Strenght Training to Reduce Biomechanical Risk Factors for ACL Injuries in Athletes

Anterior cruciate ligament (ACL) injuries can significantly affect an athlete’s ability to participate in sport, emphasizing the importance of prevention strategies to mitigate knee impairments. Strength training has been shown to enhance landing mechanics during sidestepping and jumping, movements often linked to ACL injuries. This systematic review with meta-analysis investigated the effects of strength training on biomechanical risk factors for ACL injuries in athletes. After searching trials up to May 4, 2022, eight articles were included. The articles included in the study seemed to be limited to female athletes who participated in sports that required cutting, jumping, or pivoting. Due to the heterogeneity of the included studies, only three articles (78 participants) could be included in the meta-analysis. The results from the meta-analysis suggest that strength training may favor lower ACL stress as it is correlated with an increased landing knee flexion angle during drop vertical jump. The data are limited, however, and the literature remains sparce in quality and number. This review exposes the need for a deeper understanding of how strengthening influences landing mechanics, reduces knee overload, and decreases the risk of ACL injuries. Future research should focus on standardizing the evaluation of ACL injury-related movements, including the definition of biomechanical outcomes, training interventions, and functional tasks for measurements. Strengthening of pelvic, core and lower body muscles 2-3 times per week seems to lower the ACL injuries risk.