ACL Injuries in Sports


Healthy Living – November 7, 2017
JP Stowe, ATC, CSCS – Eastern Maine Medical Center
Julien Edelman, Dalvin Cook, Deshaun Watson. Each year we see the effect that ACL injuries have on professional athletes’ careers, especially football players. Luckily, an ACL tear is no longer a career ending injury due to better surgical procedures and more functional rehabilitation after surgery. High school athletes are still suffering ACL injuries at increasing rates as well. According to the journal Pediatrics in February 2017, the incidence of pediatric ACL tears increase by 2.3% each year; and have been at that pace for the last 20 years.

The anterior cruciate ligament is an important stabilizer of the knee protecting against anterior translation of the shinbone and rotational forces that occur at the knee joint. Every year, about 200,000 people in the US will tear their ACL, 70% of which will occur by non-contact mechanisms (planting and pivoting, landing from a jump). After an ACL injury gets diagnosed by an orthopedic surgeon, the decision to perform a surgical repair depends on the patient, their age, and activity level. Most patients may choose to undergo surgery with the understanding that a full recovery takes nine to twelve months, sometimes longer. A more aggressive return to sports, especially between four to six months post-op, is an extremely risky decision. The ACL graft is still going through an important phase of the healing process and the risk if a re-tear is exponentially higher. Athletes also have not regained proper strength, movement, and neuromuscular control in that short period of time and are not ready to return to sports.

Prevention of ACL injuries by following a knee protection program is key in combatting this injury from occurring. Programs like FIFA 11+ and the PEP program incorporate strength, jump mechanics, plyometrics, and core training into a 15 min dynamic warm up sports teams can complete before each practice. These types of programs have been shown to reduce ACL injuries by 70%, especially in females, who are far more likely to tear their ACL than males. Smaller ACL size, different biomechanics, and greater quadriceps-to-hamstring strength ratio are thought to be the reason why.

Here are some tips to help protect you child from an ACL injury:
  1. Make sure their team performs a dynamic warmup prior to practices and games.
  2. Participation in a prevention program that focuses on core strength, agility, jump training and plyometrics is important in protecting the knee.
  3. Kids can start some light strength training around 11-13 years of age. Please consult with proper professionals before doing such a program. Strength and conditioning specialists can create proper, well rounded programs for your young athlete.
  4. Stretch after practice when your muscles are warm and more pliable. Hold stretches for 30-40 seconds each. More flexibility equals less injury risk.
  5. REST! Take at least a day off each week from any athletic activity and a few weeks off in between seasons. Avoid playing one sport all year round due to the higher injury risk that come with specialization. If you do play year round, take at least three months off throughout the year from that sport.
Even with all of these prevention strategies, ACL injuries are still going to happen, but taking these steps towards mitigating the risk will go a long way in you and your child’s health.
  1. Beck, Nicholas A., et al. “ACL Tears in School-Aged Children and Adolescents Over 20 Years.” Pediatrics, American Academy of Pediatrics, 22 Feb. 2017,
  2. Friedberg, Ryan P. “Anterior Cruciate Ligament Injury.” Anterior Cruciate Ligament Injury, 4 Aug. 2017,