Injury prevention in children ́s football


Evert Verhagen


This project team is an international multicenter study between the universities of Basel (Switzerland; Roland Rössler, Oliver Faude), VUmc (Evert Verhagen), Saarland University (Germany; Tim Meyer, Karen aus der Fünten), Charles University (Czech Republic). The project is sponsored and supervised by the FIFA-Medical Assessment and Research Centre (F-MARC; Astrid Junge).


Background:Football (soccer) is the world ́s most popular sport. The highest proportion of participants is younger than 18 years. Playing football can induce considerable beneficial health effects, and thus, football has a great potential to support a healthy lifestyle. Football is also a high-intensity and high-impact sport with many situations of direct contact between players which bear the risk of injury. Hence, there are also potential negative outcomes both for the individual as well as for the health care system. Thus, it is necessary to implement preventive measures starting at young age to reduce the risk of injury and consequently support the health benefits associated with playing football.

Comprehensive epidemiological data on football injuries are necessary to develop efficacious and effective prevention programmes. Injury characteristics of players older than 13 years were similar to adult players and, thus, similar preventive measures might be beneficial for this age- group. Younger players seem to show partly different injury characteristics as compared to their older counterparts. For instance, fractures of the upper extremities, growth-related diseases as well as complaints related to skeletal and coordinative immaturity seemed to be more frequent in young players. Consequently, preventive programmes proven effective in late adolescent or adult players need to be adapted for younger age groups to accommodate for the different injury profile and maturational status of children. To date, no study investigated the prevention of football injuries in children under the age of 13 years.

Based on a literature review, own epidemiological data on football injuries in players aged 7 to 12 years and a meta-analysis on injury prevention in children and youth sports, an adapted injury prevention programme was developed (based on the FIFA 11+ programme) focusing on players younger than 13 years. This preliminary program was pilot tested in 123 children with regard to possible effects on motor performance. At least possibly beneficial improvements were observed in nearly all performance tests. These improvements in motor performance may contribute to a reduction of injury risk.

Objective: To assess the effectiveness of an exercise-based prevention program to reduce football-related injuries in children younger than 13 years.

Methods:The study is a two-armed cluster-randomized controlled trial in 4,000 9 to 12 year old children (boys and girls, born 2002 to 2005) participating in regular training and match play in an officially registered football club in Switzerland (further study centres are located in the Netherlands, Germany and the Czech Republic). The injury prevention program will be included at the beginning of the usual football training by replacing the traditional warm-up. The programme will be conducted at least two times a week by the intervention teams. The prevention programme contains seven exercises and lasts about 10 to 15 min after familiarisation. Injury surveillance will include a baseline questionnaire, players ́ exposure and injury registration. Anthropometric baseline data and information regarding previous football-related injuries will be obtained prior to the start of the study from the parents.