Do Soccer Coaches Use ACL Injury Prevention Programs? Yes—but Use Is Uneven

Yes, some soccer coaches use ACL injury prevention programs, but adoption is uneven—and doing a warm-up is not the same as delivering a tested prevention program. For coaches choosing a routine, the useful decision is to build a structured neuromuscular program into regular training, rather than rely on occasional stretching or a few balance drills.

These programs combine strength, balance, jumping and landing, and movement-control exercises. FIFA 11+ is one option with soccer-specific evidence; it targets injuries more broadly, not just the anterior cruciate ligament (ACL). The male collegiate soccer trial describes it as a 15–20-minute on-field warm-up.

How many coaches actually use them?

Available surveys show a gap between warming up, knowing about prevention, and implementing it:

• Youth soccer: A survey contacted 418 coaches of boys’ and girls’ U12–U18 teams from 15 local clubs and received 101 responses. It reported that 92.6% used a warm-up before practices and games, but only 29.8% used an injury prevention program in the previous season. This measured broader injury prevention, not exclusively ACL-specific protocols. Youth-soccer coach survey
• Girls’ high school sports in Metro Detroit: In a survey conducted during August 2022–July 2023, 73.7% of 57 responding coaches knew about ACL prevention programs, but 47.4% reported an ACL-specific protocol. Another 19.3% answered no and 33.3% answered N/A. Soccer accounted for 15 of 62 sport entries; the other entries were basketball and volleyball. The 47.4% figure is therefore not a soccer-only adoption rate. Metro Detroit survey

Neither survey establishes what percentage of all soccer coaches currently use these programs. Response rates were low—24.2% of invited coaches in the youth survey and 21% of schools in Detroit—and reports of program use do not establish exercise quality or frequency. The defensible answer is that coaches do use prevention programs, but use was far from universal in these samples.

Does the injury evidence justify using one?

Two soccer trials help separate actual ACL outcomes from general injury-reduction claims.

Adolescent girls: A Swedish cluster-randomized trial followed 4,564 players aged 12–17. Teams assigned a knee-control program were instructed to perform it twice weekly throughout the season. There were seven ACL injuries among 2,479 intervention players versus 14 among 2,085 controls. The ACL injury rate, analysed using individual playing time, was 64% lower, although only 21 ACL injuries occurred overall. This was the Knäkontroll program, not FIFA 11+. Swedish trial

College men: A FIFA 11+ trial reported three ACL injuries among 675 intervention players versus 16 among 850 controls across the teams completing the study. That supports using the program in male soccer too, but four intervention teams withdrew because of insufficient time, and the analysis was per protocol. The small injury count and withdrawals mean the size of the benefit should not be treated as a guaranteed reduction for another squad. Male collegiate trial

For the populations studied, a tested, regularly delivered neuromuscular warm-up is an evidence-based choice; a generic warm-up should not be assumed to provide equivalent ACL protection. These trials support risk reduction, not injury elimination.

How to make it part of squad training

The following is an implementation plan, not a new prevention protocol:

1. Choose a tested program suited to the players. Use its exercise instructions and progressions rather than assembling unrelated drills and calling them “ACL prevention.” Ask a physiotherapist or athletic trainer to help match the program to the squad.
2. Schedule the program’s full dose throughout the season. The Swedish trial prescribed exercises at two training sessions weekly: about 15 minutes of exercises preceded by five minutes of easy running. The male FIFA 11+ trial used a 15–20-minute warm-up two to three times weekly. Reserve that time within the existing warm-up slot rather than make prevention an optional extra. Knäkontroll schedule · FIFA 11+ trial schedule
3. Keep the whole structure. FIFA’s 11+ exercise poster organizes the program into initial running; strength, plyometrics and balance; and faster running. Its middle section includes trunk exercises, hamstring work, single-leg balance, squats and jumps.
4. Coach the repetitions. The FIFA instructions emphasize controlled landings, bent hips and knees, and avoiding inward knee buckling. In the Swedish trial, coaches advanced players only when exercises were performed with good control. FIFA technique instructions · Swedish trial progression
5. Record delivery, not just intention. Log the program completed, player attendance, exercise levels and omitted components. Add these to your session reflection record so that “we use prevention” means a repeatable weekly practice.

Players with knee pain, swelling, instability or a previous ACL injury need individual clinical guidance. A team prevention warm-up is not rehabilitation or return-to-play clearance.