Four Months Training with the Football+ and 11+ Improves the Landing Quality of Female Players

Abstract The effectiveness of the Football+- and 11+-programs in improving landing quality among players with a history of severe ankle or knee injury remains unexplored. This study examined (i) the efficacy of these programs in developing landing assessed via the Landing Error Scoring System (LESS) and (ii) the association between injury history and landing quality. Fifty-six amateur female players (24.12±5.37 y) reported their injury history and completed the LESS test before and after a 4-month intervention. Repeated-measures analysis of variance and independent t-tests analyzed the outcomes at p≤0.05. Players with a history of severe ankle (6.33±1.53; p = 0.019 and d = –0.76) or knee (5.92±0.74; p =0.041, d =–0.77) injury exhibited higher LESS scores compared to the non-injured counterparts (5.25±1.37). Analysis of variance revealed a significant time (p = 0.001 and η 2 = 0.31) and time-group effects (p = 0.002 and η 2 = 0.24) following the 11+ (5.59±1.35 vs. 5.04±1.47) and the Football+ (5.76±1.55 vs. 4.65±1.37). A history of severe knee or ankle injury reduces the landing quality. Both the Football+ and 11+ improved landing, with the Football+ demonstrating greater efficacy. Previously injured players benefited most, although their landing performance remained inferior to non-injured peers. While the injury history is traditionally regarded as a non-modifiable risk factor, targeted neuromuscular programs may partially mitigate its impact on movement quality.