Preventing ACL Injuries

Topic Overview

A lot of the research on preventing anterior cruciate ligament (ACL) injuries has focused on women: women athletes injure their ACLs up to 8 times as often as men athletes.^{footnote 1} Although the following tips come from women's programs, they can help anyone prevent ACL injuries.

• Training and conditioning should take place year-round. Strength and stretching exercises in the off season will help coordination and balance when the season starts.
• Always warm up before training or competition, such as jogging easily or riding a stationary bicycle for 5 to 10 minutes. Warming up your muscles reduces the risk of injury.
• Make stretching part of your warm-up before the activity and your cool-down after the activity. Stretching can help you keep and improve your range of motion and reduce stiffness in your joints. It may also reduce soreness after exercising and reduce the risk of injury.
• Practice landing skills. This is especially important for women, because they don't usually bend their knees as much as men do when landing from a jump. Not bending the knees enough exposes them to more pressure and increases the risk for an ACL injury. When landing after jumping:
  • Land with the knees bent. As the knees bend during landing, make sure they travel in a straight path. Do not let them move closer together.
  • Land softly on the balls of the feet and roll back onto the heels.
  • Keep your knees and hips aligned and your upper body upright. Don't bend too far forward or backward as you land.
  • Try not to land on one foot. If this is not possible, bring the other foot down as soon as possible to distribute weight evenly.
• Improve agility. Women tend to turn and pivot in a more erect position than men, which strains the ACL. Learning to crouch and bend at the knees and hips when turning may reduce the stress on the ACL. Agility exercises include running forward and backward and running in diagonals (run diagonally to one spot, then cut the other way and run to another).
• Work on muscle strength. The muscles in the back (hamstrings) and front (quadriceps) of the thighs work together to bend or straighten the leg. Women tend to use their quadriceps when changing direction rapidly. This can result in an ACL injury. Stretching and strengthening the quadriceps and hamstrings can help reduce the risk.

Plyometrics

Plyometrics help build power, strength, and speed, and also help you practice landing skills. When you practice these skills, a coach can give you specific instructions and watch to be sure you are landing correctly.

• Jump and spin. On the same spot, bend your knees and jump into the air. Spin one-quarter turn (90 degrees) to the right and land on both feet. Repeat to the left. Advance how much you spin to a half turn, three-quarters turn, and full turn.
• Tuck jumps. On the same spot, jump straight up with your hands at your side. As you jump, bring your knees up toward your chest. Repeat immediately 10 times.
• Hopping. You will need a small object to hop over for this exercise. You can start with a small object like a book or even a piece of tape along the floor. Place the object or tape on the floor to your left, and hop over it using both legs. Then hop back to your right. Hop back and forth over the object 20 times. You may also hop back and forth on one leg.