Although significant and meaningful headway has been made, researchers have yet to establish a gold standard regarding the most effective dose and specific parameters administrating an ACL prevention program.  Six published papers targeting ACL prevention in female athletes found significant effects implementing a supervised, structured neuromuscular training program. There were 29 total ACL injuries in the training groups vs 110 total ACL injuries in the control groups (no intervention). We have summarized the following after a review of the literature, and in consideration of practical implications.

  • Prevention Programs should be initiated at, or prior to the onset of puberty in order to prevent maladaptive neuromuscular control and faulty biomechanical patterns from developing.
  • Prevention Programs should begin prior to the sport season to enhance the effectiveness and potential to prevent non contact anterior cruciate ligament injuries.
  • Biomechanical analysis should always be performed prior to implementing intervention to objectify quality of movement. Frequent re assessments with visual and critical feedback during training should match the athlete’s style of learning.
    • Duration: It is highly recommended that Prevention Programs span at least 6 weeks in duration during the preseason.
    • Frequency: Each session should last 20 minutes – 30 minutes, at least 3 times a week.
    • Time: Athletes should continue neuromuscular training  n a regular basis for the remainder of their careers; especially if they have experienced a knee injury. Injury prevention programs can be continued throughout season to maintain proper form, and can be effective as replacement of the traditional warm up.
  • Type:
    • Neuromuscular training is believed to positively alter active knee joint stabilization, ultimately an important variable in decreasing ACL injury rates in female athletes.
      • Neuromuscular training increases the athletes body awareness in order to improve proper sport-specific mechanics.  Examples include shock absorption techniques executing lateral bounding to facilitate safe changes in direction.
    • Plyometric training is believed to better prepare the muscles, connective tissue, and the nervous system to effectively carry out stretch-shortening cycle in order to facilitate proper technique and body mechanics to correct for neuromuscular imbalances
      • Plyometric training should be progressed appropriately in order to meet the demands specific to the athlete.  For example, soccer players repeatedly produce maximums or near max actions:  striding, turning, cutting, sprinting, jumping of short duration with brief recovery periods. Prevention program must match the increased demands placed on neuromuscular system, including strength, coordination, finesse and power.

Here at The FIT Institute we now have top of the line biomechanical analysis dorsaVi. ViPerform consists of wearable motion and muscle activity sensors tracking and measuring how the athlete moves and where their deficits may be.  We can assess if an athlete is ready to return to play post ACLR, or analyze as movement specialist where we should intervene to keep the athlete on the field.  Contact us for more information!

By: Stephanie Ferro, DPT