February 2018

Group urges training exercises to prevent ACL injury

In the moment: Sports medicine

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Athletic trainers and healthcare professionals have a fresh set of recommendations to help prevent noncontact and indirect contact anterior cruciate ligament (ACL) injuries in athletes and physically active people. The position statement, “Prevention of Anterior Cruciate Ligament Injury,” from the National Athletic Trainers’ Association (NATA),” was published in the Journal of Athletic Training.

In general, training programs that include a minimum of 3 of the 5 exercise categories (strength, plyometrics, agility, balance, and flexibility) along with feedback regarding technique, are recommended, in addition to a multicomponent injury-prevention training program. These training programs can help improve balance, lower-extremity strength and power, biomechanics, and functional performance measures.

Given the variability among successful training programs and exercise groups to prevent ACL injury, the position statement offers general guidelines, rather than specifics, regarding the organization and types of exercise to include in multicomponent training programs.

The recommendations also call for injury-prevention training exercises performed at increasing intensity levels that are challenging and allow for excellent movement quality and technique. In addition, the position statement recommends that multicomponent training programs be performed during preseason and 2 or 3 times a week in-season, and should be continued from season to season to maintain benefits achieved.

Skilled individuals, such as athletic trainers, should supervise the training programs, providing feedback on technique and offering correction as appropriate. NATA also recommends that multicomponent training programs be implemented as a warm-up or as part of a comprehensive strength and conditioning program. In addition, the association recommends multicomponent preventive training program for all participants in sports and physical activity.

“Preventing ACL injuries during sport and physical activity may dramatically decrease medical costs and long-term disability,” says lead author Darin Padua, PhD, ATC, director of the Sports Medicine Research Laboratory at the University of North Carolina at Chapel Hill. “Working with athletic trainers, physicians, and other healthcare and fitness professionals will help ensure athletes and those who are physically active are benefiting from injury-prevention training programs with proper technique and education.”


Padua DA, DiStefano LJ, Hewett TE, et al. National Athletic Trainers’ Association position statement: prevention of anterior cruciate ligament injury. J Athl Train. 2018;53(1):5-19.


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