March 2018

Neuromuscular training in high-risk female adolescent athletes 696784988

Noting that an up to 10-fold increased risk of injury has been demonstrated in female athletes compared with male athletes, particularly for anterior cruciate ligament (ACL) sprains, patellofemoral pain, and ankle injuries, researchers sought to evaluate the effects of a school-based neuromuscular training (NMT) program on sport-related injury incidence at the high school and middle school levels.

Focused on school-based basketball, volleyball, and soccer, a prospective randomized controlled clinical trial included 474 female athletes from a public school district in Kentucky. Of these athletes, 222 were middle-schoolers, and 252 were high-schoolers. Students could engage in more than 1 sport.

Players were cluster assigned to an NMT group or sham group. The sham group performed resisted running using elastic bands, while the NMT group performed exercises focused on the trunk and hip. From the first day of team practice until the first competition, teams performed the NMT training for 20 to 25 minutes, 3 times per week, and then a reduced-volume protocol of 10 to 15 minutes, twice a week through the competition season.

The data indicate that an NMT program implemented at the middle school and high school levels prevented injury in female basketball and volleyball athletes over the athletic season, particularly knee injuries, and was most pronounced for knee injuries in middle school volleyball players. No difference was observed for ankle injuries between the NMT and sham groups either by level, or by sport.

The researchers further noted that the knee-injury reduction observed for middle school volleyball athletes was of particular interest, concluding that their data might suggest the importance of implementing injury-prevention strategies at younger ages to have the greatest effects on young female athletes.


Foss KDB, Thomas S, Khoury JC,Myer GD, Hewett TE. A school-based neuromuscular training program and sport-related injury incidence: A prospective randomized controlled clinical trial. J Athl Train. 2018;53:20-28.

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