Background Goalkeepers appear to be the players who are at most risk of sustaining a shoulder injury. Many researchers have reported that goalkeepers are more likely, than outfield players, to injure their upper limb. The FIFA 11+S is structured according to the FIFA 11+ program which is already being successfully used to prevent injuries.

Objective To investigate the effectiveness of the FIFA 11+S in reducing the incidence of upper extremity injuries

Design Randomised controlled trial.

Setting Amateur soccer.

Patients (or Participants) Male goalkeepers aged 14 to 35 years were randomly assigned to the experimental group (n = 360) or the control group (n =366).

Interventions (or Assessment of Risk Factors) Experimental groups performed FIFA 11+S exercises for 20–25 minutes. The control group practiced their usual warm up.

Main Outcome Measurements The incidence of upper extremity injuries, mechanism, type and severity of injury.

Results During one season, 50 injuries (0.62 injuries/1000 exposure hours) were reported in the experimental group and 122 injuries were reported in the control group (1.94 injuries/1000 hours). The FIFA 11+S significantly reduced the total number of upper extremity injuries (RR =0.42 [0.31–0.56]; p < 0.00001; Number Needed to Treat= 5.1), the incidence of contact injury (RR =0.39 [0.27–0.55]; p < 0.00001), the incidence of initial injury (RR =0.43 [0.31–0.59]; p < 0.00001) and the incidence of recurrent injury (RR =0.32 [0.12–0.86]; p < 0.05) more than the usual warm up. Minor injury severity (RR = 0.41 [0.29–0.58]; p < 0.00001) and moderate injury severity (RR = 0.44 [0.20–0.94]; p < 0.05) were significantly reduced in the experimental group (FIFA 11+S) compared to the control group.

Conclusions This is the first study investigating the effectiveness of the FIFA 11+S in reducing the incidence of upper extremity injuries. This randomised trial provides evidence that implementation of the FIFA 11+S can reduce the incidence of upper extremity injuries among goalkeepers more than usual warm-up.