How Effective are F-MARC Injury Prevention Programs for Soccer Players? A Systematic Review and Meta-Analysis



The FIFA Medical and Research Centre (F-MARC) has designed a comprehensive warm-up program targeting muscular strength, body kinaesthetic awareness, and neuromuscular control during static and dynamic movements to decrease injury risk for soccer players. Prior studies have investigated the effectiveness of the F-MARC programs, but have not consistently reported a statistically significant reduction in injury and reduction in time loss due to injury from utilizing the program.


The purpose of this study was to conduct a systematic review and meta-analysis of randomized controlled trials and interventional studies that evaluated the efficacy of the F-MARC injury prevention programs in soccer.


Two independent researchers searched the relevant article databases. The keyword domains used during the search were ‘F-MARC’, ‘FIFA 11+’, ‘the 11+’, ‘injury prevention programs’, ‘soccer’, and variations of these keywords. The initial search resulted in 4299 articles which were filtered to nine articles that met the inclusion criteria. Main inclusion criteria were randomized controlled trials or interventional studies, use of F-MARC injury prevention programs, and the primary outcome measuring overall and lower extremity injuries. Extracted data were entered and analyzed using Comprehensive Meta-Analysis software, version 2 (CMA.V2).


The pooled results based on total injuries per 1000 h of exposure showed that F-MARC injury prevention programs had a statistically significant reduction in the overall injury risk ratio of 0.771 (95 % CI 0.647–0.918, p = 0.003) and the lower extremity injury risk ratio of 0.762 (95 % CI 0.621–0.935, p = 0.009). Moreover, FIFA ‘11+’ had a statistically significant reduction in the overall injury risk ratio to 0.654 (95 % CI 0.537–0.798, p < 0.001) and the lower extremity injury risk ratio of 0.612 (95 % CI 0.475–0.788, p < 0.001). However, FIFA ‘11’ did not reach significance for the lower extremity and overall injury reduction. It can be suggested that teams involved in the FIFA ‘11+’ warm-up program will reduce injury rates by between 20 and 50 % in the long term compared with the teams that do not engage in F-MARC programs.


This systematic review and meta-analysis indicated that use of F-MARC injury prevention programs, particularly the ‘11+’ program, decreases the risk of injuries among soccer players. These data also support the case for the development and introduction of sport-specific programs.

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All authors of this paper have contributed substantially to the conception and design of the review, the analysis and interpretation of the data, the drafting of the article or revising it critically for important intellectual content, and the final approval of the published version.

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Correspondence to Wesam Saleh A. Al Attar.

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Wesam Saleh A. Al Attar is supported by Umm Al Qura University in Makkah, Saudi Arabia. No sources of funding were used to assist in the preparation of this review.

Conflict of interest

Wesam Saleh A. Al Attar, Najeebullah Soomro, Peter Sinclair, Evangelos Pappas and Ross Sanders declare they have no conflicts of interest with the content of this review.

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Al Attar, W.S.A., Soomro, N., Pappas, E. et al. How Effective are F-MARC Injury Prevention Programs for Soccer Players? A Systematic Review and Meta-Analysis. Sports Med 46, 205–217 (2016).

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  • Soccer Player
  • Injury Rate
  • Injury Risk
  • Lower Extremity Injury
  • Injury Prevention Program