How it all began

World football’s governing body FIFA attaches particular importance to players’ health. Thus, in 1994 an independent research unit was established by members of the Medical Committee: the FIFA Medical Assessment and Research Centre (F-MARC).

The objective was for F-MARC to develop the scientific basis to protect the health of all players and promote football as a healthy leisure activity. 

Prevention is possible

F-MARC’s first task was to reduce the incidence of injury in football. In order to achieve this, it was first necessary to establish how often and why elite and amateur players suffer injuries and whether there are differences between men, women and young players in this respect. This was no easy task, but was an essential prerequisite for effective prevention, because injuries can only be prevented if we know how often, when, where and how they occur. F-MARC conducted studies not only with male and female players at different levels of play, but also developed a system for the standardised registration of all injuries at football tournaments which has since been adapted for other sports and adopted by the International Olympic Committee.

This thorough preparatory work allowed F-MARC to develop “The 11”, a prevention programme for amateur players, whose effectiveness has been impressively proven in Switzerland. The nationwide implementation led to a significant decrease in injuries during matches and training, proving not only the effectiveness of the programme, but that it is easily and broadly applicable. Since then, “The 11” has been further developed into a complete warm-up programme – “The 11+”. In a major study in Norway, “The 11+” resulted in the overall injury rate decreasing by a third, and the number of serious injuries by half – an unparalleled achievement (see page …).

The Laws of the Game and their interpretation play a huge role in minimising the risk of injury. F-MARC established that elbow-to-head contact constitutes a particular risk for serious injury. These results led the International Football Association Board to make an amendment to the Laws of the Game prior to the 2006 FIFA World Cup™: cases of elbowing to the head would be sanctioned with red cards. As a result, fewer head injuries and concussions were registered at the FIFA World Cup™ in Germany than before.

In addition to injury prevention, F-MARC has addressed a variety of other medical issues over the years, including, for example, the best initial examination to prevent sudden cardiac death, environmental influences such as heat and altitude, optimum nutrition and the effects of fasting during Ramadan on performance.

It is important that players worldwide actually benefit from these scientific findings and the status of current research, and to this end, as well as scientific articles, F-MARC has also published a host of information material for doctors, physiotherapists, coaches and players.

Football makes and keeps you healthy

The most important project at present and in the future goes far beyond the game itself: the focus of “Football for Health” is not on players’ health but on the health of communities and society as a whole. Football’s popularity means it has the potential to play a unique role in disease awareness and prevention.

Thanks to the preparatory work of F-MARC, the game could be considered safe for everyone provided that some precautions are taken. This allowed to now fully explore the health benefits of playing and the use of football as a tool in health education.

In 2010, the Scandinavian Journal of Sports Medicine and Science published a special issue of the effects of playing football on a leisure time base on health. It could be shown that enjoying a small-sided game two to three times a week considerably improved all risk factors for heart disease, high blood pressure, diabetes and osteoporosis in formerly untrained middle-aged men and women. The effects of football were more prominent than those of jogging and strength training. Playing also helped to reduce overweight in addition to numerous social benefits not experienced with the other sports.

Simultaneously, the efficacy of F-MARC’s “11 for Health” was first tested in school children from disadvantaged areas in World Cup host country South Africa. The pilot study showed that the simple health messages combined with different elements of football play, such as defence, headers, taking shots at goal and attacking, were indeed able to considerably improve knowledge and change attitudes towards health among the boys and girls.

Further studies in Zimbabwe and Mauritius followed and in fact the Mauritian government as early as in January 2011 launched “11 for Health”in all secondary  schools of the country. Further countries followed suit: Kenya, Namibia and Mali entered into discussions with F- MARC on nationwide implementation of the programme. 

The FIFA Medical Committee and F-MARC have clear goals: to protect the health of the 265 million players worldwide, to promote football as a safe and healthy leisure activity and to develop its contribution to world health.

Dr Michel D’Hooghe                                                            Prof. Jiri Dvorak          

Chairman FIFA Medical Committee                                   Chairman of F-MARC