On-Field Assessment of Joint Load in Football Using Machine Learning (Part II)

Anterior cruciate ligament (ACL) injury risk is elevated in female youth football, yet knee joint loading has mainly been studied under controlled laboratory conditions. This limits understanding of how injury risk emerges during realistic match situations. This study provided a field-based kinetic characterization of football-specific movements by estimating knee abduction moments (KAMs) using wearable sensors and machine learning. Fifty-two highly talented female youth players performed agility tasks during training, including structured exercises (F-EX) and game-based play (F-GAME). Full-body kinematics were collected with inertial measurement units, and a validated support vector machine model, trained on synchronized motion capture and force plate data, classified trials as high or low KAM. Across 662 change-in-direction trials, 9-12% were classified as high KAM in both conditions, indicating that potentially high-risk loading regularly occurs during routine actions. High KAM trials showed reduced knee and pelvis flexion, increased hip flexion, and greater pelvis rotation toward the cutting direction, reflecting upright, stiff movement strategies. Performance analyses revealed smaller cut angles in exercises and greater approach acceleration in game play, without differences in peak velocity. These findings demonstrate the feasibility of field-based kinetic screening and support a complex-systems perspective on ACL injury risk.