The FIFA11+ Program
Is Effective in Preventing Injuries in Elite Male Basketball Players: A Cluster
Randomized Controlled Trial

UG, Loppini M, Berton A, Marinozzi A, Maffulli N, & Denaro V. The American
Journal of Sports Medicine. 2012; 40: 996-1005.

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.

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?
by: Nicole Cattano
by: Stephen Thomas


Longo, U., Loppini, M., Berton, A., Marinozzi, A., Maffulli, N., & Denaro, V. (2012). The FIFA 11+ Program Is Effective in Preventing Injuries in Elite Male Basketball Players: A Cluster Randomized Controlled Trial The American Journal of Sports Medicine, 40 (5), 996-1005 DOI: 10.1177/0363546512438761