Football injury prevention: if you have searched for this, you have probably already stopped once too often. The good news is that prevention programmes work. The less comfortable news is that they work less than the headlines suggest, and only under one precise condition that almost nobody meets.
The honest number is this: in the reference meta-analysis on the FIFA programmes, FIFA 11+ reduced overall injuries by 39% in recreational and sub-elite football. Not 70%, not "up to 90%". And its predecessor, FIFA 11, in the two studies that tested it did not reduce anything at all. Two programmes from the same federation, one works and the other does not: this alone should tell you that "warming up well" is not enough.
⚠ Important: read this before continuing
The exercises and advice in this article are general guidelines and may not suit your situation. Every person has a unique clinical history: what works for others could be counterproductive for you.
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First of all: when this is not an exercise matter
Football injury prevention is about the healthy player. If you are already in one of these situations, the programme can wait: you need a clinical eye first.
After an ankle sprain, you cannot bear weight. If you cannot take four steps putting weight on it, or if it hurts on the tips of the malleoli, at the base of the fifth metatarsal or on the navicular bone, the most validated clinical rule in the world (the Ottawa Ankle Rules, with sensitivity close to 100% in a review of more than 15,000 patients) says to get an X-ray before anything else.
You heard a "pop" in the knee, with rapid swelling and a sense of giving way. It is the typical picture of an anterior cruciate ligament injury. A knee that "gives way" when you change direction is not something to train through: it needs assessing.
A sudden, violent muscle pain that made you stop on the spot. It is not fatigue. Carrying on playing on top of it is the best way to turn a two-week injury into a two-month one.
A blow to the head with confusion, nausea, double vision or memory loss. You leave the pitch and do not return that day, full stop.
Chest pain, abnormal palpitations, fainting or blacking out under exertion. This is not a physiotherapy matter: it is a cardiology assessment, and it must be done before returning to running.
Groin pain with fever, general malaise, or pain even at night at rest. The picture does not fit an overload-related pubalgia and needs investigating.
What actually gets injured, and in what proportion
In men's professional football, muscle injuries alone account for about 31% of all injuries and 27% of total days lost. 92% of these involve just four groups: hamstrings (37%), adductors (23%), quadriceps (19%) and calf (13%). A squad of 25 players can expect around 15 muscle injuries per season. These data were collected from 2,299 players in 51 European teams.
Hamstrings (back of the thigh). They are the number one target, and the picture is getting worse. In the UEFA monitoring over 21 seasons and 3,909 players, hamstring injuries rose from 12% of all injuries in the first season to 24% in the last, and the days lost because of them doubled, from 10% to 20% of the total. Twenty years of prevention research and the problem has grown: it is the best evidence that knowing what to do and doing it are two different things.
Ankle. Sprains from tackles, uneven surfaces, awkward landings. They are the most common injury in women's football and remain among the leading injuries in men's. The big risk is recurrence: an ankle that has already rolled twice tends to roll again, and that is where an episode turns into chronic instability. If you are already there, the path is the one for ankle proprioception exercises, not generic prevention.
Anterior cruciate ligament. The least frequent of the serious injuries, but the one that changes a season. In most cases it happens without contact, during a change of direction or a landing. Recovery after reconstruction is long and structured, and it is never a simple return "when it no longer hurts": we covered this in the cruciate ligament rehabilitation guide.
Adductors and pubis. Groin pain is endemic in football, and it has the bad habit of becoming chronic because people keep playing. If groin discomfort has been with you for weeks, it is already a problem to be framed: see pubalgia in footballers.
An important tip: before trying these exercises, make sure you have a correct diagnosis. People often assume they have one problem when the real source of the pain is something else. Doing the wrong exercises can make things worse instead of better.
FIFA 11+: what it showed and what it did not
FIFA 11+ is a structured 15 to 20 minute warm-up that replaces the traditional one. It is divided into three blocks: running (about 8 minutes), then strength, plyometrics and balance (about 10 minutes), then higher-intensity running (about 2 minutes). It is the most studied football injury prevention programme there is.
What it showed. The systematic review that pooled six cluster randomised trials found, in the four that tested FIFA 11+, an incidence rate ratio of 0.61 (95% CI 0.48 to 0.77): in other words, 39% fewer injuries compared with control groups. The figure comes from recreational and sub-elite football, not from professionals.
What it did not show. For the anterior cruciate ligament specifically, the evidence is more fragile than it is presented. In the most cited randomised study on American men's college football, 65 teams were randomised, with 850 players in the control group and 675 in the group doing FIFA 11+, over one season: knee injuries fell markedly (relative risk 0.42; 95% CI 0.29 to 0.61). Even looking at cruciate ligaments alone, the comparison favours the programme: 3 ruptures in the FIFA 11+ group against 16 in the controls. The problem is scale: 19 ruptures in total, in a single season, with 70 players needing to train with the programme to avoid one; and as soon as you break the data down into subgroups (match or training, position, division, type of pitch), the differences almost always do not hold. It is an encouraging hint from a single study, not proof that FIFA 11+ "prevents cruciate ligament injuries". In women's football, a meta-analysis of 11,773 players (twelve studies, nine of them on under-18 teams) estimated -27% overall injuries and -45% ACL injuries with multicomponent programmes, but the authors themselves classify the evidence as "low-level": eleven of the twelve studies had a high risk of bias.
How to use this information anyway. FIFA 11+ remains the most sensible choice because it is free, lasts twenty minutes and carries practically no risk. But it should be presented for what it is: a shift in probabilities, not a shield. Anyone promising that it "eliminates injuries" is selling you something. There is also a version for younger players, the "11+ Kids", and there the numbers are even clearer: if your child plays, the picture that concerns them, with growth plates, ankle and groin, is in what to really look for in a child who plays football.
The exercises with the most evidence behind them
These are the building blocks that recur in every programme that has worked.
Nordic hamstring curl. On your knees, ankles held by a partner, you lower yourself forward, braking for as long as possible. It is the exercise with the strongest single data point: a meta-analysis of 15 studies and 8,459 athletes, from different sports and not only footballers, found a risk ratio of 0.49 for programmes that include it, meaning up to 51% fewer hamstring injuries. To be honest: considering only randomised studies the ratio rises to 0.52, and removing those with a high risk of bias it rises again to 0.55. The effect remains large, but it is a "generous" halving, not a clean one. The ideal dose is not established: protocols start with very few repetitions and build up slowly over weeks, because doing it at full volume straight away leaves soreness that makes you give up by the third day.
Copenhagen adduction. Lying on your side, elbow on the ground, the top leg resting on a bench or held by a partner: you lift the hips and keep the body in line. In the randomised study of 35 Norwegian men's semi-professional teams, a programme built around this exercise alone brought the average prevalence of groin problems from 21.3% to 13.5%, meaning a 41% lower risk. The protocol used: three times a week in pre-season (6 to 8 weeks), then once a week for the rest of the league. Note that the problems were self-reported by players through a questionnaire, not diagnosed by a doctor.
Single-leg balance and progressions. This is the part that protects the ankle. A review of nine studies and 4,959 footballers found 36% fewer ankle injuries with programmes that include balance work, and 42% fewer with balance work alone. You start standing on one leg on stable ground, then with eyes closed, then on unstable surfaces, then with a ball and with an external disturbance. If you want the full progression, we wrote it up in the guide to single-leg balance.
Controlled landing and change of direction. Jumps, landing on two legs with hips and knees bent, and the knee must not collapse inwards. Then the same on one leg, then deceleration, then a change of direction. It is the block that in the studies always goes together with strength and balance, and the available reviews do not allow us to isolate how much it counts on its own: keep it as part of the package, not sold as "the anti-cruciate exercise". What is known is that programmes with several components together work better than those with just one.
Single-leg squat and glute strength. They serve to handle the load that the other exercises ask you to control. A knee that collapses on landing is often a hip that does not hold.
Plank and trunk stability. It is part of FIFA 11+ and of almost all effective programmes. To be honest: in the available studies it has never been tested on its own, so there is no evidence that a strong core by itself prevents football injuries. It is an ingredient in recipes that work, and a trunk that holds also helps the back work better.
Warm-up: what counts and what does not
The FIFA 11 against FIFA 11+ comparison is the most useful lesson in the entire football injury prevention literature. The first was a well-done warm-up: mobility, activation, running. The second adds load, jumps and balance. The first did not reduce injuries, the second did. So:
Warming up is not preventing. Raising muscle temperature is useful for performance and for how you feel, but on its own it does not shift injury numbers.
Progressive running and dynamic mobility open the session and prepare the joints for the range of motion you will then use. They remain the starting point, not the destination.
Progressive changes of direction and sprints at the end. If in a match you will make a 100% sprint, your warm-up has to have passed through 60, 75 and 90%. Entering the pitch without ever having gone beyond a trot is the classic way to get hurt in the first ten minutes.
The strength and jump block belongs inside the warm-up, not "afterwards, if there is time". It is exactly the piece that FIFA 11 was missing.
If you coach a youth team the lesson is the same, with even clearer numbers: a structured warm-up used instead of the usual one reduces injuries in children and teenagers by about a third, and it is the measure with the best evidence at that age. Study by study, the figures are in how much the warm-up really matters for children.
Flexibility, stretching and foam rollers: let us put things in proportion
A common misconception found in every article on football injury prevention needs correcting here.
Static stretching after training does not aid recovery. The Cochrane review on the subject pooled twelve studies: stretching before exercise reduced next-day soreness by about half a point on a 100-point scale, and stretching after exercise by about one point. In the largest study, done both before and after, the peak soreness over the week fell by 3.8 points out of 100: statistically significant, clinically irrelevant. The authors' conclusion is clear: stretching does not produce clinically important reductions in post-exercise muscle pain.
That does not mean it is useless. It means it should be used for what it really does: maintaining or gaining joint range where you lack it, for example a hip that does not open or an ankle that does not bend enough to let you squat. It is a mobility goal, not a prevention or recovery one.
Dynamic stretching before, not prolonged static holds. Before playing you need wide, controlled movements, not positions held for a long time.
Foam roller. Pleasant, safe, and it can give some immediate relief. There is no reason to drop it, and no reason to regard it as a preventive measure.
The variable that decides everything: how often you actually do it
This is the part that programmes do not tell you, and it explains the gap between the studies and the reality on the pitch.
In controlled studies someone supervises the teams, records the sessions and reminds them. Outside, no. The most recent review on adherence to cruciate prevention programmes is explicit: the benefit concentrates in those who complete at least 75% of the planned sessions, while those with moderate or low adherence get little or nothing from them. The bottleneck, the authors write, is not the design of the exercises: it is the behaviour of players and coaches, between too little time, little supervision and other training priorities.
Which leads to a practical rule worth more than any list of exercises:
A short programme done every time beats a perfect one done now and then. If you train three times a week and the full programme eats twenty minutes each time, and for that reason you skip it, you have a programme worth zero. Cut to eight minutes but done every time, and it is worth something.
Attach it to something you already do. FIFA 11+ also works because it replaces the warm-up instead of being added on. The worst moment for a preventive exercise is "at home, in the evening".
Pre-season to build, season to maintain. In the adductor study this pattern is explicit: three sessions a week for 6 to 8 weeks in preparation, then just one a week for the 28 weeks of the league. Maintenance costs little.
Someone needs to check. Nordics done badly, dropping suddenly instead of braking, do not train the eccentric and leave you sore. A single-leg squat with the knee caving in trains exactly the pattern you would want to avoid.
What prevention cannot do
Football injury prevention does not eliminate risk. It does not protect you from tackles, heavy ground or the opponent who arrives late. And above all it does not make up for a calendar that is too crowded or a premature return from a previous injury: re-injuries account for 16% of muscle injuries in professional football, and keep players out for longer than the original injuries.
The UEFA data on hamstrings rising, over twenty years of ever better knowledge, says exactly this: programmes work under the conditions in which they are studied, and on the pitch they are beaten by loads, calendars and haste.
When it makes sense to get followed
A standard football injury prevention programme is fine to start with. It becomes insufficient in three cases: if you have already injured the same spot more than once, if you have a pain that comes and goes for weeks, and if you are returning from a break and need to work out how much you can load.
In these cases what is needed is not another list of exercises, but someone who watches how you do them, chooses the right progression for you and decides when to raise the bar. With Ri-Hub this happens over a video call: the physiotherapist watches you do the Nordic, the single-leg stance, the landing, and corrects on the spot. It is the missing piece for anyone following a video who does not know whether they are doing it right.
To sum up in one line: football injury prevention shifts the odds by about a third, provided you do it almost every time. If you have no time for everything, keep the Nordic hamstring, the Copenhagen adduction and the balance work, put them into your warm-up and do not skip them.
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Sources
- Effect of specific exercise-based football injury prevention programmes on the overall injury rate in football: a systematic review and meta-analysis of the FIFA 11 and 11+ programmes, British Journal of Sports Medicine, 2017
- Including the Nordic hamstring exercise in injury prevention programmes halves the rate of hamstring injuries: a systematic review and meta-analysis of 8459 athletes, British Journal of Sports Medicine, 2019
- Injury prevention programs that include balance training exercises reduce ankle injury rates among soccer players: a systematic review, Journal of Physiotherapy, 2022
- The Adductor Strengthening Programme prevents groin problems among male football players: a cluster-randomised controlled trial, British Journal of Sports Medicine, 2019
- Making football safer for women: a systematic review and meta-analysis of injury prevention programmes in 11 773 female football (soccer) players, British Journal of Sports Medicine, 2020
- Does the FIFA 11+ Injury Prevention Program Reduce the Incidence of ACL Injury in Male Soccer Players?, Clinical Orthopaedics and Related Research, 2017
- Hamstring injury rates have increased during recent seasons and now constitute 24% of all injuries in men's professional football: the UEFA Elite Club Injury Study from 2001/02 to 2021/22, British Journal of Sports Medicine, 2023
- Epidemiology of muscle injuries in professional football (soccer), The American Journal of Sports Medicine, 2011
- Adherence as the key to anterior cruciate ligament injury prevention programme success: From efficacy to effectiveness, Knee Surgery, Sports Traumatology, Arthroscopy, 2026
- Stretching to prevent or reduce muscle soreness after exercise, Cochrane Database of Systematic Reviews, 2011
- Accuracy of Ottawa ankle rules to exclude fractures of the ankle and mid-foot: systematic review, BMJ, 2003
Sources last checked: August 2026.
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