Do exercise-based prevention programmes reduce non-contact musculoskeletal injuries in football (soccer)? A systematic review and meta-analysis with 13 355 athletes and more than 1 million exposure hours

Br J Sports Med. 2021 Oct;55(20):1170-1178. doi: 10.1136/bjsports-2020-103683. Epub 2021 May 17.


Objective: The aim of this systematic review was to investigate the effect of exercise-based programmes in the prevention of non-contact musculoskeletal injuries among football players in comparison to a control group.

Design: Systematic review and meta-analysis of randomised controlled trials.

Data sources: MEDLINE, EMBASE, CENTRAL, CINAHL, PEDro and SPORTDiscus databases were searched from the earliest record to January 2021.

Eligibility criteria: Studies were eligible if they (1) included football players aged 13 years or older, (2) used exercise-based programmes as intervention, (3) presented the number of non-contact musculoskeletal injuries (ie, defined as any acute sudden onset musculoskeletal injury that occurred without physical contact) and exposure hours for each group, and (4) had a control group (eg, usual training, minimal intervention, education). All types of exercise-based prevention programmes were eligible for inclusion. Risk of bias for each included study and overall quality of evidence for the meta-analysis were assessed.

Results: Ten original randomised controlled trials with 13 355 football players and 1 062 711 hours of exposure were selected. Pooled injury risk ratio showed very low-quality evidence that exercise-based prevention programmes reduced the risk of non-contact musculoskeletal injuries by 23% (0.77 (95% CI 0.61 to 0.97)) compared with a control group.

Conclusion: Exercise-based prevention programmes may reduce the risk of non-contact musculoskeletal injuries by 23% among football players. Future high-quality trials are still needed to clarify the role of exercise-based programmes in preventing non-contact musculoskeletal injuries among football players.

Prospero registration number: CRD42020173017.

Keywords: exercise; football; injury prevention; soccer; sporting injuries.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Athletes
  • Athletic Injuries* / prevention & control
  • Exercise*
  • Humans
  • Musculoskeletal System / injuries*
  • Randomized Controlled Trials as Topic
  • Soccer* / injuries