Prevention of anterior cruciate ligament (ACL) injury

Abstract

Along with the increase in number of female athletic participants, the number of resultant athletic injuries among female athletes has also rapidly increased. Anterior cruciate ligament (ACL) injury is more prevalent in physically active females as compared to their male counterparts in the sports of basketball and soccer. ACL injury was classified into three categorizations based on three common pathomechanics, and the relative distribution of ACL injury was analyzed between sexes. The most common mechanism of ACL injury was noncontact in nature, and such noncontact ACL injury was more prevalent in female athletes as compared to male athletes. Because a majority of ACL injuries occur in noncontact mechanism, especially in female athletes, a few clinical trials were conducted to examine the effectiveness of preventive neuromuscular training on ACL injury reduction in the female population. Recent meta- analytic reports have confirmed significant ACL injury reduction by female athletes who performed preventive neuromuscular training compared to those who did not or only maintained their routine warm-up. Numerous evidence supports the proposition that specific exercises incorporated into preventive neuromuscular training protocols lead to favorable biomechanical alteration in dynamic movements, which likely contribute to ACL injury reduction in female athletes. Future directions of ACL injury research include the development of an effective screening system in order to identify at-risk athletes. Also, a strategy to implement preventive neuromuscular training programs and to enhance compliance and adherence needs to be developed.