Effects of the ’11+ Kids’ injury prevention program on severe injuries in children’s football: a secondary analysis of data from a multicentre cluster-randomized controlled trial.

Florian Beaudouin, Roland Rössler, Karen aus der Fünten, Mario Bizzini, Jiri Chomiak, Evert Verhagen, Astrid Junge, Jiri Dvorak, Eric Lichtenstein, Tim Meyer, Oliver Faude. Br J Sports Med. 2018. [Epub ahead of print]


Take Home Message: A youth football (soccer) player performing the 11+ Kids program was 58% less likely to have a serious injury during one season compared with a player doing a usual youth soccer warm-up regimen.

An injury prevention program can increase performance and decrease the risk of injury. We recently described two reports from a randomized clinical trial where the authors found that the 11+ Kids program reduced the risk of injury in youth soccer players (7 to 13 years of age) and reduced healthcare costs. It remains unclear if the 11+ Kids program can specifically reduce the risk of severe injuries that prevent a patient from practicing/competing for 28 days or more and increase the risk for poor long term health outcomes. Therefore, the authors performed a secondary analysis of a cluster-randomized trial to assess the effect of the 11+ Kids program on reducing severe injuries in 7 to 13-year-old football (soccer) players during 1 season (2014/2015). The authors included 3,895 athletes that participated in under-9, under-11, or under-13 football in 4 European countries. The athletes randomized into the 11+ Kids program (2066 athletes) completed the 11+ Kids program (15 20 minutes, 7 exercises; 5 levels; focused on balance, cores stability, and optimization of falling technique) 2 times a week in lieu of a regular warm-up. The control group (1829 athletes) followed their regular warm-up regimen. The control group experienced about 1 severe injury every 3000 soccer hours (50 injuries overall) compared with only 1 severe injury for every 6,667 soccer hours among athletes performing the 11+ Kids program (21 injuries overall). This represented a 58% injury rate reduction. Fractures were the most common injury in both groups. Fractures were reduced by 49% among athletes performing the 11+ program compared with their peers in the control group.

The authors found that the 11+ Kids program had a large preventive effect on severe injuries in young athletes. This is a simple program that can be performed in only 15 to 20 min just twice per week. Many severe injuries that are sustained in this age group are due to fall on outstretched hand mechanisms as well as muscle and ligament injuries due to poor technique and stability. This program may be effective in reducing injuries due to the focus of the program on falling technique, balance, and core stability. Severe injuries can be traumatic in this age group because they increase the risk of long-term health problems and time away from sport and/or school activities. It should be noted that less than 5% of the population were; therefore, more research is needed to determine if this program is effective among girls participating in sport. Currently, medical professionals should encourage parents and coaches to adopt the 11+ Kids program, which can be easily implemented.

Questions for Discussion: What is the best way to disseminate this information to youth leagues? Does your youth athlete perform a structured warm-up? Do you think this would be easy to implement?

Written by: Jane McDevitt

Reviewed by: Jeffrey Driban

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