ACL Injury: Understanding the Risks and How Prevention Programs May Help
If you follow sports such as AFL, NBA, EPL, rugby or netball, you’ve likely heard plenty about ACL injuries. They are commonly discussed in the media and often result in long periods away from sport. Seeing an athlete go down holding their knee can be confronting, especially given how frequently ACL injuries are talked about in high-level sport.
The ACL (anterior cruciate ligament) is an important structure that helps stabilise the knee during movements such as pivoting and changing direction. Australia has some of the highest reported ACL injury rates globally, and many cases involve surgery and extended rehabilitation.
Recent research has also highlighted a rise in ACL injuries among children and adolescents. This has implications for sporting participation, longer term knee health, and the emotional and financial burden associated with injury and rehabilitation.
What does the research say about ACL injuries and recovery?
While everyone’s situation is unique, studies have reported several broad trends:
Around two-thirds of recreational athletes return to their previous level of sport following ACL reconstruction
Re-injury rates can be higher in younger athletes, particularly those aged 18 and under
Some people may have an increased likelihood of developing knee osteoarthritis in the years following an ACL injury, regardless of whether surgery was performed
These findings highlight the complexity of ACL injuries, both physically and psychologically.
Can injury prevention programs help?
Several large studies have found that structured warm-up and strengthening programs can reduce the risk of ACL injuries in certain sporting populations. Some programs have also been shown to improve general athletic performance measures such as balance, strength and landing control.
These programs aim to develop:
Lower limb strength
Neuromuscular control
Agility and direction-change mechanics
Safe landing techniques
You can view a selection of evidence-informed injury-prevention resources here.
A general ACL injury-prevention routine
We’ve put together a simple 15-minute routine that uses minimal equipment and can be incorporated into training sessions or performed a couple of times per week. This routine is based on widely used evidence-supported components of ACL prevention programs.
Please see the video below.
Important:
This program is general in nature. It is not a substitute for individual assessment. If you have a current lower limb injury, or experience pain during these exercises, we recommend seeking personalised advice from a physiotherapist.
References:
Rick Joreitz et all (2016): Patient-specific and surgery-specific factors that affect return to sport after ACL reconstruction
Ardern, C. L., Webster, K. E., Taylor, N. F., & Feller, J. A. (2011). Return to sport following anterior cruciate ligament reconstruction surgery: a systematic review and meta-analysis of the state of play.
Poulsen, E., Goncalves, G. H., Bricca, A., Roos, E. M., Thorlund, J. B., & Juhl, C. B. (2019). Knee osteoarthritis risk is increased 4-6 fold after knee injury - a systematic review and meta-analysis.
