The Impact of the FIFA 11+ Injury Prevention Program on Injury Incidence in Football Athletes: A Systematic Review of Randomized Controlled Trials

Football is associated with a high incidence of lower-extremity injuries, creating a substantial burden on athletes, teams, and healthcare systems. The Fédération Internationale de Football Association <i>(</i>FIFA) 11+ warm-up program was developed as a structured neuromuscular training routine to reduce injury risk by improving strength, balance, proprioception, and movement control. This systematic review synthesised controlled trials evaluating the effectiveness of the standard FIFA 11+ program among football players across youth, collegiate, and adult levels. Electronic databases were searched from 2008 to 2025 following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Five controlled trials met the inclusion criteria. Due to heterogeneity in injury definitions, adherence reporting, and exposure-hour documentation, a narrative synthesis was performed. Across all studies, teams performing the FIFA 11+ demonstrated meaningful reductions in overall and lower-extremity injury incidence compared with those using traditional warm-ups, with preventive effects ranging from approximately 30% to 46%. The program's effectiveness appeared to be mediated by improvements in neuromuscular control, trunk and hip stability, eccentric strength, and dynamic alignment during high-risk football movements such as cutting and landing. Adherence emerged as the primary determinant of success. These findings support the FIFA 11+ as an effective, low-cost, and accessible strategy for reducing football injuries when implemented consistently.