Short-term - change on physical capacities of football players within few days before ACL-injury: a retrospective case-control study

Maximum speed showed the strongest association with ACL rupture risk, with significant differences at matchday 2 (p = 0.005) and across aggregated intervals (the average values across the last four, three, and two matches before injury). Reduced playing time emerged as an additional indicator. Although distance covered, sprint count, and pass accuracy did not reach statistical significance individually, their temporal patterns revealed a predisposing risk constellation: injured players demonstrated reduced cumulative exposure combined with acute high-intensity spikes at matchday 2, declining technical precision, and increased physical confrontation at matchday 1. This suggests ACL injury risk manifests through deterioration of integrated performance capacity under acute load fluctuations rather than isolated thresholds. Multifactorial approaches integrating biomechanical, physiological, and temporal performance patterns are essential for effective ACL injury prevention in professional football.