2 of the 11+ program are often modified or not performed.…”

“…16,18 Furthermore, given the importance of strengthening exercises in reducing injury risk, 19 it is concerning that research has shown that the strengthening exercises performed in Part 2 of the 11+ program are often modified or not performed. 15 Potential fatigue caused by the exercises in Part 2 may contribute to why compliance to the full 11+ program is poor, 15 with fatigue considered by practitioners to be a primary injury risk factor in football. 20,21 Interestingly, it has been found that performing an exercise in Part 2, the Nordic Hamstring Exercise (NHE), prior to football activity exacerbates eccentric hamstring fatigue, 22,23 although administering these exercises after training did not affect the exercise stimulus.…”

A Fraction of Recommended Practices: Implementation of the FIFA 11+ in NCAA Soccer Programs

“…A focus on the implementation of injury prevention programs in football and professional development for coaches has continued to grow in settings outside of American collegiate soccer. This has included studies of high school programs [20], professional youth teams [21,22], female adolescents [23,24], club-level teams [25], and a nation-wide effort across amateur teams [26]. These prior studies tended to focus upon developmental (youth or amateur) programs, although a dichotomy of professional versus developmental was noted within the professional youth setting.…”