A tear of the anterior cruciate ligament (ACL) is a common injury that occurs in athlete’s and can jeopardize an athlete’s athletic future. This is a devastating injury requiring many months of intense and painful rehabilitation and an interruption in sports participation. Post-operative rehabilitation can take 6-9 months, delaying return to sport and in some cases preventing return to prior intensity and skill level. ACL injuries can occur through contact, however, majority of these injuries occur through a non-contact mechanism. Female athletes have been reported to sustain non-contact ACL injuries at a rate of two- to eightfold greater than male athletes. Many explanations for the increased risk of injury to female athletes have been proposed, including increased knee valgus or abduction moments, generalized joint laxity, knee recurvatum, ACL size, and the hormonal effects of estrogen on the ACL.
Regardless of mechanism of injury, the number of ACL injuries that are occurring today continues to increase. It is estimated that 350,000 ACL reconstructions are performed annually in the United States. Despite surgical repair, 79% of those individuals develop knee osteoarthritis (OA) and 20% suffer re-injury within 2 years. One in four youths who suffer an ACL injury will suffer a second ACL injury in their athletic career. The increasing number of ACL injuries, risk of re-injury, and possible development of early-onset knee OA has put an increased emphasis on the need for prevention.
ACL injury prevention programs have been a focus of sports medicine research in the past two decades. Various ACL prevention programs have been designed in an attempt to correct deficiencies in athletes that increase their risk of injury. These programs include exercises that address muscle strengthening, muscle recruitment patterns, landing and deceleration patterns, proprioception, and plyometrics. Majority of these programs last about 20-30 minutes and are easy to incorporate into a practice setting. It is important to include an ACL injury prevention program in an athlete’s workout regimen due to the substantial evidence that supports the effectiveness of these programs. One study showed an ACL injury risk reduction of 52% in female athletes and 85% in male athletes with the incorporation of an ACL prevention program. There is promising evidence that these prevention programs work and will help to keep athletes on the field and out of the training room.