RPI-logo Header



  • ACL injury continues to be the single largest problem in orthopedic sports medicine
  • Research has demonstrated that female athletes have a 4 to 6 fold increased risk of ACL injury compared to males playing at similar levels in the same sports, with highest risk at 14-19 years old
  • On average, 70%-78% of ACL injuries occur via non-contact mechanism, more commonly seen in high risk sports such as soccer, basketball, football, and volleyball
  • For basketball, the rate of injury in the younger female age group is highest – nearly 4 times that of males
  • Injury results in increased potential for loss of season (avg 6-9 month rehabilitation), loss of possible scholarship funding, lowered academic and athletic performance, long-term disability, and up to 100 times greater risk of osteoarthritis

Mechanism/Risk Factors

  • Most non-contact ACL injuries occur when individual is landing from a jump, rapidly stopping, cutting, or suddenly decelerating with change in direction
  • Research indicates higher risk in women due to anatomical, hormonal, and biomechanical risk factors
  • Females have higher tendency to have risky landing patterns and potential neuromuscular imbalances that significantly increase risk of injury


  • Factors that have been studied and incorporated into ACL prevention programs include strength training, neuromuscular training, landing and decelerating patterns/techniques, proprioception, and plyometrics
  • Evidence indicates that injury prevention programs can significantly reduce the rate of NON-CONTACT ACL injuries by greater than 70% compared to untrained individuals
  • High intensity neuromuscular training has shown to improve performance measures of speed, strength, and power and increase in vertical jump height
  • Successful ACL programs include a multi-factorial approach, are performed more than 1x/week for a minimum of 6 weeks, and most effective when completed prior to onset of the season
  • ACL programs should be initiated at or prior to the onset of puberty in order to prevent maladaptive neuromuscular and biomechanical patterns from developing in the first place
  • SPORTSMETRICS is a nationally recognized sport specific ACL injury prevention program developed by Dr. Frank Noyes and the Cincinnati Sports Medicine staff that is scientifically proven to reduce knee ligament injury and enhance performance


  1. Hewett TE, Ford KR, Myer GD, et al. Anterior Cruciate Ligament Injuries in Female Athletes. Part 2, A Meta-analysis of Neuromuscular Interventions aimed at Injury Prevention. The American Journal of Sports Medicine. 2006;3:490-497.
  2. Renstrom P, Ljungqvist A, Arendt E, et al. Non-Contact ACL injuries in female athletes: An International Olympic Committee current concepts statement. Br J Sports Med. 2008;42:394-412.
  3. Voskanian N. ACL Injury prevention in female athletes: review of the literature and practical considerations in implementing an ACL prevention program. Curr Rev Musculoskeletal Med. 2013;6:158-163.

Created by Ashley Crain, DPT. Program Director of RPI Sports Therapy Services