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Prevention of non-contact anterior cruciate ligament injuries in soccer players
Knee Surgery, Sports Traumatology, Arthroscopy, 05/21/09

Alentorn-Geli E et al. - Non-contact ACL injuries in soccer players likely has a multi-factorial etiology. The identification of those athletes at increased risk may be a salient first step before designing and implementing specific pre-season and in-season training programs aimed to modify the identified risk factors and to decrease ACL injury rates.

Methods

A review to sequence the most recent literature that reports potential mechanisms and risk factors for non-contact anterior cruciate ligament (ACL) injury in soccer players

Results

Most ACL tears in soccer players are non-contact in nature
Common playing situations precluding a non-contact ACL injury include:
- Change of direction or cutting maneuvers combined with deceleration
- Landing from a jump in or near full extension, and
- Pivoting with knee near full extension and a planted foot
Most common non-contact ACL injury mechanism include a deceleration task with high knee internal extension torque combined with dynamic valgus rotation
Potential extrinsic non-contact ACL injury risk factors include: dry weather and surface, and artificial surface instead of natural grass
Intrinsic risk factors include:
- generalized and specific knee joint laxity, small and narrow intercondylar notch width,
- pre-ovulatory phase of menstrual cycle in females not using oral contraceptives,
- decreased relative hamstring strength and recruitment, muscular fatigue by altering neuromuscular control,
- decreased “core” strength and proprioception,
- low trunk, hip, and knee flexion angles, and high dorsiflexion of the ankle when performing sport tasks,
- lateral trunk displacement and hip adduction combined with increased knee abduction moments and increased hip internal rotation and tibial external rotation with or w/o foot pronation