ACL Injury Prevention

Female ACL Injury Prevention Program

Over the last decade the Neuromuscular Research Laboratory has conducted research examining the risk factors for noncontact ACL injuries in female athletes and the role of intervention strategies to reduce the risk for injury. Our research agenda has been modeled after the public health approach to the injury control process which integrates a five step process designed to determine injury patterns, risk factors for injury, and the effectiveness of intervention programs. Our previous research has focused on identifying modifiable neuromuscular and biomechanical differences between female and male athletes and the effect of an intervention training program designed to alter these potential risk factors. Currently we are examining the hormonal influence on risk factors for injury, comparing genders while performing a reactive athletic task, and determining the predictive ability of neuromuscular and biomechanical characteristics on dynamic knee stability. In the future we will continue to explore the risk factors for noncontact ACL injury, the role of neuromuscular development in adolescent athletes on these risk factors, and the influence of training on adaptability and retention.

The incidence of injury to the ACL in high school and college aged female athletes has reached significant proportions with reports of up to an eight-fold noncontact ACL injury occurrence compared to males. These injuries result in considerable disability due to complicating osteoarthritis that eventually develops in up to 80% of all individuals sustaining an ACL injury. What is not clear is whether or not the gender-specific differences are inherent or the result of development and/or societal influences. As such, there is no data that suggests an appropriate age for initiating the intervention training programs for young girls since the investigation of developmental neuromuscular and biomechanical characteristics during childhood has not been undertaken. The overall objective of this proposal is to assess how the modifiable neuromuscular and biomechanical characteristics change from childhood to adulthood in both males and females. Specifically, the aim of this study is to determine the most effective age at which intervention programs should be implemented in order to optimize the effectiveness of these training programs to reduce ACL injuries. Additionally, we will determine if training programs need to be modified based on previously unidentified differences in neuromuscular and biomechanical characteristics between genders at earlier ages. The results of this study will provide valuable insight for the appropriate age for implementation of prevention programs that can reduce the risk of disabling knee injuries.

We have previously utilized biomechanical and neuromuscular characteristics to predict proximal anterior tibia shear force during a vertical stop-jump task. Recent research has indicated that shear force alone may not be capable of producing the amount of strain in the ACL that would result in rupture of the ligament. Additional epidemiological research has indicated that females who demonstrate a high valgus moment during a drop landing are at greater risk for noncontact ACL injuries. The purpose of this study is to utilize previously collected data to determine factors that predict high valgus moments which when combined with high shear forces can increase strain in the ACL. The results of this analysis may assist clinicians in developing training programs designed to reduce these dangerous loading patterns.