Comparison of the ‘11+ Kids’ injury prevention programme and a regular warm-up in children’s football (soccer): a cost effectiveness analysis
Rössler R, Verhagen E, Rommers N, Dvorak J, Junge A, Lichtenstein E, Donath L, Faude O. Br J Sports Med. 2018. [Epub ahead of print]
Full Text Freely Available
Take Home Message: Participation in the 11+ Kids program resulted in ~50% lower healthcare costs compared with a usual youth soccer warm-up program.
Injuries sustained during an athlete’s youth can lead to health problems later in life (e.g., reduced physical activity, early-onset osteoarthritis). Additionally, the economic burden of these injuries is experienced individually and societally. Preventing injuries in youth sports may promote better long-term health and reduce the financial burden of an injury. However, more studies are needed to quantify the cost effectiveness of injury prevention programs for young athletes. Therefore, the authors completed an economic analysis to compare the cost-effectiveness of the 11+ Kids program with a typical warm-up routine among young soccer athletes. The cost effectiveness analysis was based on data collected from a cluster randomized trial, where coaches reported injuries that occurred over the 2014/2015 soccer season. Sixty-two different teams were randomized into 2 groups: 11+ Kids and normal warm up). Six hundred and fourteen athletes completed the 11+ Kids program and 388 completed the typical warm up (both groups: ~11 years of age). The authors estimated costs as the sum of the healthcare costs and the cost of performing the warm-ups (e.g., printed manuals, instruction courses for coaches). The healthcare cost was derived by contacting the parents of the injured children via telephone. Total healthcare cost was then estimated with standardized medial fees according to the national medical association. Out of pocket costs (e.g., braces, chiropractor) were estimated based on various providers. Ninety-nine athletes sustained injuries (42 in 11+ Kids program, 57 from typical warm up) and 53 were medically treated (62% were in the normal warm up group). The cost per player in the 11+ Kids group was 16.28 (Swiss Francs; ~ $16.41 US dollars) and 39.40 (Swiss Francs) in the typical warm up group. If scaled up, the 11+ Kids program would reduce healthcare costs in Switzerland by 1.48 million Swiss Francs per year.
The authors found that the 11+ Kids program reduced injuries and decreased cost per player by over 50%. Additionally, these reports could be considered conservative since they did not assess sideline resources (first aid, tape) nor previous injuries. These findings as well as two others from Canada (>$46 Canadian dollars savings per player per season) and the United States ($100 savings per player per season) provide support for coaches to implement injury prevention programs into their normal warm-up routine. These studies show short-term cost savings. However, there may be long-term cost benefits of preventing injures and helping these athletes be more likely to preserve a healthy active lifestyle as they age. The 11+ Kids program is only 15 minutes and does not require any special training or equipment. Currently, medical professionals should assist and encourage coaches to implement injury prevention programs.
Questions for Discussion: Have you implemented a prevention program? What were some barriers you had to overcome to effectively implement the program and how did you overcome them?
Written by: Jane McDevitt
Reviewed by: Jeffrey Driban
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Warming up is often skipped over in youth athletics. I feel like there is a general consensus that kids do not need to warm up. The 11+ program is so simple and saves money in the long run. It would be interesting to do something like this in collegiate sports to see how much money could be saved by preventing injuries with a warm up program similar to the 11+ program.