ACL Injury Prevention

The number of females competing in sports continues to rise each year, which has led to a rapid increase in the number of sports-related injuries occurring in women. Of these, injuries to the anterior cruciate ligament (ACL) of the knee are one of the most common causes for season ending surgery.

While some injuries can occur as the results of a collision, the majority of ACL injuries occur without contact with another player, when the knee suddenly buckles or gives way during sporting activities such as pivoting or landing from a jump. Noncontact ACL injuries are 4-8 times more likely to occur in women than men, due to gender differences in lower-extremity anatomy, neuromuscular control and landing mechanics.

Fortunately, the risk of ACL injuries can be significantly decreased with implementation and compliance with a preventative training program.

What is an ACL Preventative Training Program (PTP)?

An ACL preventative training program is a series of exercises designed to help decrease an athlete’s risk of knee injury, while also improving functional performance. Typically, this program can be incorporated in to a 15-20 minute dynamic warm-up before practice or sports activities.

PTPs focus on optimizing lower extremity movement patterns and improve neuromuscular control of the muscles that support the knee, in order to minimize the amount of stress placed on the ACL during high risk sporting activities. The main components of a PTP are the following:

• Plyometrics
• Strength training
• Agility
• Balance
• Flexibility

Why is an ACL PTP important?

When performed correctly on a consistent basis, ACL PTPs can decrease the risk of an ACL injury up to 75%.

The efficacy of a PTP can depend on the following:

• Tailoring the exercises and intensity based on the athlete’s individual risk profile (determined through screening)
• Progression of training exercises to allow for continued efficacy
• Compliance with the program

The effectiveness depends not only on the completion of the exercises, but performing them in the appropriate manner. The program should be initiated with a healthcare professional trained in body mechanics to allow for correction of improper movement technique.

Who should perform ACL PTPs?

Ideally, every female athlete should be aware of PTPs. Studies have shown that the greatest risk reduction from PTPs are in the following groups:

• Athletes who participate in high-risk sports for ACL injuries that involve jumping, cutting and pivoting (eg, basketball, soccer, lacrosse, volleyball, etc)
• Athletes who demonstrate movement patterns that are high risk for injury (can be determined through screening assessments)
• Athletes with a history of lower extremity injury
• Athletes under the age of 18, as early as age 12

Services we offer:

• Our physicians offer educational seminars on the importance of ACL injury prevention. Geared towards female athletes, parents and coaches, these seminars also include a preventative exercise workshop. To schedule an educational seminar, please call (617) 643-3866.
• The Mass General Sports Physical Therapy team offers evaluation and consultation for individual athletes of all levels, including ACL injury prevention screening, preventative training programs and personalized performance optimization recommendations. To make an appointment for a consultation or screening, please call Mass General Sports Physical Therapy at (617) 643-9999.