Volume 11, Issue 1 (6-2025)                   J Sport Biomech 2025, 11(1): 46-62 | Back to browse issues page

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Ghorbani M, Varmaziar M, Heydarian M. A Review of Training Protocols for Preventing Anterior Cruciate Ligament Injuries in Soccer Players. J Sport Biomech 2025; 11 (1) :46-62
URL: http://biomechanics.iauh.ac.ir/article-1-368-en.html
A Review of Training Protocols for Preventing Anterior Cruciate Ligament Injuries in Soccer Players
Moosareza Ghorbani *1 , Mostafa Varmaziar2 , Mona Heydarian3
1- Department of Sport Injuries and Corrective Exercise, Faculty of Physical Education and Sport Sciences, University of Guilan, Rasht, Iran.
2- Department of Sports injuries and Corrective exercise, Faculty of Physical Education and Sports Sciences, University of Tehran, Iran.
3- Department of Biomechanics and Sports Injuries, Faculty of Physical Education and Sports Sciences, Kharazmi University, Karaj, Iran.
Abstract:   (607 Views)
Objective Anterior cruciate ligament (ACL) injuries are among the most common injuries in athletes, particularly soccer players. While numerous studies have examined the effectiveness of injury prevention programs for ACL injuries across various sports, no study was found that specifically reviewed training protocols for ACL injury prevention in soccer players. Therefore, the aim of this study was to review training protocols designed to prevent ACL injuries in soccer players.
Methods This systematic review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Articles published between 2000 and 2025 focusing on ACL injury prevention were searched. Relevant articles were identified using both English and Persian keywords, including: prevent ACL injury, knee injury prevention, prevention of knee injuries, injury prevention in soccer, knee prevention, neuromuscular training, injury prevention programs, neuromuscular intervention, prevention of ACL injuries, prevention of knee injuries in soccer, lower limb injury prevention, and soccer injury prevention programs. The search was carried out in both Persian and international databases, including Magiran, Medlib, ISC, SID, PubMed, Google Scholar, PEDro, Scopus, ScienceDirect, and Irandoc.
Results After applying inclusion and exclusion criteria, a total of 20 articles were selected. Among these, 10 studies focused on general warm-up routines, while the remaining 10 investigated neuromuscular training programs.
Conclusion ACL injury prevention programs incorporating both general warm-up routines and neuromuscular training appear effective in reducing the incidence of ACL injuries among soccer players. However, no single comprehensive program has yet been shown to be effective across all age groups and populations. A notable strength of these interventions is that none have been associated with an increased risk of injury. Nevertheless, due to the complexity and challenges involved in combining various exercise types, it remains difficult to definitively determine the superiority of one approach over another.
Keywords: Anterior cruciate ligament, Soccer, Injury prevention, Neuromuscular training, ACL prevention programs
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Type of Study: Applicable | Subject: Special
Received: 2025/03/2 | Accepted: 2025/04/5 | Published: 2025/04/5
References
1. Carter EA, Westerman BJ, Hunting KL. Risk of injury in basketball, football, and soccer players, ages 15 years and older, 2003-2007. Journal of Athletic Training. 2011;46(5):484–488. [DOI:10.4085/1062-6050-46.5.484] [PMID]
2. Sugimoto D, Alentorn-Geli E, Mendiguchía J, Samuelsson K, Karlsson J, Myer GD. Biomechanical and neuromuscular characteristics of male athletes: implications for the development of anterior cruciate ligament injury prevention programs. Sports Medicine. 2015;45:809-822. [DOI:10.1007/s40279-015-0311-1] [PMID]
3. Mall NA, Chalmers PN, Moric M, Tanaka MJ, Cole BJ, Bach Jr BR, et al. Incidence and trends of anterior cruciate ligament reconstruction in the United States. The American journal of sports medicine. 2014;42(10):2363-2370. [DOI:10.1177/0363546514542796] [PMID]
4. Lucci S, Cortes N, Van Lunen B, Ringleb S, Onate J. Knee and hip sagittal and transverse plane changes after two fatigue protocols. Journal of science and medicine in sport. 2011;14(5):453-459. [DOI:10.1016/j.jsams.2011.05.001] [PMID]
5. Murray JJ, Renier CM, Ahern JJ, Elliott BA. Neuromuscular training availability and efficacy in preventing anterior cruciate ligament injury in high school sports: A retrospective cohort study. Clinical Journal of Sport Medicine. 2017;27(6):524-529. [DOI:10.1097/JSM.0000000000000398] [PMID]
6. Mandelbaum BR, Silvers HJ, Watanabe DS, Knarr JF, Thomas SD, Griffin LY, et al. Effectiveness of a neuromuscular and proprioceptive training program in preventing anterior cruciate ligament injuries in female athletes: 2-year follow-up. The American journal of sports medicine. 2005;33(7):1003-1010. [DOI:10.1177/0363546504272261] [PMID]
7. Irmischer BS, Harris C, Pfeiffer RP, DeBeliso MA, Adams KJ, Shea KG. Effects of a knee ligament injury prevention exercise program on impact forces in women. The Journal of Strength & Conditioning Research. 2004;18(4):703-707. https://doi.org/10.1519/00124278-200411000-00003 [DOI:10.1519/R-13473.1]
8. Kirkendall DT, Dvorak J. Effective injury prevention in soccer. The physician and sportsmedicine. 2010;38(1):147-157. [DOI:10.3810/psm.2010.04.1772] [PMID]
9. Silvers-Granelli HJ, Bizzini M, Arundale A, Mandelbaum BR, Snyder-Mackler L. Does the FIFA 11+ injury prevention program reduce the incidence of ACL injury in male soccer players? Clinical Orthopaedics and Related Research®. 2017;475:2447-2455. [DOI:10.1007/s11999-017-5342-5] [PMID]
10. Kazemi AS, Daneshmandi H, Sedaghati P, Hoseini Y. Comparison of the Effect of Sportsmetrics Soccer Training on Movement Performance in Soccer Players with and without Anterior Cruciate Ligament Reconstruction. Muscles, Ligaments & Tendons Journal (MLTJ). 2024;14(2). [DOI:10.32098/mltj.02.2024.18]
11. Gilchrist J, Mandelbaum BR, Melancon H, Ryan GW, Silvers HJ, Griffin LY, et al. A randomized controlled trial to prevent noncontact anterior cruciate ligament injury in female collegiate soccer players. The American journal of sports medicine. 2008;36(8):1476-1483. [DOI:10.1177/0363546508318188] [PMID]
12. Silvers-Granelli H, Mandelbaum B, Adeniji O, Insler S, Bizzini M, Pohlig R, et al. Efficacy of the FIFA 11+ injury prevention program in the collegiate male soccer player. The American journal of sports medicine. 2015;43(11):2628-2637. [DOI:10.1177/0363546515602009] [PMID]
13. Eslami A, Sahebozamani M, Bahiraei S. The Effect of the FIFA 11+ Kids Warm-Up Training Program on Lower Limb Injury Prevention and Football Player Performance (A Systematic Review). Journal of Sport Biomechanics. 2023;9(1):2-15. [DOI:10.61186/JSportBiomech.9.1.2]
14. Weir G. Anterior cruciate ligament injury prevention in sport: biomechanically informed approaches. Sports biomechanics. 2024;23(11):1867-1887. [DOI:10.1080/14763141.2021.2016925] [PMID]
15. Knussen C, Tolson D, Brogan CA, Swan IR, Stott DJ, Sullivan F. Family caregivers of older relatives: Ways of coping and change in distress. Psychology, Health and Medicine. 2008;13(3):274-290. [DOI:10.1080/13548500701405483] [PMID]
16. Heidt RS, Sweeterman LM, Carlonas RL, Traub JA, Tekulve FX. Avoidance of soccer injuries with preseason conditioning. The American journal of sports medicine. 2000;28(5):659-662. [DOI:10.1177/03635465000280050601] [PMID]
17. Söderman K, Werner S, Pietilä T, Engström B, Alfredson H. Balance board training: prevention of traumatic injuries of the lower extremities in female soccer players? Knee surgery, sports traumatology, arthroscopy. 2000;8(6):356-363. [DOI:10.1007/s001670000147] [PMID]
18. Pfeiffer RP, Shea KG, Roberts D, Grandstrand S, Bond L. Lack of effect of a knee ligament injury prevention program on the incidence of noncontact anterior cruciate ligament injury. JBJS. 2006;88(8):1769-1774. [DOI:10.2106/JBJS.E.00616]
19. Steffen K, Myklebust G, Olsen OE, Holme I, Bahr R. Preventing injuries in female youth football-a cluster‐randomized controlled trial. Scandinavian journal of medicine & science in sports. 2008;18(5):605-614. [DOI:10.1111/j.1600-0838.2007.00703.x] [PMID]
20. LaBella CR, Huxford MR, Grissom J, Kim K-Y, Peng J, Christoffel KK. Effect of neuromuscular warm-up on injuries in female soccer and basketball athletes in urban public high schools: cluster randomized controlled trial. Archives of pediatrics & adolescent medicine. 2011;165(11):1033-1040. [DOI:10.1001/archpediatrics.2011.168] [PMID]
21. Hägglund M, Atroshi I, Wagner P, Waldén M. Superior compliance with a neuromuscular training programme is associated with fewer ACL injuries and fewer acute knee injuries in female adolescent football players: secondary analysis of an RCT. British journal of sports medicine. 2013;47(15):974-979. [DOI:10.1136/bjsports-2013-092644] [PMID]
22. Parsons JL, Coen SE, Bekker S. Anterior cruciate ligament injury: towards a gendered environmental approach. British journal of sports medicine. 2021;55(17):984-990. [DOI:10.1136/bjsports-2020-103173] [PMID]
23. Dalvandpour N, Zareei M, Abbasi H, Abdoli B, Mohammadian MA, Rommers N, et al. Focus of Attention During ACL Injury Prevention Exercises Affects Improvements in Jump-Landing Kinematics in Soccer Players: A Randomized Controlled Trial. The Journal of Strength & Conditioning Research. 2023;37(2):337-42. [DOI:10.1519/JSC.0000000000004201] [PMID]
24. Junge A, Rösch D, Peterson L, Graf-Baumann T, Dvorak J. Prevention of soccer injuries: a prospective intervention study in youth amateur players. The American journal of sports medicine. 2002;30(5):652-659. [DOI:10.1177/03635465020300050401] [PMID]
25. Engebretsen AH, Myklebust G, Holme I, Engebretsen L, Bahr R. Prevention of injuries among male soccer players: a prospective, randomized intervention study targeting players with previous injuries or reduced function. The American journal of sports medicine. 2008;36(6):1052-1060. [DOI:10.1177/0363546508314432] [PMID]
26. Soligard T, Myklebust G, Steffen K, Holme I, Silvers H, Bizzini M, et al. Comprehensive warm-up programme to prevent injuries in young female footballers: cluster randomised controlled trial. BMJ: British Medical Journal. 2009:95-99.
27. Kiani A, Hellquist E, Ahlqvist K, Gedeborg R, Byberg L. Prevention of soccer-related knee injuries in teenaged girls. Archives of internal medicine. 2010;170(1):43-49. [DOI:10.1001/archinternmed.2009.289] [PMID]
28. Waldén M, Atroshi I, Magnusson H, Wagner P, Hägglund M. Prevention of acute knee injuries in adolescent female football players: cluster randomised controlled trial. Bmj. 2012;3:344. [DOI:10.1136/bmj.e3042] [PMID]
29. Silvers-Granelli HJ, Bizzini M, Arundale A, Mandelbaum BR, Snyder-Mackler L. Does the FIFA 11+ injury prevention program reduce the incidence of ACL injury in male soccer players? Clinical Orthopaedics and Related Research®. 2017;475(10):2447-2455. [DOI:10.1007/s11999-017-5342-5] [PMID]
30. Asgari M, Jaitner T, Nazari B. 207 Effects of the FIFA 11+ injury prevention programme on physical and technical performance, biomechanical measures and physiological responses. BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine. 2021;A80-A81. [DOI:10.1136/bjsports-2021-IOC.190]
31. Benjaminse A, Verhagen E. Implementing ACL injury prevention in daily sports practice-It's not just the program: Let's build together, involve the context, and improve the content. Sports medicine. 2021;51(12):2461-2467. [DOI:10.1007/s40279-021-01560-4] [PMID]
32. Soligard T, Myklebust G, Steffen K, Holme I, Silvers H, Bizzini M, et al. Comprehensive warm-up programme to prevent injuries in young female footballers: cluster randomised controlled trial. Bmj. 2008;337. [DOI:10.1136/bmj.a2469] [PMID]
33. GALI JC, FADEL GW, MARQUES MF, ALMEIDA TA, GALI FILHO JC, FARIA FAS. O RISCO DE NOVAS LESÕES APÓS RECONSTRUÇÃO DO LCA PODE SER MINORADO COM O TREINAMENTO FUNCIONAL. Acta Ortopédica Brasileira. 2021;29:21-25. [DOI:10.1590/1413-785220212901240903] [PMID]
34. Bizzini M, Impellizzeri FM, Dvorak J, Bortolan L, Schena F, Modena R, et al. Physiological and performance responses to the "FIFA 11+"(part 1): is it an appropriate warm-up? Journal of sports sciences. 2013;31(13):1481-1490. [DOI:10.1080/02640414.2013.802922] [PMID]
35. Nakase J, Inaki A, Mochizuki T, Toratani T, Kosaka M, Ohashi Y, et al. Whole body muscle activity during the FIFA 11+ program evaluated by positron emission tomography. PloS one. 2013;8(9):e73898. [DOI:10.1371/journal.pone.0073898] [PMID]
36. Daneshjoo A, Mokhtar AH, Rahnama N, Yusof A. The effects of injury prevention warm-up programmes on knee strength in male soccer players. Biology of sport. 2013;30(4):281-288. [DOI:10.5604/20831862.1077554] [PMID]
37. Pangestuputra AW, Changestu DA. Neuromuscular Training in ACL Injury Prevention: A Narrative Review. Orthopaedic Journal of Sports Medicine. 2024;12(10_suppl3):2325967124S2325900394. [DOI:10.1177/2325967124S00394]
38. Alentorn-Geli E, Myer GD, Silvers HJ, Samitier G, Romero D, Lázaro-Haro C, et al. Prevention of non-contact anterior cruciate ligament injuries in soccer players. Part 2: a review of prevention programs aimed to modify risk factors and to reduce injury rates. Knee surgery, sports traumatology, arthroscopy. 2009;17:859-879. [DOI:10.1007/s00167-009-0823-z] [PMID]
39. Hajivand H, Babaei Khorzoughi M. Effectiveness of Proprioceptive and Paaryaad Exercises on Motor Coordination, Balance, and Executive Functions in Girls with ACL Injury. Journal of Sport Biomechanics. 2023;9(2):156-170. [DOI:10.61186/JSportBiomech.9.2.156]
40. Muaidi QI, Nicholson LL, Refshauge KM, Adams RD, Roe JP. Effect of anterior cruciate ligament injury and reconstruction on proprioceptive acuity of knee rotation in the transverse plane. The American journal of sports medicine. 2009;37(8):1618-1626. [DOI:10.1177/0363546509332429] [PMID]
41. Taylor JB, Waxman JP, Richter SJ, Shultz SJ. Evaluation of the effectiveness of anterior cruciate ligament injury prevention programme training components: a systematic review and meta-analysis. British journal of sports medicine. 2015;49(2):79-87. [DOI:10.1136/bjsports-2013-092358] [PMID]
42. Yoo JH, Lim BO, Ha M, Lee SW, Oh SJ, Lee YS, et al. A meta-analysis of the effect of neuromuscular training on the prevention of the anterior cruciate ligament injury in female athletes. Knee surgery, sports traumatology, arthroscopy. 2010;18(6):824-830. [DOI:10.1007/s00167-009-0901-2] [PMID]
43. Sadoghi P, von Keudell A, Vavken P. Effectiveness of anterior cruciate ligament injury prevention training programs. JBJS. 2012;94(9):769-776. [DOI:10.2106/JBJS.K.00467] [PMID]
44. Small K, Mc Naughton L, Matthews M. A systematic review into the efficacy of static stretching as part of a warm-up for the prevention of exercise-related injury. Research in sports medicine. 2008;16(3):213-231. [DOI:10.1080/15438620802310784] [PMID]
45. Wilderman DR, Ross SE, Padua DA. Thigh muscle activity, knee motion, and impact force during side-step pivoting in agility-trained female basketball players. Journal of athletic training. 2009;44(1):14-25. [DOI:10.4085/1062-6050-44.1.14] [PMID]
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