ACL injuries are on the rise among young athletes; new recommendations provide detailed guidance on prevention

Published: February 2, 2018 | Updated: September 19, 2024

The National Athletic Trainers’ Association (NATA) recently unveiled its recommendations for reducing anterior cruciate ligament (ACL) injuries in the knee. It includes specific exercises and guidelines on how athletes should implement an injury prevention program to improve their chance of avoiding an injury.

The recommendation supports calls from sports medicine professionals  and provides training recommendations that can be useful to parents, coaches and sports health professionals.

Just this season, two of the best young quarterbacks in the NFL, Carson Wentz and Deshaun Watson,  injured their ACLs. But it isn’t just high-powered professional athletes falling; ACL injury rates among young athletes are rising and leaving parents, coaches and athletes with a lot of questions.

Some of the NATA recommendations

• • An injury prevention program needs to include at least three of the following: strength, plyometrics, agility, balance and flexibility:*
    • Strength: lunges, leg press, side plank
    • Plyometrics: squat jump, bounding, box jump
    • Agility: speed run, high knee running, carioca
    • Balance: single leg balance, single leg jumps
    • Flexibility: calf stretch, quadriceps stretch, hamstring stretch

*These examples are not in order of progression and do not encompass all exercises that can be performed.

• • The program should be used during the season and in the off-season.
  • Sessions should be conducted two to three times a week and, at a minimum, be part of a dynamic 10- to 15-minute warm-up.
  • The program should be revisited each year. As with any skill, it needs to be fine-tuned throughout an athlete’s playing career.
  • It should be challenging. Progression of exercises and intensity are important to keep strengthening the body.
  • Someone trained to recognize improper technique should supervise the program. This includes, but is not limited to, an athletic trainer, a certified strength and conditioning coach, or a physical therapist.
  • While all athletes benefit from an ACL injury prevention program, it’s highly encouraged for certain types of athletes:
• Those involved with frequent landing, cutting or direction changes and decelerations, such as basketball, football and soccer
• Female athletes, who have a higher rate of ACL injury compared with their male counterparts
• Athletes with a history of ACL injury