Welcome to Stay in the Game, a monthly blog where the team from The Queen's Health Systems share the latest tips on the treatment and prevention of sports injuries. We want to help you play hard and be well - a winning combination that will keep you in the game all season long.

Preventing ACL injuries


Approximately 250,000 ACL injuries occur in the U.S. each year and 70% of them are non-contact related.  Licensed physical therapist at the Queen's Center for Sports Medicine, David Kurihara, DPT, explains why these injuries happen and what can be done to help prevent them in the future.

Question 1:  What is an ACL?

David Kurihara, DPT: The ACL (anterior cruciate ligament) is responsible for providing stability within the knee and runs diagonally through the middle of the knee from the thigh bone (femur) to the shin bone (tibia).
When the ACL is injured, in addition to pain and inflammation, it can lead an athlete to have feelings of instability ("giving way") of the knee during their sport.

Question 2:  How do non-contact ACL injuries occur?

David Kurihara, DPT: Non-contact ACL injuries commonly involve a sudden change in direction, a landing from jumping, or stop deceleration - going from quick movement to a stop. The risk of injury is greater when the movements of the lower half of the body are not ideal, such as not having enough bend at the knee and hip.

Other factors that can contribute to non-contact ACL injuries include fluctuations in hormone levels and the type of playing environment.

Question 3: What can be done to prevent non-contact ACL injuries?

David Kurihara, DPT: ACL injury prevention programs for various sports have shown a 60-80% overall reduction in ACL injury. It is important to have athletes perform a battery of exercises (15-20 exercises) that focus on neuromuscular control (agility, mobility, strengthening, balance, correct movement patterns) before and during the season.   

Below are a few exercises that can be incorporated into an athlete's warm-ups.

1) Single Leg Squat:

Starting position: Stand on one leg.

Exercise: Slowly bend the knee of the supporting leg, if possible, until it is flexed to 90 degrees, then straighten the leg. Bend slowly, then slowly increase the speed used to straighten the leg. Do two sets of 10 squats on each leg.

Important: Do not let the knee buckle inwards. Keep upper body facing forward and pelvis horizontal.

2) Lateral Jumps:

Starting position: Stand on one leg. Bend hips, knee and ankle slightly and lean upper body forward.

Exercise: Jump to the side, from your supporting leg onto the other leg. Land gently on the ball of your foot and bend your hips, knee and ankle. Hold this position for 1 second,  then jump back onto the other leg. Repeat for 30 sec. 2 sets.

Important: Do not let your knee buckle inwards. Keep upper body stable and facing forward, and pelvis horizontal.

3) Quick Forwards and Backwards:

Set up cones three feet apart, along the width of the field.

Run quickly from the first cone to the second cone, then run backward quickly to the first cone, keeping your hips and knees slightly bent. Repeat, running two cones forwards and one cone backwards until you reach the other side of the field 2 sets.

To learn the complete set of preventative exercises and proper movement patterns to prevent ACL injuries, consult with a physician, physical therapist or athletic trainer or contact the Queen’s Center for Sports Medicine at 808-691-4449.

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