The FIFA11+ Program Is Effective in Preventing Injuries in Elite Male Basketball Players: A Cluster Randomized Controlled Trial
Longo UG, Loppini M, Berton A, Marinozzi A, Maffulli N, & Denaro V. The American Journal of Sports Medicine. 2012; 40: 996-1005.
Basketball is a popular and competitive team sport across the world with injuries commonly occurring. Across all sports, there has been a recent focus on warm-up programs designed to prevent injuries. The purpose of this randomized cluster trial was to assess the effectiveness of a warm-up program involving running exercises, strengthing, balance, jumping and hamstring exercises, as well as speed training with sport specific changes in direction in elite male basketball players. This warm-up program was previously proven to be successful in reducing the prevalence of injuries in a soccer population and the specific exercises can be found here. Eleven elite men’s basketball teams (121 players) were randomized as a team to either the intervention (7 teams) or control group (4 teams). The coaches and captains of the teams allocated to the intervention group were trained on how to perform a specific set of exercises that they would show their respective teams. The control teams were instructed to warm-up as they normally would, and there was no standardization or instruction given to any of the control teams. Injuries, body part, activity, and exposure hours were reported. Throughout the course of the season, the intervention group had significantly lower overall injury rates (0.95 vs. 2.16), lower extremity injuries (0.68 vs. 1.4), training injuries (0.14 vs. 0.76), acute injuries (0.61 vs. 1.91) and severe (fracture) injuries (0 vs. 0.25) than the control group.
This study demonstrates that there are warm-up or training programs that can be introduced to help reduce the number of injuries that occur. This is not uncommon territory for basketball athletes. Injury (specifically ACL) prevention programs have commonly been attempted within various athletes. It was interesting that they used the FIFA 11+ (which was previously found to be successful in female soccer players in reducing injuries) on a male basketball population. The FIFA 11+ was a modification of the FIFA 11, which was found to be successful at reducing injury rate among male soccer players. It seems that there may be gender specific exercises that should be applied, which include an emphasis on the importance of avoiding knee collapse (into valgum) as well as soft landings and the introduction of controlled partner contact. Knee collapse is often seen in the female population. For instance, female basketball players are at a much higher risk for knee injuries, and as a result, this type of a program has the potential to be more beneficial in this population. Interestingly enough, this study did not find any significant differences in ankle and knee injury rates between the two groups. These are by far the two most common types of injuries suffered in a basketball population. It is possible that these exercises were not specific enough to the functional activities that basketball athletes are performing when they suffer injuries. These exercises may need to be further modified to be more appropriate for this specific population. Clinically, it seems that the “warm up” has continually changed and evolved over time. Enough time may not be dedicated to giving a certain program a chance to be modified/perfected in order to be effective. Has anyone had any experiences using injury prevention programs with any of the teams that they work with clinically? There is a significant amount of literature on the effectiveness of ACL prevention programs, but the answer does not seem clear. What are your thoughts on whether a broader injury prevention program has the possibility to be effective in this population?
Written by: Nicole Cattano
Reviewed by: Stephen Thomas