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New Study Finds Link Between Injury Prevention and Winning

Bert R. Mandelbaum, MD, DHL (Hon)


November 19, 2015

In This Article

Why Adoption Has Been Slow

We've been sharing such results from our previous studies for years. Our group has won NCAA awards. We have published articles and books. But we still have failed to convey our points about players' safety to a great many coaches. Why aren't teams eagerly embracing this approach?

There appear to be several reasons. Many teams don't have medical staff. Recreational teams often have no access even to a professional trainer. That means that everything falls on the coach. Coaches feel intense pressure to satisfy their constituents—athletic directors, parents, alumni, and fans—who too often think only of winning. For too many coaches, winning means a tunnel-vision focus on strategy and skills.

If coaches had to choose between preventing injuries and winning games, I'd still argue that safety should come first. What most young athletes learn about how to tackle, throw, or run in team competition won't matter a few years from now when high school and college are behind them. But knowledge of fitness and safety will serve them for a lifetime.

But we now know that programs like the FIFA 11+ meet both goals. Analyzing the win/loss ratio, our research group—led by physical therapist Holly Silvers-Granelli at the University of Delaware—found that NCAA Division I teams using the FIFA 11+ program had an average record of 9.86 wins, 5.71 losses, and 2.43 ties, while the control teams had an average record of 7.6 wins, 8.48 losses, and 2.57 ties (Silvers-Granelli H, Mandelbaum B, Adeniji O, et al, unpublished data, 2015). The difference in wins and losses was statistically significant, and when we looked at Division II teams, we found a similar pattern.

Recommendations for Coaches

Of course, safety goes far beyond the FIFA 11+ program. At FIFA, we're trying to raise awareness about coaches' responsibilities by disseminating a number of key points. We recommend that coaches:

  • Coordinate with physicians, trainers, biomechanists, nutritionists, and other experts to acquire and implement the best safety and performance information available;

  • Maintain constant and complete communication with the medical team;

  • Insist on electrocardiogram screening before athletic participation to ensure that all team members have healthy hearts;

  • Obtain baseline psychoneurologic data on team members by using instruments that I discussed in a previous column, such as the ImPACT® and King-Devick tests for diagnosing concussion or the Sports Concussion Assessment Tool (SCAT 3);

  • Use an evidence-based program like FIFA 11+ to strengthen and train athletes to avoid injury;

  • Teach players about healthy food choices;

  • Be aware of the limits to training imposed by the climate in which players train and offer them ample opportunity for hydration;

  • Teach players how to play hard without hurting each other;

  • Be aware that players' needs will vary depending on their level of fitness, age, body mass index, the nature of the sport in which they're participating, and the climate in which competition occurs;

  • Honor the gradual steps by which players can return to sports after injuries; and

  • Insist that players avoid the nonmedical use of performance-enhancing and other drugs.



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