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Anterior Cruciate Ligament (ACL) Injuries In Young Athletes

Reducing injuries in youth athletes may be one fo the greatest ways you can help young athletes. The number of ACL injuries in young athletes increased by approximately 150% between 2005 and 2015. Read here for some tips on how to avoid ACL injuries.

ACL Injuries and Young Athletes

ACL injuries used to be unusual for children and adolescents, but they have become more common. ACL injuries are most common in sports that involve landing, jumping, cutting and pivoting (for example, American football and soccer). ACL injuries for young athletes usually require surgical repair and extensive physical therapy that is often painful, difficult, discouraging, and long. It often takes up to one year before the young athlete who experienced the ACL injury is ready to return to sport. Considering all of this, it is not surprising that ACL injuries cause physical and psychological suffering for the young person who experiences an ACL injury. Additionally, young athletes who suffer an ACL injury, and undergo surgical repair are at increased risk for long-term knee knee osteoarthritis, an incurable and debilitating disease: about half of all young athletes who undergo surgical repair, after an ACL injury, will experience knee osteoarthritis 10 to 20 years after the ACL surgical repair.

Who is most at risk?

Young female athletes are more likely to experience an ACL injury than young male athletes. Approximately 10% of all multisport high school female athletes will experience an ACL injury. Soccer, basketball, and lacrosse are the sports that are most likely to result in an ACL injury for girls. The sport that is most likely to result in an ACL injury for boys is American football. ACL injuries are approximately seven times more likely to occur during competition than during practice.

How to potentially reduce ACL injury risk for young athletes?

When performed correctly, certain exercises can reduce the risk of ACL injury for young athletes. Here are some of the exercises that are known to effectively reduce ACL injury risk for young athletes:

  1. Leg strengthening exercises, especially exercises that strengthen the hamstring muscle group. One important hamstring-strengthening exercise is the Russian/Nordic hamstring curl. 
  2. Proximal control strengthening exercises that strengthen the core and upper body, including planks and side planks, hyperextension exercises for the back musculature, sit-ups and abdominal curls, push-ups, bench press, and pull-downs. 
  3. Multi-genre exercise plans that combine plyometric exercises, like jumping forward and backward, jumping side to side, and tuck and scissor jumps, with strengthening and proximal control exercises. 

References (Original Research)

  1. Bram et al. (2021). Am J Sports Med, 49(7), 1962-1972. 
  2. Sugimoto et al. (2015). Br J Sports Med, 49(5), 282-9.