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Biomechanical and Neuromuscular Characteristics of Male Athletes: Implications for the Development of Anterior Cruciate Ligament Injury Prevention Programs

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Abstract

Prevention of anterior cruciate ligament (ACL) injury is likely the most effective strategy to reduce undesired health consequences including reconstruction surgery, long-term rehabilitation, and pre-mature osteoarthritis occurrence. A thorough understanding of mechanisms and risk factors of ACL injury is crucial to develop effective prevention programs, especially for biomechanical and neuromuscular modifiable risk factors. Historically, the available evidence regarding ACL risk factors has mainly involved female athletes or has compared male and female athletes without an intra-group comparison for male athletes. Therefore, the principal purpose of this article was to review existing evidence regarding the investigation of biomechanical and neuromuscular characteristics that may imply aberrant knee kinematics and kinetics that would place the male athlete at risk of ACL injury. Biomechanical evidence related to knee kinematics and kinetics was reviewed by different planes (sagittal and frontal/coronal), tasks (single-leg landing and cutting), situation (anticipated and unanticipated), foot positioning, playing surface, and fatigued status. Neuromuscular evidence potentially related to ACL injury was reviewed. Recommendations for prevention programs for ACL injuries in male athletes were developed based on the synthesis of the biomechanical and neuromuscular characteristics. The recommendations suggest performing exercises with multi-plane biomechanical components including single-leg maneuvers in dynamic movements, reaction to and decision making in unexpected situations, appropriate foot positioning, and consideration of playing surface condition, as well as enhancing neuromuscular aspects such as fatigue, proprioception, muscle activation, and inter-joint coordination.

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No sources of funding were used to assist in the preparation of this review. The authors have no potential conflicts of interest that are directly relevant to the content of this review.

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Authors and Affiliations

  1. The Micheli Center for Sports Injury Prevention, Waltham, MA, USA

    Dai Sugimoto & Gregory D. Myer

  2. Divison of Sports Medicine, Department of Orthopaedics, Boston Children’s Hospital, Boston, MA, USA

    Dai Sugimoto

  3. Duke Sports Medicine Center, Department of Orthopaedic Surgery, Duke University, Durham, NC, USA

    Eduard Alentorn-Geli

  4. Department of Physical Therapy, Zentrum Rehab and Performance Center, Barañain, Navarre, Spain

    Jurdan Mendiguchía

  5. Department of Orthopaedics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

    Kristian Samuelsson & Jon Karlsson

  6. Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Gregory D. Myer

  7. Departments of Pediatrics and Orthopaedic Surgery, University of Cincinnati, Cincinnati, OH, USA

    Gregory D. Myer

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  1. Dai Sugimoto
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Sugimoto, D., Alentorn-Geli, E., Mendiguchía, J. et al. Biomechanical and Neuromuscular Characteristics of Male Athletes: Implications for the Development of Anterior Cruciate Ligament Injury Prevention Programs. Sports Med 45, 809–822 (2015). https://doi.org/10.1007/s40279-015-0311-1

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