Preventing ACL Tears in High School Athletes

You most likely know an adolescent that plays on a sports team and you may have noticed how sports have become very different in recent years with increased practices, competitions and longer seasons.  The level of athletics seems to have increased to a greater level which also puts higher demand on athletes.  This has also correlated to higher rates of injuries in high school athletes.  Today I want to talk about preventing these injuries in high school athletes in order to keep them healthy, avoid costly medical bills and a lengthy rehabilitation path.

One of the most common injuries in high school athletes right now is an ACL tear and 76.6% of ACL tears result in surgery.  Soccer, football, and basketball are the sports most commonly associated with this type of injury.  Girls soccer has a 12.2% injury rate for ACL tear and is the highest rate of all high school sports.  There are also gender differences associated with risk of ACL tear with girls at a higher rate than boys.

Although these numbers are quite surprising, preventive programs have been developed in order to decrease the risk of ACL injury.  For example, a preventative program used with a girl’s soccer team showed decreased ACL injuries and it has been suggested that those athletes compliant with the preventative program have an 88% decrease in ACL injury risk.

Most preventative programs focus on strengthening particular muscles in order to decrease any muscular imbalances, as well as improve neuromuscular control.  In sports that require jumping and cutting movements, knee position is imperative for decreasing the stress on the ACL.  I frequently see adolescents land from a jump and their knees collapse inward upon landing, termed medial collapse.  This movement is a risk factor for ACL injuries and most adolescents have to train their bodies to control against that movement as well as strengthen the hip abductors for increased control.

Try this at home in front of a mirror: jump up in the air as high as you can then land in a squat.  Second, stand on one leg and squat down only on that leg.  If you saw your knee moving in rather than staying in a straight line over your toes, that indicates a risk for injury.  One thing you can do to try to improve this is continue to practice these movements in front of the mirror while concentrating on maintaining proper knee position over the toes.  This will help re-train the body for improved neuromuscular control.

It may be worth while to find a knowledgeable Physical Therapist in your area that may be able to set you up with a preventative program.  I have been hired by entire teams to come out and establish a program to incorporate into the team’s warm-up.  It’s also worth mentioning that most states have direct access to PT’s meaning you do not need a physician order in order to be evaluated by a PT.  It is different in each state and your local PT can tell you what you need but if your state does have direct access, it may save you an additional visit to the physician.  Here in Wisconsin we do have direct access.

As more demand is placed on our high school athletes, beginning a preventative program will help keep them injury free in their sport.  Please contact me at with any questions you may have about specific preventative programs or any additional questions; I would be happy to answer them.  Or check out the website to learn more about preventative programs at


Joseph AM, Collins CL, Henke NM, Yard EE, Fields SK, Comstock RD. A multisport epidemiologic comparison of anterior cruciate ligament injuries in high school athletics. J Athl Train. 2013; 48(6): 810-7.

Wingfield K. Neuromuscular training to prevent knee injuries in adolescent female soccer players. J Sports Sci. 2014;32(6):583-90.


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