Rescheduling Part 2 of the 11+ reduces injury burden and increases compliance in semi-professional football
Although the 11+ program has been shown to reduce injuries in sub‐elite football, program compliance is typically poor, suggesting that strategies to optimize delivery are necessary. This study investigated the effect of rescheduling Part 2 of the three‐part 11+ program on program effectiveness. Twenty‐five semi‐professional football clubs were randomly allocated to either a Standard‐11+ (n = 398 players) or P2post group (n = 408 players). Both groups performed the 11+ program at least twice a week throughout the 2017 football season. The Standard‐11+ group performed the entire 11+ program before training activities commenced, whereas the P2post group performed Parts 1 and 3 of the 11+ program before and Part 2 after training. Injuries, exposure, and individual player 11+ dose were monitored throughout the season. No significant between group difference in injury incidence rate (P2post vs Standard‐11+ = 11.8 vs 12.3 injuries/1000 h) was observed. Severe time loss injuries > 28 days (33 vs 58 injuries; P < .002) and total days lost to injury (4303 vs 5815 days; P < .001) were lower in the P2post group. A higher 11+ program dose was observed in the P2post (29.1 doses; 95% CI 27.9‐30.1) versus Standard‐11+ group (18.9 doses; 95% CI 17.6−20.2; P < .001). In semi‐professional football, rescheduling Part 2 of the 11+ program to the end of training maintained the effectiveness of the original 11+ program to reduce injury incidence. Importantly, rescheduling Part 2 improved player compliance and reduced the number of severe injuries and total injury burden, thereby enhancing effectiveness of the 11+ program.