Active Voice: Small-Sided Soccer Provides Broad Spectrum Fitness and Health Benefits Across the Lifespan

By Peter Krustrup, Ph.D., and Jens Bangsbo, Sc.D.

Viewpoints presented in SMB commentaries reflect opinions of the authors and do not necessarily reflect positions or policies of ACSM.

Peter Krustrup is professor of sport and health sciences at the University of Exeter in the United Kingdom, working in Physical Activity and Health Across the Lifespan and Bioenergetics and Human Performance research groups. Jens Bangsbo is professor of integrated physiology in the Department of Nutrition, Exercise and Sports at University of Copenhagen, Denmark, and head of Copenhagen Centre for Team Sports and Health. Drs. Krustrup and Bangsbo have conducted pioneering work on the cardiovascular, metabolic and musculoskeletal effects of soccer for untrained individuals across the lifespan. They have published more than 35 scientific articles in this area since 2009. They are currently engaged in a series of studies investigating the potential of regular small-volume recreational soccer in the prevention and treatment of cardiovascular diseases, type-2 diabetes and osteoporosis, as well as rehabilitation of prostate cancer patients. This commentary presents Dr. Krustrup’s and Dr. Bangsbo’s views on the topic of a related research article which they and their colleagues published in the March 2013 issue of
Medicine and Science in Sports and Exercise®.

As recently stated in the Lancet article Sport and Exercise as Contributors to the Health of Nations by Khan et al. (2012), large cohort studies suggest that sport participation reduces all-cause mortality by 20-40% and recent randomized controlled trials (RCTs) provide evidence that playing sport is associated with specific health benefits. These statements are fully supported by our recent studies on recreational soccer for sedentary individuals aged 6-80 years, revealing that small-sided soccer has broad spectrum fitness and health effects, as it combines elements of high-intensity interval (HIIT), endurance and strength training. Small-sided soccer elicits high heart rates and multiple intense actions such as sprints, turns, jumps, tackles, dribbles and shots, independently of age, gender, fitness status, socio-economic status and prior experience.

These findings are of great public interest, considering that soccer is the most popular sport in the world with an estimated 400 million active players. Soccer also has positive motivational and social factors that may facilitate compliance and persistence with the sport and contribute to the achievement and maintenance of a physically active lifestyle. The beneficial effects of small-sided soccer training occur rapidly and only medium-volume training is required, as two one-hour sessions over 12-16 weeks markedly improves VO2max, heart function, capillarization, muscle strength, bone mineralization and postural balance. In addition, this exercise inherent in small-sided soccer lowers blood pressure (BP), cholesterol and fat mass for 20-50 yr old sedentary men and women. Improvements that were maintained over 1 year with 90 minutes of weekly training, suggesting that less than an average of 30 minutes of physical activity per day can indeed be effective if the intensity is sufficiently high.

Small-sided soccer may also be used in the treatment of diseases lifestyle. In our recent research report published in MSSE®, we described study results for 30-55 year old men with mild-to-moderate hypertension. In this study, men were randomized either to soccer training that involved an average of ~85% of maximal heart rate in each of two one-hour sessions/week over 6 months or to a group that received physician-guided recommendations on training and healthy diet. The soccer training lowered systolic and diastolic BP by 13 and 8 mmHg, respectively, with three-quarters of subjects normalizing their BP during the intervention period. The soccer training resulted in an array of other favorable effects on the cardiovascular risk profile, including an increase in maximum oxygen uptake (VO2max) from 32.6 to 35.4 mL/min/kg, whereas no fitness effects were observed in the physician-advice group. Soccer training may therefore be a valuable broad spectrum non-pharmacological treatment for hypertensive men. Do other team sports provide the same benefits as soccer? This question will be addressed in the newly formed Copenhagen Centre of Team Sport and Health ( supported by Nordea-fonden, Denmark, and F-MARC.