Background The efficacy of injury prevention exercise programs (IPEPs) for amateur youth soccer has been established, but little is known about their adaptability to other soccer populations.

Objective This study aimed to assess the use of individual injury prevention exercises by professional youth soccer teams, against the industry-standard, FIFA 11+ program.

Design Prospective observational study.

Setting A European professional youth soccer academy.

Participants Soccer coaches, fitness coaches and physiotherapists (n=18) from four teams.

Data collection The teams' chosen IPEPs (total 160 sessions) were observed across one season and documented on a standardized form. The use of each FIFA 11+ exercise was coded as “performed” (in its original form), “performed modified” or “not performed”.

Main Outcome Measurements The primary outcome measure was the proportion of the 160 observed sessions containing each individual exercise in original or modified forms. The secondary outcome measure was the staff members' reasons for using and modifying FIFA 11+ exercises.

Results On average, individual FIFA 11+ exercises were conducted in original form in 12% of the sessions (range 0–33%), and in modified form in 28% of sessions (range 2–62%). The five most frequently observed exercises, in either original or modified form, were “bench” (72%), “squats” (69%),“running straight” (68%), “single-leg stance” (66%), and “sideways bench” (64%). Staff modified exercises to add variation, progression, and individualization, and to align with specific training formats and goals.

Conclusions Professional youth soccer teams often use injury prevention exercises similar to those in the FIFA 11+, but tailor them considerably to fit their implementation context. These findings will inform the design and delivery of future, context-specific IPEPs.