Injury Prevention Programmes

It is a neuromuscular warm-up in 3 parts: running and activation; strength, balance and plyometric exercises including a Nordic-style hamstring exercise and knee-stability work; and higher-speed running. It takes around 20 minutes, needs minimal equipment, replaces the usual warm-up and reduced football injuries by 39% in a meta-analysis of randomised trials.

Programmes that include it consistently reduce hamstring injuries, by roughly half in meta-analyses from 2017 and 2019. A 2026 network meta-analysis of football trials also found a reduction for the exercise alone, smaller and not statistically significant. The uncertainty is about the size of the benefit, because the trials are of moderate to low quality, rather than about whether it helps. It builds the eccentric strength the hamstrings need to decelerate the lower leg in fast running.

Yes. In a pooled analysis of meta-analyses, prevention programmes reduced all ACL injuries by about 50% and non-contact ACL injuries in female athletes by about 67%. Evidence in male athletes is insufficient. A preseason start appears to help, with the programme continued through the season.

A neuromuscular warm-up works only when it is done consistently and correctly, and higher adherence is generally associated with greater effect. Implementation, through coach education, physiotherapist or medical input to teach technique, and adherence monitoring, is as important as the content of the programme.