By Lisa Rapaport

(Reuters Health) – An injury prevention program tailored to children’s soccer is not only more effective than typical warmups and stretches at keeping players safe, it’s also associated with lower healthcare costs, a Swiss study suggests.

Researchers studied soccer teams for kids under age 9 and under age 13 over a season in Switzerland. The teams were randomly chosen to do their usual warm-ups or to warm up with the “11+ Kids” injury prevention program, which includes 15 minutes of exercises focused on dynamic stability, power, core strength, and falling techniques.

Previously, the study team found the 11+ Kids program reduced the overall injury risk in children’s soccer by 48 percent and cut the risk of severe injuries by 74 percent, researchers report in the British Journal of Sports Medicine.

The new analysis focused on the costs of the 11+ Kids program – including printed manuals and instructions for coaches – and the cost of treating injuries sustained by young soccer players during the season they tested the program.

Healthcare costs for every 1,000 hours of soccer exposure totaled 228.34 Swiss francs (US$235.74 at current exchange rates) for players who participated in the 11+ Kids program all season, compared with 469.00 francs ($484.20) for children who did only traditional warmups.

This translates into a savings of 240.66 francs ($248.46) for every 1,000 hours of soccer participation with the 11+ Kids program. Implementing the program nationwide would save 1.48 million francs ($1.53 million) a year, the researchers calculated.

“It is especially important to keep children injury free, as certain types of injuries clearly increase the risk for subsequent injury, potentially lead to drop out from sport, or even lead to long-term disability,” said lead study author Roland Rössler of the University of Basel in Switzerland.

“As such, the implementation of injury prevention from early age is highly (recommended),” Rössler said by email. “It is a win-win situation: The player (by reducing the risk of injury) as well as the society (by reducing health-care costs) could profit.”

A separate study in the same journal offers fresh evidence of the need for injury prevention in youth soccer. This study, done in Finland, examined overuse injuries in 733 soccer players ages 9 to 14.

During the 20-week study, researchers texted athletes’ parents weekly to find out about any injuries, then followed up by phone with players to determine whether these injuries might be due to overuse.

A total of 343 players, or 47 percent, had overuse injuries during the study.

Each week, about 13 percent of players had an overuse injury, and 6 percent had serious overuse injuries.

Knee injuries were the most common, and girls were almost three times more likely to report these injuries than boys, the study found.

For boys, the likelihood of heel injuries was almost triple the odds for girls.

Older players were also more apt to get overuse injuries than younger athletes.

While it’s no surprised that kids can get hurt on the field, the type of injuries might surprise some players and parents, said lead study author Dr. Mari Leppänen of the Tampere Research Center of Sports Medicine at the UKK Institute in Finland.

“There has been a belief that most of the injuries in youth soccer are acute injuries such as ankle sprains,” Leppänen said by email.

“This study showed that overuse problems in children’s soccer are more common than previously expected,” Leppänen added. “Although these conditions often require no medical treatment, these problems cause a long absence from sports, cause significant pain and discomfort, and may discourage child from participating in physical activity.”

More information about the 11+ Kids program is available here:

SOURCE: and British Journal of Sports Medicine, online August 14 and 21, 2018.