Team Approach: Neuromuscular Training for Primary and Secondary Prevention of Anterior Cruciate Ligament Injury

Abstract

Neuromuscular training is a method of performance optimization-typically combining plyometrics, balancing training, agility, and dynamic stabilization-predicated on improving the efficiency of fundamental movement patterns. Neuromuscular training has consistently been shown to reduce the risk of anterior cruciate ligament injury, particularly for athletes engaged in activities associated with noncontact knee injuries (i.e., women's soccer). Successful implementation of neuromuscular training programs requires input from coaches, physical therapists, athletic trainers, and physicians to generate efficacious programs with high rates of adherence.

Fig. 1

Check-list of best practices evaluating the components of a neuromuscular training program. (Reproduced, with permission, from Petushek EJ, Sugimoto D, Stoolmiller M, Smith G, Myer GD. Evidence-based best practice guidelines for preventing anterior cruciate ligament injuries in young female athletes: a systematic review and meta-analysis. Am J Sports Med. 2019;47[7]:1744–53.)

Fig. 2

Example of smart phone-based application available for neuromuscular training.

Fig. 3

Summary of meta-analyses for (Fig. 3-A) all ACLinjuries in all athletes and(Fig. 3-B)noncontact ACL injuries in female athletes. (Reproduced, with permission, from Webster KE, Hewett TE. Meta-analysis of meta-analyses of anterior cruciate ligament injury reduction training programs. J Orthop Res. 2018;36[10]:2696–708.)