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

Injury Prevention Training in Girls' and Women's Elite Football in Denmark: A Survey of Practices and Perceptions

Through a national cross-sectional survey, the present study investigated the use and content of injury prevention training (IPT), and associated attitudes and beliefs, involving stakeholders in Danish girls' and women's elite football (U14, U16, U18, and Danish Women's League teams). A total of 168 stakeholders (coaches, physical performance coaches, physiotherapists, medical doctors, and club management) from 18 Danish elite clubs were invited to participate. Of these, 158 were eligible to participate, and 110 participants (69.6% response rate) provided 191 valid survey responses, as some provided more than one response due to multiple affiliations within the same club. The use of IPT ranged from 91.1% to 100% across team levels, with approximately 50% reporting up to 1-2 h/week. Interestingly, only 52.9%-72.7% of the responses indicated use of an evidence-based IPT program, with lowest adoption at the U14 and Danish Women's League teams. The FIFA 11+ was the most used evidence-based IPT program. The majority of the participants (>72%) had positive perceptions regarding IPT impact on injury reduction. These findings indicate that, while IPT is broadly used across Danish girls' and women's elite football teams, the implementation of evidence-based IPT programs varies, with lower adoption of these programs among the youngest and senior elite teams. Hence, there is a need to enhance integration of IPT programs proven effective in girls' and women's elite football. Notably, stakeholders expressed positive perceptions regarding the impact of IPT on injury reduction, which provides valuable support for future efforts to strengthen IPT in football practice.

Don't Peak Too Early: Evidence for an ACL Injury Prevention Mechanism of the 11+ Program

Background

The 11+ program prevents anterior cruciate ligament (ACL) injuries in athletes through unknown mechanisms.

Purpose

The aim of the current study was to evaluate the effects of The 11+ intervention program, performed by female soccer players during a single season, on the frequency of Early Peaks during athletic tasks.

Methods

Three teams (69 players) of collegiate female soccer athletes (Divisions I and II) were recruited. Two teams (49 players) volunteered to perform The 11+ three times per week for one season (~22 weeks plus three weeks pre-season), and one team (20 players) served as controls. The athletes performed three repetitions of a cutting maneuver, side shuffle direction change, and forwards to backwards running direction change before and after the competitive season and were recorded using marker-based 3D motion capture. Knee valgus moment time series were calculated for each repetition with inverse kinematics and classified as either "Very Early Peak", "Early Peak" or "other" using cluster analysis. The classification was based timing of the peak relative to the timing of ACL injuries. The effect of the intervention on the frequency of Very Early Peaks and Early Peaks was evaluated with a mixed Poisson regression controlling for the movement task and pre-season frequency.

Results

The 11+ intervention reduced the frequency of Early Peak knee valgus moment in one intervention team (coefficient = -1.16, p = 0.004), but not the other (coefficient = -0.01, p = 0.977). No effect was observed on the frequency of Very Early Peak knee valgus moment.

Conclusions

Reduced frequency of knee valgus moment Early Peak during athletic tasks may explain the mechanism by which The 11+ program decreases risk of ACL injury. Prospective studies with a much larger sample size are required to establish a link between Early Peak knee valgus moments and risk of ACL injury.

Level of evidence

2b.