Injury to the anterior cruciate ligament (ACL) is common and affects young individuals, particularly girls, who are active in sports that involve jumping, pivoting, as well as change of direction. ACL injury is associated with potential long-term complications including reduction in activity levels and osteoarthritis. Multiple intrinsic and extrinsic risk factors have been identified, which include anatomic variations, neuromuscular deficits, biomechanical abnormalities, playing environment, and hormonal status. Multicomponent prevention programs have been shown to be effective in reducing the incidence of this injury in both girls and boys. Programs should include a combination of strengthening, stretching, aerobic conditioning, plyometrics, proprioceptive and balance training, as well as education and feedback regarding body mechanics and proper landing pattern. Preventive programs should be implemented at least 6 wk prior to competition, followed by a maintenance program during the season.
Strength, flexibility, and stability are physiologic parameters associated with health-related physical fitness. Each of these domains affects health in general, the risk of injury, how an injury is treated, and performance in activities of daily living and sports. These domains are affected by individual phenotype, age, deconditioning, occupational activity, and formal exercise. Deficits or loss of strength, flexibility, and stability can be prevented or reduced with exercise programs. Normal muscle strength has been associated with general health benefits, increased life expectancy, psychological benefits, prevention of illness, and reduction of disability in older adults. Static flexibility programs have been shown to improve joint range of motion and tolerance to stretch but do not appear to reduce the risk of musculoskeletal injury and may impair muscle performance immediately after a static stretch. Dynamic flexibility, on the other hand, may enhance power and improve sports-specific performance. Stability training leads to improved balance and neuromuscular control, may prevent injury to the knee and ankle joints, and can be used for treatment of patients with low back pain.
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