Reducing risk in sports: Help prevent ACL injuries

Reducing risk in sports: Help prevent ACL injuries


Reducing risk in sports: Help prevent ACL injuries


Scott Sailor, president of National Athletic Trainers’ Association (NATA).

USA TODAY High School Sports and the National Athletic Trainers’ Association have partnered on a monthly column to address injuries, prevention and related issues to help schools, coaches and student-athletes. Here is the latest column from Scott Sailor, the president of NATA.

Throughout March Madness, staying injury-free was likely on the minds of many of the players and coaches as their teams moved closer to championship games. Teams capitalize on peak performance during the postseason, but unfortunately, injuries, especially those to the knee, can be devastating.

The knee is the most commonly injured joint in sports, and the anterior cruciate ligament (ACL) is one of the most frequently injured knee ligaments. Damage to the ACL can happen to athletes in any sport, but basketball, soccer and football players are particularly susceptible. The injury can occur when an athlete suddenly pivots or stops, quickly changes direction or lands after jumping. Half of ACL injuries are accompanied by damage to other ligaments or cartilage in the knee, and surgery is generally recommended when dealing with a combination of knee injuries.

An ACL injury is painful and can be detrimental due to the loss of time away from play, a lengthy rehabilitation process and potential long-term health consequences such as osteoarthritis. Half of those diagnosed with an ACL injury will develop osteoarthritis within 10 to 20 years after the injury.

What can be done to help prevent an ACL injury? An injury prevention training program can help reduce the risk of ACL and other knee injuries as well as improve performance. This type of program is ideal for all athletes and those who are physically active. It is highly recommended for anyone participating in sports that involve landing, jumping and cutting tasks (e.g., basketball, soccer, team handball) and those with a previous ACL injury. Because numerous research studies suggest that female athletes are at greater risk of an ACL injury, those involved in sports that involve a lot of jumping or sudden changes of direction should strongly consider a prevention training program.

The school’s athletic trainer can help develop an injury prevention training program tailored to each individual athlete’s needs. Here are some guidelines:

Exercise Selection and Training Intensity

  • The program should comprise at least three of the following exercise categories: strength, plyometrics, agility, balance and flexibility. The athletic trainer will provide feedback on movement techniques.
  • Injury prevention training exercises should be performed at progressive intensity levels that are challenging and allow for excellent movement, quality and technique.

Frequency and Duration

  • The program should be performed year-round at least two to three times a week.
  • To maintain the benefits of reduced injury rates and improved neuromuscular function and performance over time, multicomponent training programs (preseason, in season and offseason) should be performed each year. This should not be discontinued after a single season.

Program Adoption and Maintenance

  • The program should be regularly supervised by athletic trainers, physicians or other sports medicine professionals.
  • Multicomponent training programs are effective when implemented as a dynamic warmup or as part of a comprehensive strength and conditioning program. If time constraints are a concern, evidence shows they can be performed 10 to 15 minutes before the start of practices or games.

Research suggests that when done correctly, injury prevention training programs help reduce the risk of ACL and other traumatic knee injuries by more than 50 percent. The National Athletic Trainers’ Association has created a resource on 10 things to know about ACL injuries. Also, visit for additional sports safety tips for athletes and parents.


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