The ACL, along with the PCL (posterior cruciate ligament) is one of the major ligaments that help stabilize the knee joint. The ACL is most often stretched, or torn by a sudden twisting motion while the feet remain planted. The majority of ACL injuries occur when an athlete misses a landing from a jump, pivots quickly while changing direction, or decelerates abruptly. These movements may cause the ACL to stretch to the point of tearing.
There's a growing number of ACL injuries in young athletes who play sports such as soccer, basketball and volleyball. Physicians speculate that part of the reason for the increase in ACL injuries may be related to the year-round sports training that many teens are doing. Playing sports constantly with no time off, playing multiple sports or playing field and court sports that emphasize quick starts, stops, and pivots makes teen athletes more susceptible to ACL tears. The risk is particularly high among athletes who play soccer, football, volleyball, or basketball.
However, teens who participate in ACL prevention programs may greatly reduce their risk of an injury. These prevention programs are becoming more popular in youth sports and generally include exercises to help strengthen muscles and improve faulty movement patterns in teens. Multiple studies have demonstrated the effectiveness of ACL injury prevention programs.
These prevention programs are made up of training drills that emphasize balance, power and agility. Plyometric exercises and balance drills help improve neuromuscular conditioning and reaction time and may decrease the risk of ACL injury. Many coaches use an ACL conditioning program, especially for their female players, as a basic part of sports practice. These programs should include the following phases:
More Tips for Preventing ACL Injuries in Young Athletes
- Coaches and trainers should help the teen athletes learn proper body mechanics and move with good alignment to protect the knees. This includes drills to teach proper jumping and landing, accelerating and decelerating with the knees directly over their feet and not angling inward.
- Teen athletes who have poor alignment should be tested for muscle weakness or imbalance. Strengthening programs should be designed to correct any weaknesses.
- Teen athletes should be required to complete a thorough warm-up before all practices and games.
- Teen athletes should perform the six phases of the ACL prevention program 2-3 times per week during the preseason until proper movement patterns and body alignment are consistently demonstrated.
- Teen athletes should be encouraged to take a break from sports during the year or perform some cross training that emphasizes different movement patterns. For example, a teen who plays on the soccer team may benefit from cycling or swimming in the off-season. This will help prevent overuse injuries, which can also lead to ACL tears.
American Academy of Orthopaedic Surgeons, Three studies examine causes, prevention of ACL injuries in women, News Item, February 26, 2005.
American Journal of Sports Medicine, A randomized controlled trial to prevent noncontact anterior cruciate ligament injury in female collegiate soccer players. Gilchrist J, Mandelbaum BR, Melancon H, Ryan GW, Silvers HJ, Griffin LY, Watanabe DS, Dick RW, Dvorak J. 2008 Aug; 36(8):1476-83.
Santa Monica Orthopaedic and Sports Medicine Research Foundation, ACL Injury Prevention Project.