Preventing Anterior Cruciate Ligament Injuries

Reducing ACL Tears in Females Through Balance and Strength Training

Apr 24, 2009

Incorporating balance training, low intensity plyometric training, and strength training can lower the risk of ACL tears in young women.

It is well documented that young women are more at risk for ACL tears then young men when competing in the same sports. According to Elizabeth Quinn in her article ACL Injury Prevention – Tips for Athletes, “women are nearly three times more likely to have ACL tears than men” (December 2007).

Anterior Cruciate Ligament

Understanding the role of the ACL is important in understanding how to reduce injuries to this ligament. The anterior cruciate ligament is a strong band of connective tissue stretching from the front of the tibia to the back of the femur and is located deep within the knee. It is one of four primary ligaments that add stability to the knee.

The purpose of the ACL is to prevent the tibia from gliding forward on the femur. This ligament stabilizes the anterior movement of the tibia. When this ligament is compromised, the knee may feel unstable to the patient and additional structures (meniscus) may be at risk for injury.

Although there are multiple mechanisms for an ACL tear, the most common mechanisms are a “plant and twist” and “jump stop”. The athlete may hear an audible “pop”, experience pain in the joint, and may feel unstable when walking. Athletes who have strong hamstring muscles may be able to continue to function as the hamstring muscles also stabilize the tibia on the femur in the same capacity as the ACL.

There are different theories as to why young girls experience a higher rate of ACL injury as compared to their male peers. Some of the theories include a higher quadriceps to hamstring muscle group imbalance, physiological difference in the shape of the tibial plateau (women may have more of a “v” shape rather than a “u shape), and possible hormone effects on the strength of the connective tissue.

Regardless of the theories, attention needs to be focused on reducing these injuries in young female athletes. Although there are several exercise programs focused on preventing ACL tears, neuromuscular training has been consistently shown to reduce the risk of ACL injury (Quinn, 2007).

Balance Training Progression

One component of neuromuscular training is balance training. Balance training teaches the nervous system to work more effectively in sequentially firing the muscles of the lower extremity. Balance training progressions should begin on a static surface (non-moving) and progress to a dynamic surface (disc, half foam roll). The goal is to maintain balance for 30 seconds beginning with the first progression listed below.

Once the athlete is able to perform the balance training exercises, the athlete can then progress to more challenging plyometric exercises. Lower extremity plyometric exercises help build the strength of both the quadriceps and hamstring muscle groups. Athletes should start with low intensity plyometrics (single and multiple two foot jumps) and gradually progress to higher intensity training.

Coaches working with young women need to be aware of the problem and need to incorporate specific exercises to their workout protocol for the express purpose of reducing ACL injuries.

The copyright of the article Preventing Anterior Cruciate Ligament Injuries in Knee & Joint Injuries is owned by Terry Zeigler. Permission to republish Preventing Anterior Cruciate Ligament Injuries in print or online must be granted by the author in writing.