Protecting Athletes: The Clinical Relevance of Meta-Analyses on Injury Prevention Programs for Sports and Musculoskeletal Body Regions: An Overview of Systematic Reviews with Meta-Analyses of Randomized Clinical Trials

Background: Musculoskeletal injuries have a substantial impact on athletes, affecting sports performance and increasing the risk of future musculoskeletal disorders (e.g., osteoarthritis). Injury prevention programs are essential to reduce the risk of sport-related injuries and meta-analyses can provide a large amount of information in a single article. Objective: To summarize the pooled effects of injury prevention programs focused on any form of physical exercise in the incidence and risk of musculoskeletal injuries and reinjuries by sports and musculoskeletal body regions. Methods: The CINAHL (via EBSCOhost), Embase (via Elsevier), Epistemonikos, PubMed, Scopus, SPORTDiscus (via EBSCOhost), and the Cochrane Library e-databases were searched from inception to 7 October 2024. Systematic reviews with meta-analyses of randomized clinical trials were considered. The methodological quality of systematic reviews was assessed with AMSTAR 2. The degree of overlap between meta-analyses of interest was calculated. Results: Fourteen systematic reviews were included. Thirteen of these reviews were focused on soccer. Overall, meta-analyses including a specific injury prevention program (FIFA 11+ and FIFA 11+ kids) found that these programs may reduce the risk of musculoskeletal injuries among soccer players. Concretely, FIFA 11+ may reduce the risk of ankle, knee, hip/groin, and hamstring injuries, whereas FIFA 11+ kids may decrease the risk of ankle and knee injuries. Conclusions: FIFA 11+ and FIFA 11+ kids may reduce the risk of sports musculoskeletal injuries, mainly in the lower limbs. However, many clinical and methodological issues (e.g., the lack of meta-analyses in many types of sports) were discussed and highlighted the difficulty of making robust clinical recommendations with the current data.