By; Dr. Alan Hetherington/ Total Sports Injury Writer
FIFA 11+ A Warm-up to Prevent Unnecessary Soccer Injuries
Soccer is a sport that can cause a multitude of injuries over the course of a season. You can only do so much to prevent contact injuries but often there are non-contact injuries to the hip, knee, or ankle that can be avoided with sufficient training and preparation. Unnecessary injuries are associated with expensive treatment, prolonged withdrawal from sports which can delay athletic development. Taking appropriate steps to avoid these injuries can be both time and cost efficient to the athlete.
FIFA medical assessment and research centre developed an injury prevention warm-up program in 2010 called the “11+”. The program is a twenty minute series of fifteen exercises to prepare players for soccer training. Despite being promoted by FIFA and local soccer associations, it is underutilized. In my time providing medical coverage for soccer I have seen very few teams perform the 11+ or carry out drills with proper biomechanics. These teams miss out because there is basis to instituting it. Research on the program has demonstrated benefits to injury prevention and multiple performance factors. The twenty minutes spent warming up before training could pay off in the long run.
Injury prevention
Various studies have demonstrated a significant decrease in the incidence of non-contact injuries when implementing the 11+ twice per week for ten to twelve weeks. A systematic review found the FIFA 11+ effective for preventing injuries in soccer players after analyzing results from six studies involving 6,344 players. Using the FIFA 11+ resulted in a 30% reduction in injury occurrence compared to conventional static stretches and drills. This means that if a team that did not perform the 11+ had 100 injuries in a season, then a team that performs the 11+ had 70 injuries. This is an average reduction across different groups and not a guarantee for every team or individual. With that in mind, it is still a valuable resource to any youth soccer program that does not have knowledge in health and performance. It can be a simple way to institute proper biomechanics in soccer training while preventing injuries in a time efficient manner.
Performance factors
Teams have a limited amount of time to train. It is important if they are going to spend time on an activity that has an impact on sports performance. When the 11+ is performed over 6 weeks with high adherence there is noticeable development in the majority of biomechanical measures such as balance and core stability. It cannot improve technical soccer skills, but that is where the rest of the training session can address. Precaution should be taken in performing the 11+ before competition, as it may acutely reduce sprinting speed and agility. A suitable method can be reserving the 11+ for training sessions where pushing physical capacity for long term development is the focus and modifying a pregame warm-up that is not as demanding.
The 11+ may reduce biomechanical risk factors for injuries such as ACL injuries among children female players. It can be a simple, time efficient routine for youth soccer players to become biomechanically competent. Shortcomings in stability, strength, balance and biomechanical form in youth athletes can be addressed at training sessions while avoiding impacting competition. Based on these results it may help your team remain healthier. Reducing injuries allows your team to have the best line-up but allow players to fully develop across the season. A team performing the 11+ has the potential to increase their performance capacity without making any changes to personnel or tactics. The best development for an athlete is to learn how to move in a way that keeps them healthy and the FIFA 11+ is a good place to start for teams that have not considered injury prevention.
FIFA 11+ Program: 3 stages, 15 exercises appropriate posture techniques
*See full breakdown in 11+ manual
Running exercises (8 minutes)
1-running straight (50m, 2 sets)
2-running hip out (50m, 2 sets)
3-running hip in (50m, 2 sets)
4-running circling partner (50m, 2 sets)
5-running shoulder contact (50m, 2 sets)
6-running quick forward/backwards (50m, 2 sets)
Strength, plyometrics, balance (10 minutes)
7-plank (30 seconds, 3 sets)
8-side plank (30 seconds, 3 sets)
9-eccentric hamstring curl (30 seconds, 1 set)
10-single leg stance (30 seconds, 2 sets)
11-squat with toe raise (30 seconds, 2 sets)
12- vertical jump (30 seconds, 2 sets)
Running with direction changes (2 minutes)
13-running at 75-80% (across pitch, 2 times)
14-bounding (across pitch, 2 times)
15-run, plant, cut (across pitch, 2 times)
References
- Bizzini M, Junge A, Dvorak J.The “11+” manual: a complete warm-up programme to prevent injuries. FIFA Medical Assessment and Research Centre (F-MARC).
- Sadigursky D, Braid JA, De Lira DNL, Machado BAB, Carneiro RJF, Colavolpe PO. The FIFA 11+ injury prevention program for soccer players: a systematic review. BMC Sports Sci Med Rehabil. 2017 Nov 28;9:18. doi: 10.1186/s13102-017-0083-z. PMID: 29209504; PMCID: PMC5704377.
- Asgari M, Nazari B, Bizzini M, Jaitner T. Effects of the FIFA 11+ program on performance, biomechanical measures, and physiological responses: A systematic review. J Sport Health Sci. 2023 Mar;12(2):226-235. doi: 10.1016/j.jshs.2022.05.001. Epub 2022 May 31. PMID: 35659964; PMCID: PMC10105015.