By Dev K. Mishra, M.D.
President, Sideline Sports Doc
Clinical Assistant Professor of Orthopedic Surgery, Stanford University
• A Belgian study of soccer players provides convincing evidence that all soccer related injuries can be reduced with a comprehensive strategy
• Using a preventive training program such as FIFA 11+ or PEP program is important
• Other factors such as postponing/rescheduling matches in poor weather conditions is also important
• Injuries remain common and all coaches should have basic injury recognition training
For some reason we continue to debate the effectiveness of comprehensive injury reduction strategies in sports. I say “for some reason” because common sense indicates that these strategies should work but still we search for proper scientifically based evidence of effectiveness. A Belgian study published recently in the American Journal of Sports Medicine shows that a strategy employing the FIFA 11+ program, combined with awareness of referees to cancel matches in poor weather conditions lead to a conclusive reduction in all musculoskeletal injuries over a 10 year period. In this study, the authors performed an extensive analysis of the Belgian national database of soccer related injuries in the 1999-2000 seasons and in the 2009-2010 seasons. In the interim 10 years the Belgian soccer federation made mandatory the use of the FIFA 11+ training program and instructed referees to have a lower threshold of canceling games in poor weather conditions.
These measures led to a significant reduction of soccer-related injuries. Several interesting findings came from the study, such as the substantially higher rate of injuries earlier in the season; recreational players have a higher injury rate than professional players; and that the proportion of severe injuries was higher for female players and male youth players.
Steps We Can Take To Improve Injury Rates Further
The fact that injury rates are higher early in the season leads to the natural conclusion that preseason training improvements can further reduce the early season injury rates. However, the added intensity of early season training (fighting for a place on the team, or for a spot in the first team) may create a unique situation. But again common sense indicates that better preseason training can only help. If you assume it will take about 12 weeks of good training for meaningful improvements you should start now to get ready for August tournaments. You can access the FIFA 11+ or the Santa Monica PEP program.
Awareness of weather conditions and canceling games is another important point. In Belgium they focused on ice/snow conditions but in the U.S. the area I think we can pay better attention to is heat and humidity. A combination of high temperature and high humidity, often found in many parts of the country in August are a setup for heat illness.
Finally, the authors noted that there were multiple factors leading to the higher severe injury rates for women and girls. One area they identified was that the female players did not have access to the same quality of medical support, often leading to delayed diagnosis of injury. We can make an impact in this area now by making sure the observers on the field – the coaches – are properly trained in basic injury recognition. You can learn these principles from our downloadable pdf and mp3 audio programs.
The debate is over. It’s time for all of us to recognize that a comprehensive set of training, management, and injury recognition can go a long way to improving the health of our players.