Risk Factors and Prevention Strategies for Noncontact Anterior Cruciate Ligament (ACL) Injuries

One out of every 1,750 individuals between the ages of 15- 45 will suffer an ACL injury. While the total number of ACL injuries seen is greater for males, females are up to eight times more likely to sustain an ACL injury when compared to their male counterparts. So, what are some risk factors and what can be done to prevent an injury?
Currently there are several different avenues being researched to find direct links to ACL injuries. The primary risk factors that have been identified are as follows:
  1. Influence of shoe to surface interaction- There has been some problems with keeping consistent variables within this portion of research; however, there does seem to be one primary indicator. The greater the friction between the shoe surface and the ground, the greater the risk. While that information is easy to digest, it’s counterproductive to what an athlete wants/needs for optimal performance.
  2. Anatomical Risk Factors- The male and female lower extremities are built quite differently. The most commonly attributed differences to ACL injuries include increased femoral anteversion, increased Q angle, excessive tibial torsion, and excessive foot pronation. While one or all of these could be contributing factors, there has not been sufficient research to determine the functional movement effects of these differences. Joint laxity and muscular development are also commonly noted possibilities. All of the above are possible considerations; however, none of these factors have been directly correlated to in an increased risk of injury.
  3. Hormonal Risk Factors- There have been several recent research articles that have determined that female sex hormones can influence the composition and mechanical properties of the ACL. A couple of articles have analyzed the specifics of an individual’s menstrual cycle and its effects on injury risk, but there is not enough evidence to be conclusive due to conflicting results. More research is needed prior to making any conclusions specifically about ACL injury risk factors or prevention methods.
  4. Biomechanical Risk Factors- Neuromuscular and proprioceptive control are highly accepted as major factors in an individual’s risk of injury. These control both the conscious and unconscious motor units that are acting during movement and are needed for joint stability. The two primary locations of focus involve the knee as well as the hip-trunk in regards to being risk factors.
  5. Other Notable Risk Factors- From watching video and individual reports, these other risk factors include; deceleration, cutting, and poor movement quality.

Studies have shown that simply wearing a knee brace isn’t the solution, neuromuscular prevention programs are the best solution we have currently available. Ample research is consistently coming out pointing toward neuromuscular prevention programs as significantly decreasing the injury risk for individuals. A two year study of a Division I women’s basketball program saw a decrease of 89%. The techniques used in these programs are not complicated. They most often include learning proper mechanics for landing , cutting, and deceleration through drills and exercises. Kinetic offers multiple programs that offer help with injury prevention, don’t hesitate to ask about how we can help keep you, your child, or your team with a neuromuscular prevention program!

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