Did you know that the risk of many ACL injuries can be significantly reduced?

In a study it was noted that most frequent ACL injuries in high school sports for boys occur during football (71.2%), while for girls it occurred during soccer (53.2%) (Joseph et al, 2013).

The most common mechanisms of injury were player-to-player contact (42.8%) and no contact (37.9%).

In another study assessing 39 complete tears of the ACL in professional men’s soccer, 33 of them were non contact injuries (Walden et al, 2015).

What both studies suggest based of the statistics, is that a high percentage of ACL injuries can be reduced.

Before talking about the different factors that can affect the ACL, let’s discuss the role of the ACL.

The ACL has multiple functions:

  • Connects the femur (thigh bone) to the tibia (shin bone)
  • Provides knee stability by resisting excessive forward movement of the shin bone (hyperextension of the knee), excessive rotational forces, and lateral forces
  • Controls the centre of rotation of the knee
  • Proprioception: Gives sensory information to the brain regarding the position of the knee in space

The research has indicated various risk factors to ACL injuries (Nessler et al, 2017):

1) Biomechanics: excessive caving/falling in of the knee during a cutting maneuver or landing from a jump increases the level of stress to the ACL

2) Neuromuscular Control + Muscle fatigue: as muscular control decreases, there is greater reliance on the ligaments to provide support to the knee

3) Trunk Stability: decreased trunk stability strength and endurance results in greater displacement of the body’s center of mass and reduced control of knee caving that can predispose an individual to increased stress to the ACL

4) Quad to hamstring ratio: Optimal co-contraction of the quadriceps to hamstrings has been found to reduce the strain on the ACL

5) Environment: Dry weather and surfaces and artificial surface instead of natural grass

In keeping with the variables noted above, many of the factors can be affected through reinforcing proper behaviours and developing adequate physical characteristics to reduce the risk of ACL.

If you have any questions or inquiries about ACL injuries or are looking to ensure a healthy sport life, drop a comment below or call us directly for further information on how to optimize your health and performance.

Author: Zachary Hum MScPT BAKin


Joseph, A. M., Collins, C. L., Henke, N. M., Yard, E. E., Fields, S. K., & Comstock, R. D. (2013). A Multisport Epidemiologic Comparison of Anterior Cruciate Ligament Injuries in High School Athletics. Journal of Athletic Training48(6), 810–817.

Waldén, M., Krosshaug, T., Bjørneboe, J., Andersen, T. E., Faul, O., & Hägglund, M. (2015). Three distinct mechanisms predominate in non-contact anterior cruciate ligament injuries in male professional football players: a systematic video analysis of 39 cases. British Journal of Sports Medicine49(22), 1452–1460. Retrieved from https://bjsm.bmj.com/content/49/22/1452.info

Nessler, T., Denney, L., & Sampley, J. (2017). ACL Injury Prevention: What Does Research Tell Us? Current Reviews in Musculoskeletal Medicine10(3), 281–288. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5577417/