Professional players want to prevent injury – but don’t know how to do it…

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While players and staff in professional football teams are keen to try to prevent injuries, there is a limited understanding about what works and how to implement prevention programmes.

While there is overwhelming evidence regarding the benefits of injury prevention programmes (like the 11+), injury rates in professional football continue to increase. While it is possible that this is due to the intense demands associated with playing football at an elite level it is also possible that this increase might be related, at least in part, to a lack of effective injury prevention processes at professional clubs.

In this study players, coaches, fitness coaches and physiotherapists from four professional football clubs were invited to participate in an online survey. The survey asked about perceptions relating to lower limb injuries and the value of injury prevention programmes (including the 11+).

Study participants overwhelmingly expressed their concern about the high susceptibility to lower limb injuries in professional football, as well as the impact that these injuries have. While there was a general feeling that injuries could be prevented, there was a lack of understanding about the implementation of these programmes. Most of the staff members surveyed believed that injury prevention was the responsibility of the playing group – rather than the coaches and team medical staff. This contrasts with data which has demonstrated the importance of the coach for fostering compliance. The uptake of the 11+ programme was very poor (only 2% of respondents reported their team doing this) despite it arguably being the best validated single injury prevention strategy in football. Based on the feedback from this sample the length of the programme and a lack of variation appeared to be reasons for the poor uptake.

The results from this study show there is a high level of interest in the prevention of injury in professional football. It is likely that current injury prevention programmes need to be modified to address the needs of professional players and staff. Further education might also be useful.

To learn more about injury prevention in football complete Mario Bizzini’s “Injury Prevention” module in the FIFA Diploma in Football Medicine.


1 O’Brien J and Finch CF. Injury Prevention Exercise Programs for Professional Soccer: Understanding the Perceptions of the End-Users. Clin J Sport Med 2017;27:1–9

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20 février 2018 19:29

L un des piliers de la médecine du sport c est la PREVENTION
Dans la pratique du sport de haut niveau plus particulièrement le FOOTBALL la gestion de la PREVENTION des blessures incombe au staff médical an préparateur physique
Dans le staff médical le kinésithérapeute et le masseur jouent un rôle prépondérant dans la PREVENTION des blessures sans oublier le rôle du DIÉTÉTICIEN qui n est pas le moindre
Les sportifs doivent aussi avoir une vie saine
Dormir à temps et éviter la consommation de l alcool et du tabac
La PREVENTION est un moyen efficace pour éviter les blessuresb7

25 janvier 2018 11:38

Foot ball is a balanced sport it needs cardiorespiratory, muscle endurance, speed, strength and power, balance, agility and also it is a contact sport so there is a high chance to get the injury therefore it needs proper training with endurance, speed, balance and agility, core muscle strengthening, jump and landing techniques like fifa11 + program but also need sports nutrition, pre and post competition meal, psychology parts of injury prevention but the players mostly concentrate on their foot ball skills training, so we should educate the players about the importance of foot ball injuries program and also nutrition psychology… Lire la suite »

Zaza Telia MD
28 janvier 2018 7:04

In 2017 UEFA U-19 men championship was held in Georgia. I was tournament doctor and pitchside doctor for some matches, including the final. The participants were the teams like England (which won the tournament), Netherland and Portugal. I would like to say that none of the teams implemented FIFA11+. I am not talking about my country ( definetely lack of education and knowledge). I think that we should worry about this. FIFA11+ is the only injury prevention programme on which the meta-analysis has done and it demonstrated significant good results.

Mark Fulcher
31 janvier 2018 9:37
Reply to  Zaza Telia MD

Good feedback Zaza.

Professional clubs often prefer ‘new’ or ‘fancier’ options. While these may potentially be effective, the lack of evidence regarding their efficacy is a little concerning. There is some great work looking at eccentric training for hamstring prevention. Despite compelling evidence regarding their efficacy of this exercise it is not widely done by professional teams. This is despite hamstring injuries being one of the most common time loss injuries and injury rates (as documented in the UEFA Champions League).

Hamza Ben Maaoui
01 février 2018 12:00
Reply to  Mark Fulcher

Hi Dr Fulcher , can you give us the exact time of the first 11in11 session ? thanks

Mark Fulcher
09 février 2018 0:21

Hi Hamza. We have had a few technical issues – and so this was delayed by a few days. It has now been posted on the 11in11 page. These are recorded and will be available on an ongoing basis. A new talk will be posted each month.

zaza telia
31 janvier 2018 15:09
Reply to  Mark Fulcher

Thank you Mark for your opinion. I’m at the conference of UEFA in Athens right now. Today there was a presentation about muscle injuries. I’m little bit frustrated because the presentator hasn’t discussed injury prevention and treatment exrecises, for example the importance of hamstring strengthening and stretching for the treatment of this muscle injury. Despite this, regarding treatment of muscle injury she mentioned medication like Actovegin, Traumeel and PRP. Where is the evidence regarding this medication, I wonder??

Mark Fulcher
09 février 2018 0:18
Reply to  zaza telia

These fall under the « new and fancy » category. They are widely used – but lack quality evidence. Here is a high quality RCT that shows PRP does not work for hamstring injuries. No evidence for active gin or Traumeel despite them being widely used in professional players.

24 janvier 2018 14:24

Players need to be brief on health related to injuries, can health a lot maintaining the habits concerning injuries. Meaning more needed to be done especially in Africa in order to prevent injuries in our professional football.

Dr sreenath .s
15 janvier 2018 15:48

There are reference regarding Ayurvedic massages /musculofacial release practised since 5000yrs as a daily regimen .ayurveda is more of preventive medicine , restore the health of heathy is the motto of Ayurveda /Indian system of medicine .It is mentioned as Abhyangam (ayurvedic massage ) in ancient text of Ayurveda . Therapy is done by using medicated oils and self massage which can be done at home . This was practised since centuries . Knowledge and research regarding the same should be incorporated and studied to incorporate fruitful results in preventive aspect of football injuries .

Miguel Ángel Nazul Aké Montiel
17 janvier 2018 1:10
Reply to  Dr sreenath .s

Can you give us some literature, papers or something to know more about Ayuvedic massages?, thank you.

Mario Alejandro Reiley
28 mai 2019 11:43

Avoiding injuries in football is not easy due to the high physiological demands and contacts of the game itself but one issue that I have observed is that the functions of the team members are separated. that is to say that the trainers and physical trainers in addition to the administrative staff leave the health aspect only to the rehabilitation team. I will give an example, the proprioceptive exercises directed by the physical trainer do not have the same purpose as those prescribed by the physiotherapist. while some are only interested in the player playing the others try to get… Lire la suite »