Reducing ACL Injuries Through Strength Training

Anterior cruciate ligament (ACL) injuries are among the most devastating setbacks for athletes, often requiring surgery and lengthy rehabilitation. Through structured training programs, biomechanical knowledge, and preventative measures, strength coaches serve as a buffer between athletes and ACL injuries. Implementing the following exercises and strategies protects athletes from ACL tears while improving performance.

ACL Injuries and Risk Factors

ACL injuries occur when excessive force is placed on the knee, mostly due to sudden stops, changes in direction, or awkward landings from jumps. These injuries are common in sports like basketball, soccer, football, and volleyball. By addressing risk factors through a well-designed training program, the likelihood of ACL tears becomes significantly reduced. Several factors contribute to ACL injuries, including:

• Poor neuromuscular control, especially in landing mechanics
• Weak quadriceps-to-hamstring strength ratios
• Lack of hip stability and core strength
• Insufficient ankle mobility and poor foot positioning
• Fatigue leading to compromised movement patterns

Key Muscle Groups For Reducing ACL Injuries

• Hamstring Strengthening: Hamstrings play a vital role in stabilizing the knee joint and reducing stress on the ACL.
  • Nordic Hamstring Curls – Builds eccentric hamstring strength, reducing ACL strain
  • Romanian Deadlifts – Strengthens the posterior chain, reinforcing knee stability
  • Glute-Ham Raises – Activates hamstrings in a functional, knee-friendly movement
• Quadriceps Development: Balanced quad-to-hamstring strength is essential for knee stability.
  • Bulgarian Split Squats – Enhances unilateral leg strength, reducing asymmetries
  • Goblet Squats – Reinforces proper squat mechanics while strengthening quads
  • Wall Sits with Isometric Holds – Strengthens the VMO (vastus medialis oblique), crucial for knee alignment
• Hip and Glute: Weak hips contribute to poor knee alignment and excessive valgus stress.
  • Mini Band Glute Walks (Lateral and Forward) – Improves hip stability
  • Hip Thrusts – Reinforces posterior chain activation
  • Side-Lying Clamshells – Targets glute medius for lateral knee stabilization
• Core and Balance: A strong core prevents compensatory movements that increase ACL stress.
  • Dead Bug Variations – Engages the core in sport-specific ways
  • Single-Leg Romanian Deadlifts – Enhances balance and knee control
  • Planks with Leg Lifts – Improves core and hip coordination

Neuromuscular Training: Teaching Proper Movement Patterns

ACL injuries often result from improper movement mechanics rather than contact. Integrating neuromuscular training ensures athletes develop safe movement habits.

• Landing Mechanics and Plyometrics: Teaching athletes to land softly and absorb force with their hips reduces ACL strain.
  • Box Jumps with Controlled Landing – Reinforces knee alignment
  • Depth Jumps with Stick Landing – Teaches athletes to absorb force safely
  • Single-Leg Hops with Deceleration – Enhances proprioception and knee stability

• Change of Direction and Agility Training: Cutting and pivoting movements are common causes of ACL injuries. Proper technique reduces excessive knee stress.
  • Lateral Cone Hops – Improves knee stability in lateral movements
  • Pro-Agility Shuttle Drill – Encourages controlled deceleration
  • T-Drill with Emphasis on Low Hips – Trains proper cutting technique

Mobility and Recovery for ACL Health

• Ankle and Hip Mobility: Limited mobility forces the knee into unnatural positions, increasing injury risk.
  • Ankle Dorsiflexion Drills (Knee-to-Wall Test) – Ensures proper foot positioning
  • 90/90 Hip Rotations – Enhances internal and external hip mobility
  • Foam Rolling and Myofascial Release – Reduces tension in surrounding muscles
• Flexibility and Recovery Strategies: Preventing fatigue-related injuries requires adequate recovery.
  • Dynamic Stretching Pre-Workout – Prepares muscles for movement
  • Static Stretching Post-Workout – Improves flexibility and reduces stiffness
  • Cold Therapy and Compression – Speeds up recovery after intense training

Educating Athletes

Educating athletes on ACL risk factors and the importance of proper movement mechanics is also important for avoiding catastrophe. Some strategies include:

• Video Analysis – Reviewing an athlete’s movement patterns to highlight areas for improvement
• Pre-Season ACL Screenings – Identifying at-risk athletes for specialized training
• Injury Prevention Workshops – Teaching proper cutting, jumping, and landing techniques

ACL injuries derail an athlete’s career, but with the right training and preventative strategies, the risk can be minimized. Strength coaches have the power to implement ACL-specific programs that enhance performance while safeguarding athletes from injury. By integrating strength training, neuromuscular education, mobility work, and recovery strategies, coaches play a pivotal role in keeping their athletes safe, strong, and on the field.