Prevention of anterior cruciate ligament injuries in soccer

Abstract

Proprioceptive training has been shown to reduce the incidence of ankle sprains in different sports. It can also improve rehabilitation after anterior cruciate ligament (ACL) injuries whether treated operatively or nonoperatively. Since ACL injuries lead to long absence from sports and are one of the main causes of permanent sports disability, it is essential to try to prevent them. In a prospective controlled study of 600 soccer players in 40 semiprofessional or amateur teams, we studied the possible preventive effect of a gradually increasing proprioceptive training on four different types of wobble-boards during three soccer seasons. Three hundred players were instructed to train 20 min per day with 5 different phases of increasing difficulty. The first phase consisted of balance training without any balance board; phase 2 of training on a rectangular balance board; phase 3 of training on a round board; phase 4 of training on a combined round and rectangular board; phase 5 of training on a so-called BABS board. A control group of 300 players from other, comparable teams trained "normally" and received no special balance training. Both groups were observed for three whole soccer seasons, and possible ACL lesions were diagnosed by clinical examination, KT-1000 measurements, magnetic resonance imaging or computed tomography, and arthroscopy. We found an incidence of 1.15 ACL injuries per team per year in the proprioceptively trained group (P < 0.001). Proprioceptive training can thus significantly reduce the incidence of ACL injuries in soccer players.

Dynamic Single-Leg Postural Control Is Impaired Bilaterally Following Anterior Cruciate Ligament Reconstruction: Implications for Reinjury Risk

“…29 Alternatively, the bilateral balance deficits that we observed may have been present prior to ACL injury, and may have been a contributing factor in the original ACL rupture. 10 The few associations we observed between functional performance and postural control suggest that the 2 tasks assess different aspects of sensorimotor function. Results from the more complex hop-for-distance task also likely reflect psychological aspects such as knee-related confidence.…”

Evaluation of the effectiveness of neuromuscular training to reduce anterior cruciate ligament injury in female athletes: a critical review of relative risk reduction and numbers-needed-to-treat analyses

“…18 Since the 1990s, several prospective cohort studies have been performed to determine the effect of neuromuscular training interventions targeted to reduce ACL, knee and other lower-extremity injuries. 19–32 Studies often utilised single or limited training modes in their neuromuscular training interventions such as plyometric exercises, balance exercises or a combination of both. 192223 More comprehensive approaches have been initiated recently, which consist of a combination of different types of exercises such as plyometrics, strengthening, stretching and balancing training.…”

“…19–32 Studies often utilised single or limited training modes in their neuromuscular training interventions such as plyometric exercises, balance exercises or a combination of both. 192223 More comprehensive approaches have been initiated recently, which consist of a combination of different types of exercises such as plyometrics, strengthening, stretching and balancing training. The ‘Dynamic Neuromuscular Analysis (DNA) training’, 18 ‘Prevent Injury and Enhance Performance (PEP)’, 2429 ‘11’ 28 and ‘11+’ 31 programmes are examples of comprehensive neuromuscular training protocols.…”

An investigation of motor learning during side-step cutting, design of a randomised controlled trial

“…Neuromuscular training strategies focussing on warm-up, technique, balance, strengthening and agility exercises have continued to evolve and represent an ever-increasing and equally important research focus [5-11]. Recent epidemiological data, however, suggest that in spite of these ongoing initiatives and reported early successes [5,8,12,13], ACL injury rates and the associated gender disparity have not diminished [14-16]. The disparity between positive laboratory results and actual effects on injury outcomes in high-risk female populations suggests a missing link between current research and clinical applications for neuromuscular training interventions [17].…”