Football is a high participation sport world-wide and like most sports is associated with a certain risk of injury for players, both at the competitive and recreational level (Junge & Dvorak, 2004). However, it has been shown that the incidence of football injuries can be reduced by adopting various injury prevention strategies including warm-up, with an emphasis on stretching, proper medical attention for injuries, appropriate recovery methods and time, appropriate cool-down, use of protective equipment good playing field conditions and adherence to existing rules (Dvorak et al; 2000).

Physical conditioning interventions have been shown to provide significant benefit in the prevention of injuries in adults (Caraffa et al., 1996), particularly with respect to the reduction of anterior cruciate ligament (ACL) injuries. Similarly, in younger adolescent male (Junge et al., 2002) and female football players (Mandelbaum et al; 2005) and in other team sports (Emery et al., 2005) the usefulness of exercise-based conditioning programmes for injury prevention has been shown.

Whilst it is clear that sport- specific strength training programmes that include a balance training component are effective in improving physical condition and reducing the risk of injury in mature athletes, there is lack of documentation on such strategies among younger football players. There is a need to determine how physical conditioning intervention benefits younger children since they are skeletally immature and when participating in sport, are susceptible to a range of hard- and soft-tissue injuries (Frank et al., 2007).

Sport injuries could be one of the main reasons why athletes drop-out from sports or stop playing prematurely. However, other factors may also predispose to the prevalence of dropping out, for instance the condition of the playing field. In most countries, football is traditionally played on natural grass but for climatic and economic reasons, artificial turf has become a popular alternative playing surface. However, till date, the risk of injury on artificial turfs is poorly documented (Steffen et al., 2007). There is a possibility that playing on different surfaces or switching between turfs may lead to an increased risk of injury in elite as well as in amateur football.

2. Literature Review

2.1 Conceptual Framework of Study

In this study, experimental participant football players will subject to The “11” training programme to elucidate the effects physical performance. On other side The “11” is a time-efficient injury prevention program, and can after a short period of Familiarization is completed in 10-15 minutes (F-MARC, 2005). The exercises require no equipment except a ball, and are meant to be part of the warm-up period each training session, replacing similar exercises often used during warm-up. The “11” includes ten exercises, focusing on core stability, balance, dynamic stabilization, and eccentric hamstring strength. Training programme will increase positive effects for approaches of physical performance that involve Leg power, Coordination and Explosive Leg Power, Core Stability and Muscular Endurance , Speed, Football-Specific Agility. These positive effects will reflex obviously on injury incidence among young football players that result in decreasing injury risk and injury rate. Figure 1. Show the Conceptual framework to indicate effects of training on physical performance and injuries.

2.2 FIFA’s “The 11” a prevention programme

“The 11” comprises 10 evidence-based or best-practice exercises being enhanced by education and promotion of Fair Play. The programme is designed to reduce football injury, such as ankle sprains, hamstring and groin strains, and ligament injuries in the knee. “The 11” requires no equipment other than a ball, can be complete in 10 to 15 minutes and should be performed routinely in every training session. The programme can be performed on the field with the players wearing their usual equipment and football shoes. The exercises can be carried out anywhere at any time, ideally daily and not only during training sessions or match days (Dvorak, J. 2005).

The effectiveness of FIFA’s “The 11” to actually reduce injury incidence and physical performance in football has yet to be determined, for any age group or level of player. The impact of “The 11″ programme on actual injury risk is not possible to determine from the data collected in the present study. However, the observed improvements in physical attributes and findings of previous longitudinal studies (Hart, et al., 2001) would suggest that ”The 11” has the potential to reduce injury risk across the age range. Whilst no data currently exists showing the efficacy of exercise-based injury prevention programmes for young players, data from slightly older players is considered. However, we acknowledge the limitations in speculating on injury prevention using different populations drawn from other studies. In a study involving 42 female high school football players aged 14- 18 years, Heidt et al. (2000) demonstrated that a 7-week individualized, football-specific, pre-season training programme (focusing on cardiovascular conditioning, plyometrics, strength training and flexibility) was successful in significantly (p <0.01) decreasing the frequency and severity of all injuries, (Hart et al. 2001) observed a significant reduction of ACL injuries, in adolescent women playing competitive football, following a preseason conditioning programme involving proprioceptive and plyometric exercises, similar in nature to those included in

“The 11”. More recently, (Mandelbaum et al, 2005) investigated the effectiveness of a neuromuscular and proprioceptive training programme in adolescent football players over a 2 year period and reported a reduction in ACL injury of 88% (Year 1) and 74% (Year 2) compared to a control group. Collectively, these studies clearly show the effectiveness and usefulness of such programmes for injury prevention purposes in adolescent sport participants. Whilst speculation can only be made until further studies are conducted, it is possible that the “The 11” would offer similar benefits to previous conditioning interventions, specifically to young players, and importantly, across the age/experience continuum.

2.3 Physical Performance

All sports are a combination of technique, tactics, physical fitness and psychological fitness. The complexity of football is such that the relative importance of each of these variables can change from game to game. Probably one of the reasons that football is played by so many is that the game requires no specific gifts to be successful. Some games have traits that are unique to but a few, such as strength and power for American football, height for basketball, speed for sprinters, or endurance for distance running. Football, while not requiring any specific trait for success, does require some ability in all aspects of physical fitness (Dvorak, et al; 2000). However, explosive efforts during sprints, duels, jumps, and kicks are important performance factors in football, requiring maximal strength and anaerobic power of the neuromuscular system (Hoff & Helgerud, 2004). Low physical fitness may therefore contribute to an increased injury risk. In preventing injuries, increased strength has been shown beneficial in male (Askling et al; 2003) and female athletes (Knapik et al; 1991). In addition, jumping height among young females (Emery et al; 2005) and estimated VO2max (maximum oxygen uptake) among female and male football players could not be associated to injury risk. To conclude, there is little knowledge about the potential relationship between physical fitness and injury risk.

2.3.1 Leg Power

Many studies have reported that in soccer games, aerobic and anaerobic power are important features Players of a Danish first-division junior soccer team performed 76 high-intensity runs of 12 to 15 m during a soccer match. Therefore, sprint running performance, with or without the ball, is an important factor that may explain the superiority of a winning team. In addition, (Stolen et al). reported that 96% of sprint bouts during a soccer game are shorter than 30 m, with 49% being shorter than 10 m. In this context, it must be emphasized that the 10-m performance (or even shorter distances such as 5 m or power production from a stationary start) is a relevant test variable in modern soccer. This may be crucial in critical ball duals. Similarly, jumping performances might be considered as determinant of physical demands during soccer duals. The power produced depends on both force and velocity Power is defined as the combination of strength and speed. In any sport explosive movement is critical for improving performance. In sports like tennis, football, basketball, and football sprinting from one side of the court or field to another is an important part of winning. Also in many situations, to score goals or to stop goals being scored, the player should be faster and more powerful than the opponent. Moreover, by increasing force in appropriate muscles or muscles groups, acceleration and speed may improve in skills critical to football such as turning, sprinting, and changing pace.

In many situations, to score goals or to stop goals being scored, the player should be faster and more powerful than the opponent. Moreover, by increasing force in appropriate muscles or muscles groups, acceleration and speed may improve in skills critical to soccer such as turning, sprinting, and changing pace (3). Soccer is becoming more and more athletic and to win a running or jumping dual or to catch the ball before the opponent and to score, high short-term muscle power is necessary. The power produced depends on both force and velocity.

2.3.2 Coordination and Explosive Leg Power

Modern football requires a high level of physical conditioning throughout a competitive season. Therefore, one of the most important aims of training programs in the preparation (pre-season) period is to improve football-specific strength. Football-specific strength is a concept which is extensively used in training practice and can be defined as the ability of a football player to use muscle strength and power effectively and consistently within a game and a whole season (Bangsbo, 1994).

Also, during a football game, each player performs several dynamic movements (headers, cutting, tackling, sprints, and kicks) which require a very good level of muscle strength, power and endurance .Strength in its various forms (maximum and explosive strength, rate of force development) plays a critical role on performance of such skills (Cabri et al; 1988). Football practice suggests that a football player needs to develop a level of maximum strength and power, which is utilized effectively within the game (Buhrle, 1985).

Moreover, typical athletic movements are characterized by the occurrence of a special strength variant which is called explosive leg strength. Explosive strength is defined as the individual ability of the neuromuscular system to manifest strain in the shortest possible time-span (Verhošanski, 1979). In his definition of explosive strength, (Zatziorsky, 1995) introduced the notion of reversible strength which consists of two phases: the eccentric (stretch) and concentric (shortening) phase. The concentric phase should follow the muscle extension phase that precedes it as soon as possible. These kinds of muscle actions are used when hitting a ball, in a running start and during jumps (Stojanović & Nešić; 2005). The stretching and shortening cycles are characteristic of plyometrics training. The elastic characteristics of muscles and the reflex function have a significant influence on the stretching of muscles. The muscle stretching reflex is included in the SSC (stretch shortening cycle).

For a high quality eccentric- concentric contraction, three important conditions have to be satisfied: the timely activation of the musculature just prior to the eccentric contraction, the short duration of the eccentric contraction and the instant shift from the stretching phase to the shortening phase (Komi & Gollhofer, 1997).In addition, it has been demonstrated that explosive-type resistance training is more effective in improving vertical jump compared to high-resistance training. However, it has also been reported that resistance training does not always result in enhancement of vertical jump, which is affected by other factors such as learning effect training status and volume training. Other studies reported that combined training programs including resistance and explosive unloaded tasks such as throwing, jumping or kicking in the same training session may improve muscular strength and the speed of execution on the task term changes in football players repeated sprint ability is not documented. the jumping ability depends on inter limb coordination, muscle type fiber and occasionally, on maximum strength, depending on the level of the player vertical jump is improved through various types of training interventions, such as jumping exercises, depth jump, resistance training and combination of plyometrics exercises and electro stimulation, also starting power is necessary for sports that require high speed to cover a given distance in the shortest time possible. Athletes must be able to generate maximum force at the beginning of a muscular contraction to create a high initial speed. A fast start, either from a low position as in sprinting or from a tackling position in football, depends on the reaction time and power the athlete can exert at that instant.

In summary, Vertical jump performance is determined not only by the strength of the muscles of the lower body, but by the rate at which the muscles can develop force, the speed with which they can contract and still maintain force output, the ability to utilize the stretch-shortening cycle to maximize the jump height and the degree of coordination and skill in performing the movements. Traditional weight training strength will only increase jump height in athletes who exhibit low initial strength. If the athlete is already strong, training should concentrate on improving rate of force development and muscle power output.

2.3.3 Core Stability and Muscular Endurance

The effectiveness of core stability type exercises for treating or preventing lower back and lower and upper extremity injuries. Core stability exercises performed for rehabilitation purposes are often performed on unstable equipment such as a Swiss ball, wobble board, low density mat, or air filled disc.

However core stability can be developed with exercises that are structured to emphasize muscular characteristics such as endurance, strength, exercises designed to develop these characteristics should be performed to mimic the movement patterns encountered during sports participation. Therefore, the majority of core stability exercises should be performed with free weights while standing. The traditional free weight lifts commonly performed while standing on stable ground provide a great foundation for further core stability training. However, all of these lifts emphasize trunk movement and stabilization in the sagittal plane. Therefore, athletes should consider performing other lifts that involve trunk movement and stabilization in the frontal, transverse, and diagonal planes. Many times an athlete must execute a skill while supported on a single leg, and research has demonstrated higher core muscle activity when resistance exercises were performed unilaterally versus bilaterally. Therefore, ground based free weight lifts should be modified periodically to focus on unilateral strength and power development (Vera at el, 2000). Moreover, strength training for sports must be based on the specific physiological requirements of the sport and must result in the development of either power or muscle endurance. Furthermore, strength training must revolve around the needs of planning-periodization for that sport and employ training methods specific to a given training phase, with the goal of reaching peak performance at the time of major competitions. Strength, speed and endurance are the important abilities for successful performance. The dominant ability is the one from which the sport requires a higher contribution (for instance. endurance is the dominant ability in long-distance running). Most sports require peak performance in at least two abilities.

Power, the ability to perform an explosive movement in the shortest time possible, results from the integration of maximum strength and speed. The combination of endurance and speed is called speed-endurance, a relationship of high methodical importance exists among strength, speed, and endurance. A solid foundation for specialized training is built during the initial years of training. This sport-specific phase is a requirement for all national-level and elite athletes who aim for precise training effects. As a result of specific exercises, the adaptation process occurs in accordance with an athlete’s specialization. For elite athletes, the relationship among strength, speed, and endurance is dependent on the sport and the athlete’s needs (Tudor, 2001). In conclusion, there are two types of endurance, short and long range. Short endurance refers to ability to sprint longer and long endurance is more general and it help pull off an entire match. It’s important to know that endurance isn’t just about being able to run for the ball longer in a match. However, core stability training should receive some attention in the training programs of all athletes.

2.3.4 Speed

Speed plays in football an important role, the accelerated pace of the game calls for rapid execution of typical movements by every member in a team. In many instances, successful implementation of certain technical or tactical maneuvers by different team members is directly related with the degree of velocity deployed (Kollath & Quade, 1993).Football players running speed can be improved following several types of training interventions such as sprint training, towing, over speed and specific plyometrics exercises, According to the Dawson study (2003), the large majority of sprints performed in football take six seconds or less to complete, over distances of only 10-30 meters, and many of the sprints involve at least one change of direction. As running speed increases, longer strides are taken. In this instance, the swing phase involves greater knee flexion and hip extension, and greater hip flexion in the latter part of the phase (Howe, 1996).

During football games, many actions affect the result of games. These actions are characterized by intermittent and multi-directional movements, as well as the movements of changing intensity and time. (Reilly & Ball 1984) stated that each game typically involves about 1000 changes of activity by each individual in the course of play, and each change requires abrupt acceleration or deceleration of the body or an alteration in the direction of motion. Specific physical and physiological characteristics of football players can be used by coaches to modify training programs and to help players prepare for the game strategy. The modern football relies on the ability of all players to attack and defend whenever necessary. Therefore, it is important that all players achieve a high level of performance in the basic skills of kicking, passing, trapping, dribbling, tackling and heading. Analysis of the physical and physiological characteristics of the players and determination of the specific requirements for optimal performance are thus a necessity (Tiryaki et al., 1996).

When running with a ball, much shorter strides are taken as the player must be ready to change direction and speed. At the toe-off phase, the leg may not be as extended heel stride may not be as pronounced, rather the foot may land in a more neutral position or be plantar flexed It is known that players with sprint skills have advantage over other players, accelerating power refers to the capacity to achieve high acceleration. Sprinting speed or acceleration depends on the power and quickness of muscle contraction to drive the arms and legs to the highest stride frequency, the shortest contact phase when the leg reaches the ground and the highest propulsion when the leg pushes against the ground for a powerful forward drive. The capacity of athletes to accelerate depends on both arm and leg force. Specific strength training for high acceleration will benefit most team sport athletes from wide receivers in football to wingers in rugby or strikers in football (Howe, 1996).

In conclusion, football coaches focused on their athletes for endless sprints of the’ training speed’ purpose. It must be understood that this type of training does not amount to quantifiable speed work. Training stimulus in which athletes are asked to perform repeated efforts with limited rest time (especially when the symptom logy of the effort includes breathlessness, excessive sweating or an increase in lactic acid production) is not an efficient or realistic means by which to increase speed. Speed training involves a deliberate focus on the efficiency of motion, a targeted directive towards nervous system activation and adequate rest periods so as to allow this efficiency sequence to be repeated without undue fatigue

2.3.5 Football-Specific Agility

Agility is the ability to change the body’s position, and requires a combination of balance, coordination, speed, reflexes, strength, endurance and stamina. Agility is usually achieved when a person is using their anaerobic systems. For example, in football, an agile player can respond quicker to an opposing player, closing down or jockeying. An agile player has the ability to explosively break, change direction and accelerate again.

Also, agility is an essential attribute if a football player is going to give 100% effort and commitment during a match. Regardless of your position you need to be able to accelerate and change direction quickly. For example, a wide player must be able to dribble past an opponent using both feet and tricks. This requires the development of speed and agility. In football, the ability to accelerate, decelerate and rapid movements in all directions is more important than simply running fast. There are various methods of improving a player’s agility, these exercises and drills can be completed with or without a ball. In addition, agility refers to the capability to change the direction of the body abruptly. The ability to turn quickly, dodge and sidestep calls for good motor coordination and is reflected in a standardized agility run test. (Reilly, 1996).

Agility tests comprise different directional movements with changes between 35 m and 142 m in area (Haywood, 1986). Wilmore has defined agility as the ability to change movement direction, and it constitutes conjunction of sprint, strength, stability and coordination factors. Also, agility is the product of a complex combination of speed. Coordination, flexibility and power as demonstrated in gymnastics, wrestling, football, football, volleyball, baseball, boxing, diving and figure skating when agility and flexibility combine, the result is mobility, the ability to cover a playing area quickly with good timing and coordination Too, agility training is particularly useful to football players who spent much of the game cutting, pivoting and moving side to side. Also, agility can help on several levels in football. Goalkeepers will have better reflexes and they’ll be able to get to high balls quicker if they’re more agile. Defenders will be harder to dribble and their tackles will be more accurate and clean with the right level of agility. Midfielders can dribble with ease if they’re agile and strikers work well around their quickness in order to get in front of the defender and finish on crosses, or dribble their way to goal when possible(Wilmore, 1992).

In conclusion, an essential element of successful football performance is agility, change direction quickly and deceives the opposition. Performing these movements while dribbling with alternate feet requires considerable effort and control. This requires development of speed and agility.

2.4 Incidence of Injury among young football players

In contrast, several prospective studies have documented the injury incidence and patterns in players older than 12 years, where the incidence seems to increase with increasing age. Players in the 16- to 18-year age group appear to have injury incidences comparable with those of adult players. Because of the paucity of data on injuries among children playing organized football, we wanted to investigate whether there are differences between children aged 6 through 12 years playing 5- or 7-a-side football and adolescents aged 13 through 16 years playing regular 11-a-side football (Froholdt et al, 2009).

In addition, in youth football, rule changes to reduce aggressive contact leading to ball control may have a potential for decreasing injury. Researchers have studied the relation of football injuries to age. Higher rates of injury occur in the older male (16 -18 years). In age-matched players, relatively poor muscular strength has been shown to be associated with higher rates of injury. In one study involving male and female players, the highest injury rates were reported for the oldest girls (17-19 years), and the lowest rates were reported for the youngest girls (9 to13 years) (Kucera at el; 2005).The incident of injury in New Zealand school teams playing football is high when compared with other youth team sports, probably because of the low ratio of hours spent in training relative to hours spent playing matches. Specifically, the incidence of match injuries was more than twice as high in rugby players compared with football players, the greater severity of rugby injuries was shown by the higher incidence of fractures and dislocations in the rugby players compared with the football players (Junge, et al; 2004). In summary, Prevention programs, fair play, and the continuing improvement of skills may reduce the incidence of injuries among young football players in the long term.

2.4.1 Injury Rate in Youth Football

Injury rate provides an estimate of the chance that an athlete will experience an injury during a specified time or exposure interval. Injury rate is defined as the number of injuries per 1000 hours of player activity time, or number of injuries per 1000 athlete exposures. Athlete-exposure is one athlete participating in one competition or one training session where he/she is exposed to the possibility of being injured, no matter what amount of time is involved. For example, two competitions involving 40 participants and three training sessions involving 50 participants would result in a total of 230 athlete exposures. (Knowles et al. 2006).

On the other hand, male players have higher injury rates than female players during competition. One possible reason is that male players are usually playing at higher competitive levels. The more competitive the match, the greater the speed of movement and more body contact, all of which increase the chances of injury. On the other hand, male players have higher injury rates than female players during competition. One possible reason is that male players are usually playing at higher competitive levels. The more competitive the match, the greater the speed of movement and more body contact, all of which increase the chances of injury (Wong & Hong, 2005).

2.4.2 Injury Risk in Youth Football

Injury risk is the probability of an athlete sustaining an injury. Data on injury risk in seasonal elite football revealed surprisingly high injury rates for 15 to19 year-old French female football players. These figures reflect similar or even higher injury rates than recorded in adult elite level female football. The incidence of match injuries was also notably higher than match injury rates found among male youth and adolescent football players, suggesting that adolescent elite female football players are at high injury risk. Mismatches in biological maturity between young athletes may also have implications for an increased injury risk, specifically in sports that are characterised by physical contact between teammates and opponents for example, in ball team sports and martial arts. Competing regularly against older, more mature, and heavier opponents may lead to a higher incidence of injury in younger athletes (Kathrin et al; 2010).

In addition, Football has a higher injury rate than many contact, collision sports such as field hockey, rugby, basketball, and football, although in community study of 7- to 13 year-old players, football did have a higher percentage of serious injuries and higher frequency of injury per team per season. The US Consumer Product Safety Commission (CPSC), through its National Electronic Injury Surveillance System, estimated that there were 186544 football-related injuries in 2006.

Approximately 80% of these injuries affected participants younger than 24 years, and approximately 44% occurred in participants younger than 15 years. It is unfortunate that there is a wide variation in the reported incidence of football injuries as a result of study differences in factors such as level of competition, intensity of exposure, definition, classifications, and reporting of injuries. Because of difficulties with interestedly comparisons, standard definitions and methodology have been proposed to ensure consistent and comparable results in the future.

With respect to age, participants younger than 15 years tend to have a higher relative injury risk and greater prevalence of injuries compared with older players. According to the National Electronic Injury Surveillance System, football injuries among young athletes in the United States occur at a peak of injuries per 1000 participants. 10 For football players older than 12 years, rates of 4 to 7.6 injuries per 1000 player-hours have been reported. Over an entire football season, girls’ and boys’ teams may expect 4.0 and 3.5 injuries per season, respectively. It is notable that the risk of injury is greater during competition than during practice sessions.

Although suffering a previous injury within the past year confers a 1.74 relative risk of a new injury, there have been no consistent findings to support a higher risk to any position on the field. Some have reported overall injury rates to be similar between boys and girls, but others have found higher prevalence of injuries in female players, with girls having an increased risk of anterior cruciate ligament (ACL) tears and concussions and being more likely than boys to be injured in training situations. In contrast, boys have a greater relative risk of injury during competition (Chris et al; 2009).

In summary, the young elite athlete seems to be subjected to a high injury risk. However, the current knowledge on injury risk for this population is a part from football, based on few and for the most part small studies. Large prospective investigations are needed in most sports (Kathrin et al; 2010).

3. Problem Statement

Football is the highest incidence of sports injury and like most sports higher rates of injury occur in the young football players, especially in the 14 to16 year old players than in the 16 to18 year old players. there are many reasons lead to the occurrence of these injuries such as young football players due to lack of awareness of injury prevention, insufficient preparation, technical movements are not standardized, also this might be explained by weaknesses in techniques and tactics as well as in muscle strength, endurance, and coordination in the less experienced, younger players, too youth football players are they sometimes do not understand the importance and seriousness of some things that needs to be done. Sometimes, because o