Anterior Cruciate Ligament (ACL) Injuries Who’s at risk and How to prevent them?

The dreaded ACL injury strikes fear into the hearts of amateur and professional athletes worldwide – and for good reason. ACL ruptures are responsible for extended periods away from doing the sport and activities you love, expensive surgery and rehabilitation as well as decreased work and school performance.

This post will inform you on what the ACL is, how it is injured, known risk factors and most importantly, how to prevent it.

What is the ACL?

The ACL is one of the four major ligaments of the knee joint. It is the most important ligament for the stability of the knee. It has several functions including keeping the shin bone (tibia) and thigh bone (femur) together during pivoting and twisting activities on a planted foot as well as stopping the shin bone from sliding forwards from the thigh bone


How is the ACL injured?

ACL injuries are sadly quite common injuries, especially in sports involving pivoting, fast deceleration, jumping or contact.

Sports that fall into this category are; Rugby League, Rugby Union, Australian Rules, Touch Football, Netball, Hockey, Basketball and Football/Soccer.

ACL injuries can be divided into 2 major mechanisms – non-contact and contact.

Non-contact: The athlete will be decelerating, twisting on a planted foot and changing direction all at once. This is the cause in around 70% of cases.

Contact: This occurs in 30% of cases. It includes indirect contact and direct contact.

Indirect contact: Another athlete will put the athlete off balance and the knee will fall into a precarious position.

Direct Contact: As the name suggests, this is caused by direct contact to the knee

Who is at risk?

Risk factors for ACL injuries are divided into Intrinsic (within the body) and Extrinsic (outside the body).

Intrinsic factors include:

Female gender.

Knock knees.

Hyperextending knees.

Weak gluteal muscles/Poor control of the gluteal muscles.

Extrinsic factors include:

Wet playing surfaces

Uneven playing surfaces

Footwear with too much or too little traction for the individual playing surface

How do I Prevent ACL injuries?

When it comes to preventing ACL injuries, the four ingredients you are going to need are:

  • Good gluteal muscle strength

  • Good gluteal muscle control

  • Sport Specific Training

  • A good warm up

Gluteal muscle strength

Your Physio will figure out which exercises are most appropriate to develop your functional gluteal muscle strength. Some examples of exercises we might give you are lunges, squats and pistol squats.

Gluteal muscle control

Your Physio will give you exercises to challenge your gluteal muscles. These exercises are commonly dynamic or plyometric. We may get you to practice keeping your knee in a good position while doing jumping and landing activities.

Sport specific training

This is where your Physio will break down the individual demands of your sport and give you appropriate exercises. We may get you to practice keeping your knee in a good position during contact, throwing and catching activities.

A good warm up

A good warm up for preventing ACL injuries will aim to have the correct muscles firing in the lead up to your game. The Fifa 11+ warm up is what most Physiotherapists use.

If you are concerned about your own or your team mates’ ACL injury risk, make an appointment so your Ph