Don't Skip The Warm-Up: Keys To Preventing Injury In Soccer Athletes

What would you think if I told you that just by adding a specific dynamic warm-up program to your pre-game soccer routine that you could decrease your risk of lower extremity injury by 30-50%?

...Sounds too good to be true right.

My goal in this post is to tell you about some strong data suggesting crazy injury rate reductions just by using a specific warm-up program before games put together by the people at FIFA Medical Assessment and Research Center. 

Let's start by reviewing the facts on the most common injuries in soccer and the risk factors associated with those injuries. 

Injury Rates In Soccer

More injuries occur in soccer than basketball, rugby, or field hockey.  The majority of injuries in soccer occur in the lower half of the body.

Multiple studies have broken down the injuries in soccer into specific categories based on how the injury occurred.  Surprisingly, according to Hawkins and Fuller, 59% of injuries were due to "non-contact" mechanisms.   They also mentioned that 39% of all injuries happened while running, jumping, shooting, and turning.

What is interesting about these findings is that very little attention is given, at practice or pre-season training, to jumping, running, or turning technique.  In fact, when speaking to several local soccer parents, there is almost no attention given to proper functional movements associated with these core soccer actions.

Given the data, one might expect there to be a specific program or plan in place to teach young soccer athletes the basics of lower extremity movement in order to avoid injury (and in the process improve performance!)...we will get to this later. 

Speaking directly to this need Hawkins and Fuller comment...

The high level of muscle strains, in particular, indicates possible weaknesses in fitness training programmes and use of warming up and cooling down procedures by clubs and the need for benchmarking players’ levels of fitness and performance.

The two most common areas to sustain injury, based on data for collegiate male and female athletes, are the ankle and knee.  This should come as no surprise although it should raise some concern that many young soccer athletes are not advised to perform specific ankle strengthening, balance, or knee stabilization drills.  Often times, this is performed after an injury happens.

Lastly, most soccer injuries occur during game play versus practice and a skewed percentage of injuries occur in the last 15 minutes before each half.

Soccer Injury Risk Factors

Realizing that injury rates in youth, collegiate, and professional soccer players is quite high compared to other sports begs the question...

...WHY do these injuries happen?

There has been a vast amount of studies published in the last 10 years speaking to this exact question.  There is no smoking gun or singular cause to soccer injuries. Research has pinpointed a few key variables that are correlated to increased injury risk.

As stated previously, non-contact mechanisms make up a large percentage of all soccer injuries.  Therefore, faulty or inefficient internal biomechanical mechanisms must involved.

What are the biomechanical faults associated with lower extremity injury risk...

  1. Poor gluteal activation and strength
  2. Increased knee collapse (genu valgus)
  3. Increased pelvic drop 
  4. Poor core strength
  5. Poor dynamic hip and knee control
  6. Poor dynamic balance
  7. Decreased pre-season conditioning

The first item on this list, poor gluteal activation and strength, has been linked to all the other items on the list.  It can't be stated enough that a strong buttocks is essential to soccer athletes.  

In my experience, treating soccer athletes of all levels, very few have had adequate gluteal strength.  What's more, after an intensive gluteal strength and control focused treatment program, they return to play more confident and powerful in their movements.

Gluteal strength and proper dynamic lower extremity control needs to be part of sport education in youth athletes.  One of the issues; however, is having the proper personnel and experience to screen athletes for these movement risk factors.  Physical therapists and athletic trainers can provide this assessment, and through community based programs, can educate soccer coaches to do the same.

What if there was an intervention that soccer coaches could implement NOW which could substantially reduce injury rates? 

The FIFA 11+ Dynamic Warm-Up

Recently, an expert group at the research division at FIFA, created a dynamic warm-up program to help soccer programs, teams, and coaches reduce injury rates in soccer athletes.

Although the name and organization which created this warm-up sound academic and complicated, the warm-up program, which can be found here, is shockingly simple.

Using a series of running drills, core strengthening exercises, and sport specific movements the warm-up helps athletes practice the proper motor control actions specific to soccer.  It also addresses hip strength and core strength which we highlighted as risk factors in lower extremity injury.

Without any equipment, besides some cones and a ball, this program has transformed injury plagued soccer programs and made basic skill training commonplace at soccer fields.

How effective is the FIFA 11+ at decreasing injuries in soccer athletes?

According to multiple studies, the rate of injuries decreased 21-71%.  This was only after 1 season of doing the warm-up program!

Additionally, the FIFA 11+ program was shown to be more effective than traditional soccer warm up programs at reducing injuries.  Also, results improved when the program was administered by an athletic trainer or trained personnel. 

Conclusion

Based on the data shown here, implementing the FIFA 11+ warm-up program is imperative to protecting our youth, high school, and collegiate soccer players from unnecessary injury.  A no cost, simple, and effective program exists and needs to be brought to the attention of local teams.

Getting youth athletes physically prepared for each sports season will also help reduce their risk of injury.  Screening tools such as the Functional Movement Screen (FMS) and Y-Balance Test will help to screen athletes at risk of injury.  

Getting your athlete in a specifically designed strength and conditioning program to address gluteal weakness and dynamic lower extremity control will help prepare them for the rigors of season play. 


Train Smarter, Train Harder, Perform Better!

Written by:  Kevin Vandi DPT, OCS, CSCS
Serving: San Jose, Campbell, Los Gatos, Almaden, South Bay Area