Does prevention pay off? Economic aspects of sports injury prevention: a systematic review.

Lutter C, Jacquet C, Verhagen E, Seil R, Tischer T. Br J Sports Med. 2021 Oct 1:bjsports-2021-104241. doi: 10.1136/bjsports-2021-104241. Epub ahead of print. PMID: 34598936.
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Take-Home Message

Injury prevention programs in sports can offer substantial cost savings.


Sports-related injuries pose a substantial health burden on athletes and often lead to high medical treatment costs. While there are multiple sports injury prevention programs designed to alleviate sports-related injuries (e.g., FIFA 11+), it is unclear if they offset the associated financial burden.

Study Goal

Lutter and colleagues conducted a systematic review to assess the monetary benefits of incorporating injury prevention programs into sports (e.g., injury prevention training programs, body checking rule changes).


The authors performed a systematic literature review of articles published after December 2009 that performed cost-benefit assessments of sports-related injury prevention programs for athletes of all ages, participation levels, and sports. The authors assessed the article quality and extracted information on injury prevention program costs and healthcare costs per player and per season. When a paper offered multiple cost scenarios, the authors always selected the worst-case scenario (greatest cost for the prevention program, lowest associated savings).


The authors identified 10 studies conducted among 7,033 athletes that met the criteria for this systematic review. Most studies were randomized controlled trials that incorporated sports-injury prevention training programs for amateur soccer athletes that lasted for a single season. There was a low risk of bias and good methodological quality across studies. Sports-injury prevention training programs (e.g., FIFA 11+) that did not include bracing or other materials cost between €3.72 to 116.00 ($4.31 to 134.46) per player and per season. There was a substantial monetary benefit to this initial cost, as sports-injury prevention training programs saved each athlete between €24.82 to 462.00 ($28.77 to 535.52) per season. The authors also noted that policy changes that delay introducing body checking in youth ice hockey also saved players money.


This study supports that there is a monetary benefit to including sports-injury prevention programs. However, the authors only found a limited number of studies, and those studies assessed various program types, which precluded the authors from pooling the outcomes. It would be interesting to determine if these financial benefits persist across program types and athletes.  In the meantime, these cost savings should appeal to various stakeholders (e.g., administrators, athletes, parents) responsible for the financial costs associated with an injury, medical insurance, and sports medicine staffing.

Clinical Implications

Coaches and clinicians should consider implementing injury prevention programs among athletes to reduce the financial burden associated with lower extremity injuries.

Questions for Discussion

Have you implemented sports-injury prevention programs? Have you found additional benefits to incorporating sports-injury prevention programs?

Written by: Alexandra F. DeJong Lempke
Reviewed by: Jeffrey Driban

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