HOW FIFA CONTRIBUTES TO PROMOTING HEALTH, IN AND THROUGH FOOTBALL

Player health and well-being are essential to the success and development of football at every level. FIFA Medical’s mission has been to improve player health globally by setting standards in clinical care and governance, building a worldwide football medicine community, conducting and facilitating impactful research and education, and promoting equity and diversity in access to football medicine knowledge.

To achieve our mission, FIFA collaborates closely with the 211 member associations, the confederations and a wide range of external stakeholders. Building on the commitment that FIFA has shown since 2016 to reconnect with the beautiful game and strengthen its role within it, our aim is to deepen the engagement of world football’s governing body in safeguarding player welfare and taking on an expanded role in promoting health and well-being across all levels of the football.

The process is led through a medical governance framework, ensuring FIFA maintain high standards, improve quality, and are accountable for player care through systems like risk management, clinical audits/guidelines, education, and evidence-based practices, aiming for safe, effective, and player-centered care. We want to facilitate practitioners across the globe to first off have formalised training and education in football medicine, providing equal and fair access to football medicine opportunities globally and change the mind-shift from a culture of where medical practitioners obtain jobs based on their connections (“jobs for the boys”) to one where education, talent and work ethic are promoted, for the benefit of players and the good of the game.

One of the primary FIFA Medical pillars over the last number of years has been to promote, facilitate and standardise player health surveillance globally and create an overview of the magnitude and determinants of all major health challenges in football. By bringing together all of the stakeholders involved in player health surveillance to discuss key challenges and facilitate data-sharing and high-quality research, FIFA are able to inform discussions related to player health, such as match workload and other major topics of interest. This has allowed us to evaluate and refine player health surveillance strategies, conducting reviews of injury and illness data and updating health-related policies accordingly, as well as adapting strategies based on emerging health research and technological advances. Through a process involving the systematic collection and analysis of health surveillance data¹ , this has now positioned us to better understand injury and illness patterns, risk factors and related outcomes, which can help us develop evidenced-based strategies to improve player well-being and reduce any health risks in football. 

FIFA Medical are facilitating efforts to implement player health surveillance programmes across football globally. Our aim is for all football organisations to perform surveillance as a foundation their own risk management processes and as a basis for regional and global collaboration on common challenges. We are actively working to help football organisations implement and standardise surveillance and have already brought together many leagues from around the world who perform surveillance to address the issue of match load and injury risk, and have initiated two studies in this field.

As an International Federation (IF), conducting optimal surveillance programmes allows us to plan and provide education on injury and illness prevention and health management based on sound scientific evidence, raising standards and facilitating those currently working in football medicine, from across all professions allied to sports medicine, to obtain the necessary qualifications and skill sets necessary to obtain these goals, driving the football medicine community forward. We have used this information already to inform our education learning platforms such as the online FIFA Medical Diploma² and our tertiary degree in Football Medicine FIFA³.  The surveillance programmes assist us producing educational resources on both injury prevention and health management for players, coaches and health professionals, and ensures the global implementation of protocols through these dedicated programmes. But we are not alone in this aim. We work with the confederations and member associations to gather current best in class educational resources and establish further needs, both aligning and contextualising health educational content. In this context our primary role is in facilitating dissemination, improving access in a free and open manner to all.

Globally FIFA has an inherent responsibility to promote the physical and mental health benefits, as well as the social advantages, of football participation globally. Football is about enjoyment, competition and health. There are numerous health benefits of football participation, and our job as practitioners in football medicine is promoting football as a health intervention, particularly in the areas of physical health, mental health and social development. The game enhances cardiovascular fitness, builds muscle strength, improves coordination and supports healthy weight management, thereby contributing to the prevention and management of conditions such as obesity and cardiovascular disease. Football also plays a significant role in improving mental health by reducing stress, anxiety and depression, while raising self-esteem and enhancing cognitive function. The sport also serves as a unifying force that fosters community cohesion, promotes inclusion and empowers youth through shared experiences.

To promote the above-mentioned health benefits, FIFA have developed evidence-based educational resources and global awareness campaigns in conjunction with our health partners (e.g. the World Health Organization)^4,5, the Member Associations and the confederations. The World Cup in 2026 will be the first major footballing event with a dedicated mental health service for all players and support staff. We are taking a leading role in developing a certification for all those throughout the 211 Member Associations who wish the become FIFA Mental Health First Aiders (launching in Q2 2026). Through our Football for Schools programme and our FIFA Medical animated series we encourage the inclusion of football within physical education curricula⁶.  This safeguards the future of the game while leveraging FIFA’s global influence to improve public health.

Alas, as the Scottish poet Mary Brooksbank once said, “The World is ill-divided”. Together we must facilitate and model equity in medicine and science as an essential element of player health advocating for and modelling equity in medicine and science as an essential element of player welfare. This requires a systematic and inclusive approach. By embedding equity in football medicine and science, the game is able to enhance player health, improve performance and create a more inclusive and fairer sporting environment. Part of the FIFA Medical strategy aims to achieve this by:

• establishing equity-focused policies in football medicine, regardless of gender, race, socio‑economic status or ability;
• advocating for inclusive research and innovation in football medicine that considers gender, race, socio-economic status and ability in regard to both development and participation; and,
• ensuring equal access to medical resources and facilities, and expanding sports medicine access to underserved communities and advocating for parity in funding across men’s and women’s football research, sports science and medical care.

Using all the resources above and the tremendous global knowledge within football medicine we can build an accessible football medicine network that connects research and practice globally. The development of a truly global football medicine network will revolutionise how health professionals and researchers work together. By incorporating technology, collaboration and education, we aim to maintain a free, centralised online portal that serves as the hub for football medicine research, guidelines and best practices, facilitating open-access research, collaboration and data-sharing⁸.

We hope to continue to provide an interactive learning hub, developing additional free online courses, webinars and qualification programmes within football medicine, with the ultimate goal of creating a global community of football health experts, establishing regional working groups in collaboration with confederations that tailor medical practices to local football contexts, and ensure the inclusive development of new initiatives and the undertaking of potential research of the highest quality.

The role of international sporting federations should really be to support Member Association and confederation initiatives to improve player health, and facilitate the knowledge sharing between each country and each region.  FIFA enable this by providing strategic guidance, funding and education, as well as by standardising medical policies throughout football^9,10.  Empowering the Member Associations and confederations with evidence-based resources, education and medical policies ensures that players at all levels of the game enjoy safer, healthier and longer careers. Through the development and enforcement of medical standards and policies we can provide clear, evidence-based medical guidelines for all football stakeholders, encompassing injury prevention¹¹, emergency care¹², recovery protocols and mental health support¹³, by standardising medical screening and health management protocols and guidelines across all competitions¹⁴. By establishing regional and confederation-level medical networks that encourage knowledge‑sharing ventures within each confederation, this helps in;

• promoting multidisciplinary collaboration between sports scientists, psychologists, physiotherapists, physicians, coaches and players; and
• monitoring and evaluating health initiatives, conducting health audits for Member Associations to assess progress and identify gaps in player healthcare.

All of the above considerations then accumulate together to help in our mission to continue to investigate the long-term health outcomes of football participation.  To understand the long-term health effects of football participation, we have found that a comprehensive co‑designed research approach must be implemented. This involves longitudinal studies, medical tracking, data analysis and collaboration with experts in sports medicine, epidemiology and other health and medical specialities, as well as facilitating research partnerships with non-medical stakeholders including players, coaches and ethicists to help enhance player welfare, improve medical interventions and shape policies that promote sustainable careers and well-being beyond retirement. Since 2020 FIFA Medical have been developing policy recommendations and prevention strategies by:

• using research findings to refine injury prevention programmes and clinical guidelines, and working with Member Associations and confederations to implement evidence-based policies and education that improve long-term player health;
• ensuring anyone is able to participate in football without concern for their current or future brain health, including prioritising projects that aim to reduce a player’s risk of sustaining an acute brain/head injury in football, improving the identification and management of acute brain/head injuries in the game and exploring the risk between heading, head impacts, head injuries and long-term brain health; and
• fostering both internal and external connections and collaborations to enable the right research to be conducted by the right people at the right time, featuring both immediate outcomes and long-term planning¹⁵.

And this takes us to our flagship tournaments that we use to help disseminate our work throughout the football pyramid. Our primary aim is to ensure optimal medical care for players across all FIFA tournaments, prioritising player welfare through evidence-based medical protocols, specialised trained and accredited teams, advanced technology and collaboration with global medical experts. By implementing these elements, FIFA ensures world-class medical care at each of its tournaments, using the protocols in place to encourage other organisations to adopt a standardised approach to pitch-side emergency care globally, protecting player welfare at all levels.

FIFA Medical is responsible for all pre-tournament medical planning and regulations, ensuring the following:

• Every host country meets FIFA Medical’s infrastructure requirements, guaranteeing that hospitals, emergency response units and medical staff are prepared¹⁶.
• Medical emergency plans are created for each stadium, encompassing evacuation routes, hospitals and trauma care protocols¹⁷.
• Each tournament venue has fully equipped FIFA-standard player medical centres with emergency treatment capabilities.
• FIFA Medical staff identify and respond to on-field emergencies immediately. FIFA implements a strict concussion protocol, requiring players to undergo touchline medical evaluations before returning to play under the ethos of “suspect and protect”¹⁸. Additional concussion substitutes are allowed, ensuring that player welfare is prioritised over competition¹⁹. Advanced injury assessment tools – including the development, implementation and evaluation of a football‑specific standardised on-field concussion assessment tool and on-field video replay technology – to assist medical teams in the identification and assessment of potential head injuries are in place.

FIFA competitions provide a global platform to promote health initiatives that leave a lasting impact beyond the tournament itself. We are fortunate to use FIFA competitions to develop legacy health campaigns. By leveraging the visibility of major events, such as the FIFA World Cup™, the FIFA Women’s World Cup™ and FIFA youth tournaments, FIFA is able to create long‑term health programmes that benefit players, fans and host communities. By incorporating legacy health campaigns into every competition, FIFA is able to promote global health, improve player and fan well-being, and ensure long-term public health benefits in the host nations. We encourage the inclusion of legacy health initiatives in the host country agreements. This assists in implementing sustainable health programmes as part of the association’s tournament bid, which ensures investment in public health infrastructure, such as medical facilities and grassroots sports programmes. Tournaments offer a launch pad for global health campaigns that can serve to raise awareness of key health issues through initiatives such as offering free health screenings (e.g. to screen heart health, body mass index injury risk) in fan zones and stadiums²⁰, encouraging fans to participate in football-related fitness challenges before and during tournaments, and using football activities to promote mental health programmes.

Finally, FIFA have played a crucial role in safeguarding player health by incorporating medical expertise into rule‑making processes and shaping the sport’s future with safety-first policies. This has ensured the protection of player welfare through involvement in decisions on the development of the Laws of the Game and the future of football, based, as always, on scientific research, technological advancements, injury prevention and the continuous adaptation of both competition regulations and the Laws of the Game. By embedding medical expertise in rule-making, we ensure that player welfare remains central to football’s evolution while preserving the intensity and excitement of the game.

Proactively our aim is to identify, assess and respond to emerging health issues that could impact football or be mitigated through the game, including how pandemics, climate change, air pollution and new injury and illness patterns or behaviours might affect player welfare.

Andrew Massey

MB BCh BAO MSc(Sports Medicine) MSc(Medical Ultrasound) MSc(Sports Physiotherapy) BSc(Hons)(Physiotherapy) MRCGP FFSEM(UK) FFSEM(Ire) FFMLM

FIFA Medical Director

Chair FIFA Medical Committee

Zurich, Switzerland

Contact: andrew.massey@fifa.org

References

1. Waldén M, Mountjoy M, McCall A, et al Football-specific extension of the IOC consensus statement: methods for recording and reporting of epidemiological data on injury and illness in sport 2020 British Journal of Sports Medicine 2023;57:1341-1350.
2. https://inside.fifa.com/health-and-medical/education-awareness/diploma-football-medicine
3. https://inside.fifa.com/health-and-medical/education-awareness/msc-in-football-medicine-university-of-bath
4. https://inside.fifa.com/health-and-medical/media-releases/fifa-and-world-health-organization-launch-global-concussion-awareness
5. https://inside.fifa.com/campaigns/bring-the-moves
6. https://inside.fifa.com/health-and-medical/animated-series
7. https://inside.fifa.com/health-and-medical/centers-of-excellence
8. https://inside.fifa.com/health-and-medical/research/projects-guidelines
9. Patterson M, Gordon J, Boyce SH, et al Set-piece approach for medical teams managing emergencies in sport: introducing the FIFA Poster for Emergency Action Planning (PEAP) British Journal of Sports Medicine 2022;56:715-717.
10. https://blogs.bmj.com/bjsm/2025/09/01/simpler-means-safer-when-responding-to-an-emergency-the-new-fifa-medical-set-piece-toolkit-and-pre-match-emergency-action-plan/
11. https://inside.fifa.com/health-and-medical/injury-prevention
12. https://inside.fifa.com/health-and-medical/education-awareness/pitchside-emergency-care
13. https://inside.fifa.com/health-and-medical/reachout/all-reachout-news
14. Baggish AL, Borjesson M, Pieles GE FIFA Youth Cardiac Screening Review Panel, et al Recommendations for cardiac screening and emergency action planning in youth football: a FIFA consensus statement British Journal of Sports Medicine 2025;59:751-760.
15. https://inside.fifa.com/innovation/innovation-programmefifa
16. https://inside.fifa.com/tournament-organisation/bidding-processes
17. https://inside.fifa.com/health-and-medical/recap-medical-conference-2024
18. https://inside.fifa.com/campaigns/concussion/return-to-play-guidelines
19. https://inside.fifa.com/organisation/media-releases/the-ifab-approves-permanent-concussion-substitutes-among-several-changes-to
20. https://inside.fifa.com/health-and-medical/news/awareness-and-education-in-the-spotlight-as-fifa-focus-on-heart-health

Header Image by Ronnie Macdonald (Cropped)