Neuromuscular training warm-up in the prevention of overuse lower extremity injuries in children's football: A cluster-randomized controlled trial

The objective of this study was to examine the effect of a neuromuscular training (NMT) warm-up on the prevalence of overuse lower extremity (LE) injuries in children's football. Twenty Finnish U11-U14 youth football clubs (n = 1409 players; females 280, males 1129; age range 9-14) were randomized into intervention and control groups containing 10 clubs each (intervention: 44 teams, n = 676 players; control: 48 teams, n = 733 players). The intervention group performed a structured NMT warm-up operated by team coaches for 20 weeks. The main outcome measure was the prevalence of football-related overuse LE injuries and injuries were tracked via weekly text messages. The average weekly prevalence of overuse LE injuries was 11.6% (95% CI: 11.0%-12.2%) in the intervention group and 11.3% (10.7%-11.9%) in the control group. The most common anatomical locations were the knee (weekly prevalence 6.0% in the intervention group and 5.7% in the control group) and heel (2.4% and 2.6%). There was no difference in the prevalence of overuse LE injuries between the groups: odds ratio (OR) 1.01 (95% CI: 0.99-1.03). In conclusion, NMT warm-up was equal to standard practice warm-up in preventing overuse LE injuries in children's football during a follow-up of 20 weeks.