1. FIFA 11+ Reducing injury rates in soccer in Ontario Rhona McGlasson Stella Makris Chelsea Norris Matt Greenwood

2. Reduction of football injuries Promotion of football as a safe and health enhancing leisure activity 2 FIFA- Medical Assessment and Research Centre

3. Agenda Review of the research What is injury prevention Injuries in soccer FIFA 11+ program Ontario project 3

4. Research 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 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+ Website http://f-marc.com/11plus/home/

10. Exercises 15 exercises 3 Parts – Running 6 exercises, 8 mins – Strength, plyometrics and balance 6 exercises, 10 mins, 3 levels of difficulty – Running 3 exercises 2 mins 10

11. Part 1: Running Running Hip in Hip out Circling partner Jumping with shoulder contact Quick forward and backward sprints 11

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

13. 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 13

14. Part 3: Running Putting it all together Agility – Cutting – Knee over toe 14

15. References 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;44:787-793. 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. 2013 Aug; 47(12): 794-802 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);794-802. 15

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

17. FIFA team Matt Greenwood Mgreenwood@soccer.on.ca Rhona McGlasson Rhona.McGlasson@bell.net Stella Makris stella.makris77@gmail.com Chelsea Norris ChelseaNorris@sympatico.ca

18. Thank You For Reducing Injuries in youth!