The Center for Podiatric Care and Sports Medicine

Athletes Learn How To Avoid ACL Injury

Posted by on Wednesday, July 3rd, 2013


Sports fans have probably seen dozens of ACL injuries. A player usually goes down for seemingly no reason at all. They lie crumpled up, grabbing a knee, with a look of excruciating pain on their faces. Then they get up and limp to the sidelines. As it turns out, the anterior cruciate ligament (ACL) is incredibly easy to tear and 25,000 Americans undergo surgery to repair the ligament each year.


ACL Injury Symptoms

According to the NY Times Health Guide, early torn ACL symptoms may include:

  • A “popping” sound at the time of the injury
  • Knee swelling within 6 hours
  • Pain, especially when putting weight on the injured leg, and
  • The feeling that the leg is unstable and may give way at any moment.

What Causes Torn ACL Injuries?

For years, ACL injuries were blamed on female anatomy, since women were four times more likely than males to tear their ACLs. It was said their “wide hips” or “hormones” were factors in the injury — which is a myth that has since been debunked. Instead, bad habits and strength imbalances are largely to blame, says the LA Times.

Timothy Hewett, director of research for sports medicine at Ohio State University has been studying ACL injuries for years. He found that about 70% of ACL injuries occur without any contact from another player — but, rather, as the result of landing poorly. Often, the player lands on one leg with a flat foot and straight knee. The knee caves inward, while the foot is still firmly planted, which creates the sort of torque that snaps the anterior cruciate ligament like a rubber band.

ACL Injury Prevention Programs May Help.

In training programs, male and female athletes can learn how to land softly, says Hewett. They’ll practice jumping and landing on the ball of the foot with the knee slightly flexed. “ACLs don’t tear when the knee is flexed,” Hewett explains. In addition to unlearning bad habits, Hewett’s program also emphasizes strength-training — particularly in the hamstring muscles on the back of the thigh. Often, women with weak hamstring muscles overcompensate with their quadriceps, which stiffens the knee and pulls the tibia forward, while the ACL tugs to hold the tibia back. This sort of strain almost always ends with a torn ACL.

A 2012 study by Hewett and colleagues published in the British Journal of Sports Medicine demonstrated that women who participated in these ACL injury prevention programs were 70% less likely to suffer an ACL injury. Another study conducted in Sweden found that only three girls from 49 soccer teams received ACL injuries after going through training. Furthermore, they found the training program reduced sports injury incidence by 77 to 90%.

Beyond preventing ACL injuries, the exercises also improve fitness, balance, agility and strength — all of which enhance performance. For athletes who want to try a comparable program on their own, the Prevent Injury and Enhance Performance program offers videos and training tips at the Santa Monica Sports Medicine Foundation website.


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