Purpose (1) To quantify current practice at the most elite level of professional club football in Europe with regard to injury prevention strategy; (2) to describe player adherence and coach compliance to the overall injury prevention programme.

Methods A structured online survey was administered to the Head medical officers of 34 elite European teams currently participating in the UEFA Elite Club Injury Study. The survey had 4 sections; (1) risk factors for injury, (2) assessment and monitoring of injury risk, (3) prevention strategies and (4) coach compliance and player adherence to the injury prevention process.

Results 33 (97%) Medical officers of the teams responded. The most important perceived injury risk factor was previous injury. Four of the top 6 risk factors—physical fitness, accumulated fatigue, reduced recovery time between matches and training load—were related to player workload. The top 3 preventative exercises were eccentric, balance/proprioception and core training. Regarding monitoring, the top 3 tools implemented were measurement of workload, subjective wellness and a general medical screen. The subjectively rated level of coach compliance in UEFA teams was perceived as ‘high’, while the player adherence varied from none at all to perfect.

Summary and conclusion Medical officers place importance on workload-related variables as risk factors for injury in elite European football players. A lack of consistently high player adherence may limit the effects of contemporary injury prevention programmes in elite European footballers.