Applied Evidence

Preventative strategies for non-contact lower limb injuries among male football players: A scoping review.

The South African journal of physiotherapy · 2026 · Systematic Review · PT

Siyabonga H Kunene, Molebogeng B Mmitsi

PMID 42266208

Of 12 injury-prevention strategies for male footballers, Nordic hamstring exercises and the FIFA 11+ warm-up had the strongest evidence for reducing non-contact lower limb injuries, while bounding exercises showed no significant effect and ankle taping's protection faded within 15 to 45 minutes.

Key findings

1In a randomised trial of 942 players across 50 teams, adding eccentric hamstring exercises to regular training resulted in 15 hamstring injuries versus 52 in the control group.

2The FIFA 11+ warm-up programme reduced injury rates by 46.1% and time lost to injury by 28.6% in collegiate male soccer players.

3Adding the Copenhagen adduction exercise to the FIFA 11+ warm-up significantly increased eccentric hip adduction strength compared with the standard programme alone.

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What it does not show

The review is restricted to male footballers; no evidence is presented for female players, other sports, or clinical (non-sporting) populations. No included studies addressed non-contact quadriceps or gastrocnemius injuries, leaving a gap in the evidence base for those muscle groups. Most included studies were conducted in developed countries, predominantly the United States, with only one from South Africa, limiting generalisability to other settings. Several included trials had small samples (for example, 9 players in one hamstring fatigue study and 10 in an ankle-taping crossover), reducing the precision of their findings. As a scoping review, the paper maps the landscape of strategies but does not pool effect sizes, so the relative magnitude of benefit across strategies cannot be directly compared. The review includes studies with both significant and non-significant results, so the reader must weigh the strength of each individual trial rather than treating the 12 strategies as equally supported.

Declared interests

The authors declare that the research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

The easy way to misread this

Do not read this review as evidence that all 12 listed strategies reduce injury. The original FIFA 11 programme, bounding/plyometric training, and ankle taping all showed no significant injury reduction or only a very short-lived protective effect. The review also covers only male footballers, so the findings cannot be assumed to apply to female players, other sports, or non-sporting clinical populations.

Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →