FIFA 11+ Reducing injury rates in soccer in Ontario

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1 FIFA 11+ Reducing injury rates in soccer in Ontario Rhona McGlasson PT, MBA Stella Makris RKin Chelsea Norris CSEP-CPT Matt Greenwood April 29, 2015

2 Agenda Review of the research What is injury prevention Injuries in soccer FIFA 11+ program Ontario project 2

3 FIFA- MARC Medical Assessment and Research Centre Reduction of injuries in soccer Promotion of soccer as a safe and health enhancing leisure activity 3

4 Research on knee and ankle injuries Higher in game than training Increased rates with skill level Most caused by contact with another player Most injuries are minor Most injuries affect the lower extremity Ankle sprain Knee sprain ACL Fractures Aligns with program for head injuries 4

5 Injuries - Anterior cruciate ligament rupture Males versus females: 1 / 5 70% non-contact injuries Multiple factors Recovery 6-9 months Return to sport up to 1 year of competitive play Early development of OA Reduced ability to be active long term 5

6 Ligaments in the knee Medial collateral ligament (MCL) Lateral collateral ligament (LCL) Posterior cruciate ligament (PCL) Anterior cruciate ligament (ACL) 6

7 What happens in an ACL injury?

8 Injuries - Ankle Sprain

9 FIFA 11+ Injury Prevention What is injury prevention?

10 Positioning and landing

11 FIFA 11+ Website

12 15 exercises 3 Parts Running (8 mins) 6 exercises FIFA 11+ Exercises Strength, plyometrics and balance (10 mins) 6 exercises, 3 levels of difficulty Running (2 mins) 3 exercises 12

13 Running Hip in Hip out Circling partner Jumping with shoulder contact Quick forward and backward sprints Part 1: Running 13

14 Part 2: Strength, plyometrics and balance 3 levels of difficulty Core strength Planks Forward side Hamstring Eccentric (muscle working as it gets longer)

15 Part 2: Strength, plyometrics and balance Plyometrics Jumping and Landing Bend knees Knee over toe Girls do not do this well Improves with training Balance Dynamic Working together 15

16 Part 3: Running Putting it all together Agility Cutting Knee over toe 16

17 Summary of exercises Running Cutting/planting Strength Core strength Hamstring strength Positioning (plyometrics) Knee over toes Landing 17

18 Implementation considerations U 13 U 18 Reduces injury rate by 29 46% 2x a week Warm up routine Practice Parts 1 3 Game not Part 2 Completed by kids independently Part of the rehabilitation program for any injured player 18

19 Canadian Recommendations May

20 Ontario Project: years of funding through Ontario Trillium Foundation for an awareness and adoption program 750 clubs 150 youth clubs Qualified Coaches: 15,000 Referees: 11,000 District Associations: 21 4 Levels of Competition

21 Ontario Project: Stakeholders Soccer Culture shift Organization professionalism Injury prevention Increased programming around medical management Measurement of injury rates Improving standards for readiness to return to sports Compensating for decreased physical fitness in youth Heath care Multiple professionals Physicians, PTs, ATs, Kins Sports specialists versus generalists Increased interaction directly with clubs Messaging to parents and players Professional credits for working with clubs to develop programs Culture shift to supporting community programs

22 Ontario project: Coaches survey March 2014 Questions: Prior to this survey had you ever heard of FIFA 11+? 60% 55% 50% 45% 40% 30% 20% 10% 0% 1 Yes No

23 Ontario project: Activities Club training by project staff Coaches introductory training sessions 1 2 hours Presentation on the program mins 60 mins to do the training with a team and answer coaches questions Team training sessions 45 mins to go through exercises and assess technique

24 Ontario project: Activities Provincial and local providers Training health care professionals in the community to provide ongoing training Club conditioning or trainers Link clubs to health care professionals to assist with implementation/ training/standards for return to sports Developing a network of champions Learn from each other and problem solve Clubs arranging the services that work best in their club Seasons Winter: Sept/Oct April Summer: May Sept/Oct

25 Awareness Materials All materials used need to have been developed by FIFA Tear off pad Packages of cards that can be given to players and/or parents Poster Poster that has pictures of all the exercises

26 Other factors that affect injury Cleats: Blade cleats Turf: Different types and quality of turf Stretching 26

27 Other activities to consider in the club Build into the club culture Go to expert Policies and procedures Tracking system for injury Coaches contracts Insurance Management of injured athletes 27

28 References Campbell C et al, Canadian Academy of Sport and Exercise Medicine statement: Neuromuscular training programs can decrease anterior cruciate ligament injuries in youth soccer Clin J Sport Med 2014; 24; Soligard T, Nilstad A, Steffen K, et al. Compliance with a comprehensive warm-up programme to prevent injuries in youth football. Br J Sports Med 2010;44: Steffen K, Meeuwisse WH, Romiti M, Kang J, Bizzini M, Dvorak J, Finch CF, Emery CA. High adherence to a neuromuscular injury prevention programme (FIFA 11+) improves functional balance and reduces injury risk in Canadian youth female football players: a cluster randomized trial. Br J Sports Med Aug; 47(12): Steffen K, Romiti R, C Finch, G Myklebust, R Bahr, J Dvorak, M Bizzini, Meeuwisse WH, Emery CA. The effect of different delivery methods of the 11+ programme on performance in Canadian female youth football players Br J Sport Med 2013:47(12);

29 Acknowledgements Dr. Cathy Campbell, FIFA representative Canada Dr. Julia Alleyne, Medical Lead Pan Am Games

30 FIFA team Matt Greenwood Rhona McGlasson Stella Makris Chelsea Norris

31 Thank You For Reducing Injuries in youth!

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