The Effect of Neuromuscular Training on the Incidence of Knee Injury in Female Athletes

Abstract

To prospectively evaluate the effect of neuromuscular training on the incidence of knee injury in female athletes, we monitored two groups of female athletes, one trained before sports participation and the other not trained, and a group of untrained male athletes throughout the high school soccer, volleyball, and basketball seasons. Weekly reports included the number of practice and competition exposures and mechanism of injury. There were 14 serious knee injuries in the 1263 athletes tracked through the study. Ten of 463 untrained female athletes sustained serious knee injuries (8 noncontact), 2 of 366 trained female athletes sustained serious knee injuries (0 noncontact), and 2 of 434 male athletes sustained serious knee injuries (1 noncontact). The knee injury incidence per 1000 athlete-exposures was 0.43 in untrained female athletes, 0.12 in trained female athletes, and 0.09 in male athletes (P = 0.02, chi-square analysis). Untrained female athletes had a 3.6 times higher incidence of knee injury than trained female athletes (P = 0.05) and 4.8 times higher than male athletes (P = 0.03). The incidence of knee injury in trained female athletes was not significantly different from that in untrained male athletes (P = 0.86). The difference in the incidence of noncontact injuries between the female groups was also significant (P = 0.01). This prospective study demonstrated a decreased incidence of knee injury in female athletes after a specific plyometric training program.

No effect on performance tests from a neuromuscular warm-up programme in youth female football: a randomised controlled trial

“…Still, we found no improvements in SEBT from our intervention, unlike another study where significant improvements in the posterolateral and posteromedial directions were seen in youth female football players after an 8-week neuromuscular training programme [3]. Plyometric exercises were included in other similar neuromuscular programmes [2,9,12,17,19] but not in ours, and it is more likely that an improvement in jumping or sprinting performance would have been achieved if a plyometric training component was included. However, there is no clear trend in the literature about the effect of adding plyometrics, where two of the previous studies showed improvements in jumping ability [2,12], and two reported no effects [17,19].…”

“…Several neuromuscular training programmes have therefore been evaluated to prevent acute knee injury, ACL injury in particular, among youth female football players [8,9,11,13,16].…”

The effect of proprioceptive knee bracing on knee stability during three different sport related movement tasks in healthy subjects and the implications to the management of Anterior Cruciate Ligament (ACL) injuries

“…Each year in the United States there are approximately 250,000 ACL injuries, or 1 in 3,000 in the general population [9,10]. Numerous theories have been proposed to explain what predisposes patients to noncontact ACL injury.…”

A comparison of isokinetic knee strength and power output ratios between female basketball and volleyball players

“…In contrast, too low values of the functional H/Q indicate an imbalance in muscle strength between the agonist and the antagonist, and may contribute to a greater risk of anterior cruciate ligament (AcL) injury. A predisposition to AcL injury may also result from decreased antagonist hamstring co-activation during extension loads, as well as knee ligamentous structures bearing most of the imposed load [15,29,30]. In particular, non-contact situations may potentially occur near the foot strike when the quadriceps are eccentrically contracting to resist flexion [31,32].…”