Background The FIFA 11+ was developed as a complete warm-up programme to 3 prevent injuries in football players. No exercises included in the FIFA 11+ specifically 4 target improving hip adduction strength or ways to improve hip and groin function. 5 Objective To study whether the FIFA 11+ warm-up programme with or without 6 Copenhagen adduction exercise would improve hip and groin self-reported outcome 7 measures over a four-week period. 8
Methods 20 players were recruited from an U23 English Academy football team. 9 Players were randomised into 2 groups; 1 group carried out the standard FIFA 11+ 10 programme, while the other group carried out the FIFA 11+ but replaced the Nordic 11 hamstring exercise with the Copenhagen adduction exercise. Both groups performed 12 the intervention 2 times weekly for 4 weeks. Players completed the HAGOS 13 questionnaire and adductor squeeze testing before the four-week programme started, 14 then weekly after carrying out the 2 intervention sessions. Main outcome measures 15 were HAGOS and adductor strength from a five-second squeeze test. 16
Results Within-group analyses revealed no significant changes between the two 17 groups in self-reported outcomes, HAGOS (p = 0.256) and five-second squeeze test (p 18 = 0.976) over the four-week period of performing the FIFA 11+ warm-up programme. 19 A significant change was seen within the Copenhagen adduction exercise group from 20 baseline and week 4 in HAGOS scores (p = 0.005) and no significant change in the 21 five-second squeeze test (p = 0.052). 22
Conclusion Including the Copenhagen adduction exercise in the FIFA 11+ warm-up 23 programme improved self-report HAGOS over a four-week period, however no 24 significant improvements were found between the two groups in both self-reported 25 HAGOS measures and adductor strength at the end of the four-week programme. 26