Exercise-based prevention of knee and anterior cruciate ligament injuries: A literature review
LCA - Prevención y Programa de ejercicios
DOI:
https://doi.org/10.62059/LatArXiv.preprints.398Keywords:
Anterior cruciate ligament injuries, Physical exercise, Strength training, Proprioception, Primary preventionAbstract
Knee injuries, particularly those of the anterior cruciate ligament (ACL), are common in sports that involve twisting, jumping, and rapid changes of direction (1). These injuries can have a significant impact on a person's career and quality of life (2). Therefore, prevention based on specific exercises has become established as an effective strategy to reduce their incidence (3,4). Prevention programs include muscle strengthening exercises, proprioceptive training, proper landing and change of direction techniques, and balance and coordination exercises (3,5). Scientific evidence supports that the regular and systematic implementation of these programs, especially in young people and athletes, significantly decreases the rate of ACL and other knee injuries (4,6). Furthermore, prevention requires a multidimensional approach that includes education, proper technique, and professional supervision (5). The key is to integrate these exercises into the regular training routine to achieve neuromuscular adaptation that allows greater joint stability and movement control (3). Finally, adherence to the program is essential for achieving positive long-term results (7), and its implementation is recommended at different athletic levels to maximize prevention.
References
Montalvo AM, Schneider DK, Webster KE, Yut L, Galloway MT, Heidt RS Jr, et al. "The ACL Problem": A Global Public Health Issue in Pediatric and Adolescent Athletes. J Athl Train. 2019;54(5):457-460.
Ardern CL, Webster KE, Taylor NF, Feller JA. Return to sport following anterior cruciate ligament reconstruction surgery: a systematic review and meta-analysis of the state of play. Br J Sports Med. 2011;45(7):596-606.
Hewett TE, Myer GD, Ford KR, Heidt RS Jr, Colosimo AJ, McLean SG, et al. Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: a prospective study. Am J Sports Med. 2005;33(4):492-501.
Sugimoto D, Myer GD, McKeon JM, Hewett TE. Evaluation of the effectiveness of neuromuscular training to reduce anterior cruciate ligament injury in female athletes: a critical review of randomised controlled trials. Br J Sports Med. 2012;46(13):979-88.
Arundale AJH, Capin JJ, Smith HC, Noehren B, Hewett TE, Marshall SW, et al. Exercise-Based Knee and Anterior Cruciate Ligament Injury Prevention: Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability and Health From the Academy of Orthopaedic Physical Therapy and the American Academy of Sports Physical Therapy of the American Physical Therapy Association. J Orthop Sports Phys Ther. 2023;53(9):CPG1-CPG59.
Webster KE, Hewett TE. Meta-analysis of meta-analyses of anterior cruciate ligament injury prevention programs. J Orthop Res. 2018;36(10):2696-2708.
Omi Y, Senga S, Akiyama T, Kanamori A, Mae T, Nakata K. High adherence to a neuromuscular training program is associated with a low incidence of anterior cruciate ligament injury in female high school athletes. Knee Surg Sports Traumatol Arthrosc. 2018;26(9):2571-2577.
Sanders TL, Maradit Kremers H, Bryan AJ, Larson DR, Dahm DL, Levy BA, et al. Incidence of Anterior Cruciate Ligament Tears and Reconstruction: A 21-Year Population-Based Study. Am J Sports Med. 2016;44(6):1502-7.
Paterno MV. The Long-Term Impact of an ACL Injury. J Orthop Sports Phys Ther. 2020;50(11):592-593.
White K, Finch CF, Donaldson A. Barriers and enablers to the implementation of injury prevention programmes in community sport: A qualitative systematic review and meta-synthesis. Sports Med. 2020;50(6):1109-1125.
LaBella CR, Huxford MR, Grissom J, Kim KY, Peng J, Christoffel KK. Effect of neuromuscular warm-up on injuries in female soccer and basketball athletes in urban public high schools: cluster randomized controlled trial. Arch Pediatr Adolesc Med. 2011;165(11):1033-40.
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Copyright (c) 2025 Martín Inmediato, Saldívar M (Autor/a)

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