Limited Implementation of the FIFA 11+ Shoulder Injury Prevention Program (FIFA 11+ S) Among Professional Soccer Goalkeepers Globally

Abstract

Purpose. Soccer is one of the most popular sports worldwide. Soccer goalkeepers are more likely than outfield players to injure their upper extremities, particularly their shoulders. The Fédération Internationale de Football Association (FIFA) 11+ Shoulder Injury Prevention Program (FIFA 11+S) was developed to prevent upper extremity injuries. The aim of this study was to assess soccer goalkeepers’ and goalkeepers’ coaches’ awareness, implementation, and opinion of FIFA 11+S effectiveness in reducing upper extremity injuries.
 Materials and methods. A self-administered questionnaire was developed and distributed to worldwide professional soccer goalkeepers and goalkeepers’ coaches. The survey was available in 10 different languages. The questionnaire consisted of questions covering the awareness, implementation, and goalkeepers’ and goalkeepers’ coaches’ opinion of the FIFA 11+ Shoulder Injury Prevention Program in reducing upper extremity injuries. Questions development was guided by several authors expert in sport medicine and injury prevention programs. 
 Results. A total of 722 goalkeepers and goalkeepers’ coaches completed the survey. The vast majority (97.60%) of the participants were goalkeepers. Only 204 (28.25%) participants were aware of FIFA 11+S, and 155 (21.46 %) were implementing FIFA 11+S in their current practice. Participants who implemented FIFA 11+S reported a positive opinion about the program efficacy, with a score of 8.19 ± 0.93 out of 10. 
 Conclusions. This study is the first to investigate goalkeepers’ and coaches’ awareness, implementation, and opinion of the effectiveness of the FIFA 11+S program in reducing shoulder injuries globally. Overall, the awareness rate was exceptionally low, but the implementation level among aware participants was good. Goalkeepers and coaches attained a positive score regarding the FIFA 11+S effectiveness in reducing shoulder injuries. Further efforts and research are needed to increase the awareness and usage of the FIFA 11+S program.