ACL injury prevention training is one of the most effective, research-supported ways to reduce knee injury risk in athletes and active individuals. ACL injuries are common, costly, and often occur without contact — but the majority are preventable with proper training.
This content is based on peer-reviewed research published within the last five years.
What Is an ACL Injury and Why Does It Happen?
The anterior cruciate ligament (ACL) stabilizes the knee during cutting, pivoting, landing, and deceleration. Most ACL tears occur during non-contact movements, such as:
- Sudden changes of direction
- Jump landings
- Rapid deceleration
Research consistently shows that ACL injuries are associated with:
- Poor neuromuscular control
- Reduced hip and hamstring strength
- Dynamic knee valgus (knees collapsing inward)
- Suboptimal landing mechanics
Because these factors are modifiable, targeted prevention training is highly effective (Arundale et al., 2022).
What Is ACL Injury Prevention Training?
ACL injury prevention programs are structured exercise programs designed to improve strength, movement quality, and neuromuscular control.
Evidence-Based Components of ACL Prevention Programs
The most successful programs are multicomponent, including:
-
- Neuromuscular training (balance, coordination, proprioception) Click here for evidence with female soccer players.
- Strength training (hips, glutes, hamstrings, core)
- Plyometric training (jumping and landing technique)
- Agility and change-of-direction drills
- Movement feedback and coaching cues
Programs that include multiple components consistently outperform single-focus programs (Dai et al., 2023).
How Effective Is ACL Injury Prevention Training?
ACL Injury Prevention Success Rates
Recent systematic reviews and meta-analyses report that ACL injury prevention programs can reduce injury risk by:
📉 40–70%
Key findings from recent research:
- Programs performed 2–3+ times per week are significantly more effective
- Minimum weekly training volume of 15–20 minutes improves outcomes
- Programs with strength + plyometrics + feedback show the greatest risk reduction
A 2022 systematic review found that structured neuromuscular training reduced ACL injury incidence by nearly 50% across multiple sports (Webster & Hewett, 2022). More recent sport-specific analyses (soccer and basketball) report reductions exceeding 55% when programs are implemented consistently (Soares et al., 2024).
Why Some ACL Prevention Programs Work Better Than Others
- Multicomponent Design
Programs that combine strength, plyometrics, and neuromuscular training are more effective than balance-only or stretching-based programs (Dai et al., 2023).
- Training Frequency and Compliance
Higher compliance and in-season continuation are strongly associated with better injury reduction outcomes (Sugimoto et al., 2021).
- Coaching and Movement Feedback
Athletes who receive verbal, visual, or video feedback demonstrate:
- Improved knee alignment
- Increased knee and hip flexion during landing (versus a straight, stiff knee)
- Reduced high-risk movement patterns
These biomechanical improvements are closely linked to reduced ACL injury risk (Gokeler et al., 2023).
Important Considerations in ACL Injury Prevention Research
Recent research highlights several key considerations:
- Program adherence is a major determinant of success
- Evidence is strongest in youth and female athletes, though research in male athletes is growing
- Optimal “dose” (frequency and duration) is still being refined
- Biomechanical improvements do not always immediately translate to injury reduction, emphasizing the need for long-term implementation
Despite these limitations, the overall body of evidence strongly supports ACL prevention training as a best practice in sports medicine (Arundale et al., 2022).
How Physical Therapy Supports ACL Injury Prevention
Physical therapists are uniquely qualified to deliver individualized, evidence-based ACL injury prevention programs.
In our physical therapy clinic, prevention training includes:
- Movement and biomechanical assessments
- Strength and asymmetry testing
- Jump landing training
- Sport-specific exercise progression
- Return-to-sport and re-injury prevention strategies
For athletes recovering from ACL reconstruction, prevention training is critical — second ACL injury rates remain high without targeted neuromuscular retraining (Webster & Hewett, 2022).
Key Takeaways: ACL Injury Prevention Works
✔ ACL injuries are common — but many are preventable
✔ Research shows 40–70% risk reduction with proper training
✔ Multicomponent, well-coached programs are most effective
✔ Consistency matters more than intensity
✔ Physical therapy plays a key role in prevention and long-term knee health
Ready to Reduce Your Risk of ACL Injury?
If you’re an athlete, parent, or coach interested in ACL injury prevention training, our physical therapy team can help design a program tailored to your sport, age, and goals.
👉 Contact our clinic today to schedule an injury prevention assessment.
References
- Arundale, A. J. H., et al. (2022). Prevention of anterior cruciate ligament injuries: A clinical practice guideline. Journal of Orthopaedic & Sports Physical Therapy.
- Dai, B., et al. (2023). Effectiveness of neuromuscular training on ACL injury prevention: A systematic review and meta-analysis. Sports Medicine.
- Gokeler, A., et al. (2023). Feedback-based training improves landing biomechanics associated with ACL injury risk. British Journal of Sports Medicine.
- Gu, J., et al. (2025). Neuromuscular training for preventing knee injuries in female team athletes: a meta-analysis. Annals of Medicine.
- Soares, B., et al. (2024). ACL injury prevention programs in soccer players: A meta-analysis. American Journal of Sports Medicine.
- Sugimoto, D., et al. (2021). Compliance and dosage effects of ACL injury prevention programs. Clinical Journal of Sport Medicine.
- Webster, K. E., & Hewett, T. E. (2022). Second ACL injury rates and prevention strategies. Sports Medicine.