Does the FIFA 11+ Warp-up Protocol reduce the severity and incidence of injuries among football players?
Soccer players have an injury rate that varies depending on their age and degree of participation. However, it is estimated at 2.5 to 48.7 injuries per 1,000 hours of competitive play. Therefore, effective injury prevention strategies are important tools for coaches at all levels of the game.
The most common injuries occur in the lower extremities, with sprains, strains and bruises being the most common types of injuries suffered by players. Many studies have explored strategies for reducing the incidence of injury and this has led to the creation of protocols designed to standardize and structure the approach used by trainers.
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There are a number of different warm-up protocols in use around the world. One of the most commonly used protocols is FIFA 11+. A new study published in PLoS One aims to assess the impact of the FIFA 11+ warm-up program on the frequency and severity of injuries among footballers. With a special focus on inexperienced youth players in a new league without prior knowledge of the FIFA 11+ protocol.
What is the warm-up of the Fifa 11+?
The FIFA 11+ warm-up protocol is a multi-component football-specific injury prevention program developed by a group of experts commissioned by FIFA. The goal of the protocol is to reduce intrinsic risk factors for injury and is based on evidence that recommends footballers participate in strength, balance, coordination and plyometric exercises to reduce the overall injury rate.
The program consists of 15 exercises, which are divided into three components and should take place at least three times a week:
Slow running and dynamic stretching
Six sets of leg and core exercises with three levels of progress
Drills running at increased speed and changes of direction.
So far, four RCTs have examined the effectiveness of the FIFA 11+ protocol, with a systematic review summarizing the results. The result is promising, with a 39% reduction in injuries and greater effectiveness than the previous FIFA 11. However, these studies disagreed with the definition of injury and duration and took place at the recreational and sub-elite levels, and there have been more in particular Studies recommended from different countries.
Methods & Demography
The study is a cluster randomized controlled trial approved by the University of Cape Town with 630 players from 24 teams playing in the Rwandan second division. The players were divided into two groups, 309 in the intervention group and 317 in the control group.
The control group used the usual warm-up protocols of their teams and the intervention group used the football-specific warm-up program FIFA 11+ during training and games during the seven-month season at least three times a week. The average age of the players was 20 years and on average the players had 3 years of gaming experience, so they were classified as beginners.
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The primary result of the study was the overall incidence, severity, definition, severity, mechanism of action and location of the training and match injuries. Training information was collected using a standardized training exposure registration form created by FIFA, match data was also collected using a standardized FIFA form, and injury information was collected by team medical personnel using standard FIFA and Olympic procedures.
For example, an injury is defined as any physical complaint that results from participating in football in training or in a game. This does not necessarily mean that medical attention is required. The severity of the injury was classified according to the number of days on which no football was played due to an injury. Injuries that resulted in an absence from training or games for 1–3, 4–7, 8–21, and more than 21 days were classified as “minimal”, “mild”, “moderate”, and “severe” injuries, respectively .
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None of the trainers in the control group were familiar with warming up the 11+ and received basic training in first aid and emergency procedures on the first day of the study. The test group received full FIFA 11+ training from an instructor recognized by the Confederation Africaine de Football. For details on training control and experimental trainers, see the article.
Clinical significance
In total, players who participated in the FIFA 11+ protocol group completed 61,043 hours of training and 4,290 hours of game play. The control group completed 59,165 hours and 4,224 hours of play. Players in the intervention arm had significantly more training hours than players in the control arm which probably influenced the injury and fitness rates.
In terms of injury prevention, the teams using the FIFA 11+ protocol suffered 163 players (52%) injuries while, as in the control group, 200 players (63%) suffered injuries. The majority of the players in both groups suffered single injuries, but the control group suffered more than twice as many multiple injuries per player per season.
"Overall, players using FIFA 11+ lost 40% fewer days due to injuries than the control group (1-84 days versus 1-153 days)."
There was no significant reduction in training injuries, but there was a significant reduction in lower extremity injuries suffered by the intervention group (37% versus 45%). There was also a lower risk of traumatic injuries sustained from contact with the teams using FIFA 11+.
Overall, players using FIFA 11+ lost 40% fewer days due to injuries compared to the control group (1-84 days versus 1-153 days). There was also a decrease in the rate of moderate and major injuries in the Interventon group.
Brief summary of the warming up of Fifa 11+
By complying with the FIFA 11+ protocol, players receive more training hours
The control group suffered more than twice as many multiple injuries per player and season.
The risk of injuries with less external exposure was significantly lower in the FIFA 11+ group .
Players using FIFA 11+ lost 40% fewer days due to injuries than the control group
The overall, training and match incidence rates were all significantly lower in the intervention group, with an 11% reduction in the total number of injured players and an average reduction in leisure time of six days. compared to the control group.
With respect to the limitations of this study, the bias of both teams could have been reduced if an outside health professional had assessed and investigated the injuries of both teams, since the coaches and medical staff of the teams were not blind to the intervention.
