Prevention of anterior cruciate ligament injuries in soccer

A prospective controlled study of proprioceptive training
  • A. Caraffa
  • G. Cerulli
  • M. Projetti
  • G. Aisa
  • A. Rizzo
Knee Injuries


Proprioceptive training has been shown to reduce the incidence of ankle sprains in different sports. It can also improve rehabilitation after anterior cruciate ligament (ACL) injuries whether treated operatively or nonoperatively. Since ACL injuries lead to long absence from sports and are one of the main causes of permanent sports disability, it is essential to try to prevent them. In a prospective controlled study of 600 soccer players in 40 semiprofessional or amateur teams, we studied the possible preventive effect of a gradually increasing proprioceptive training on four different types of wobble-boards during three soccer seasons. Three hundred players were instructed to train 20 min per day with 5 different phases of increasing difficulty. The first phase consisted of balance training without any balance board; phase 2 of training on a rectangular balance board; phase 3 of training on a round board; phase 4 of training on a combined round and rectangular board; phase 5 of training on a so-called BABS board. A control group of 300 players from other, comparable teams trained “normally” and received no special balance training. Both groups were observed for three whole soccer seasons, and possible ACL lesions were diagnosed by clinical examination, KT-1000 measurements, magnetic resonance imaging or computed tomography, and arthroscopy. We found an incidence of 1.15 ACL injuries per team per year in the control group and 0.15 injuries per team per year in the proprioceptively trained group (P<0.001). Proprioceptive training can thus significantly reduce the incidence of ACL injuries in soccer players.

Key words

Anterior cruciate ligament Proprioceptive training 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Beard DJ, Kyberd PJ, Fergusson CM, Dodd CAF (1993) Proprioception after rupture of the anterior cruciate ligament. J Bone Joint Surg [Br] 75: 311–315Google Scholar
  2. 2.
    Beard DJ, Dodd CA, Trundle HR, Simpson HRAW (1994) Proprioception enhancement for anterior cruciate insufficiency. J Bone Joint Surg [Br] 76:654–659Google Scholar
  3. 3.
    Caraffa A, Buompadre V, Rizzo A, Cerulli G (1996) Does coordination training after ACL-reconstruction improve postural control? Sports Exerc Inj (in press)Google Scholar
  4. 4.
    Ekstrand J, Gillquist J, Moeller M, Ocberg B, Liljedahl SO (1983) Incidence of soccer injuries and their relation to training and team success. Am J Sports Med 11:63–67Google Scholar
  5. 5.
    Ekstrand J, Gillquist J, Liljedahl SO (1983) Prevention of soccer injuries. Supervision by doctor and physical therapist. Am J Sports Med 11: 116–120Google Scholar
  6. 6.
    Engstroem B, Johansson C, Toernquist H (1991) Soccer injuries among elite female players. Am J Sports Med 19: 375–472Google Scholar
  7. 7.
    Eriksson E, Svensson L-I, San TK, Valentin A (1996) Late results and sequaelae after soccer. In: Garrett WE Jr (ed) The U.S. Soccer Federation sports medicine book of soccer. Williams & Wilkins, PhiladelphiaGoogle Scholar
  8. 8.
    FIFA (1982) Statistics on the 150 affilitated national associations of FIFA. FIFA News 235:528Google Scholar
  9. 9.
    Folksam Insurance Company (1994) Sports injuries 1986–1990. The 1994 Folksam report on 26,000 sports injuries studied between 1986–1990. Folksam, StockholmGoogle Scholar
  10. 10.
    Gauffin H, Tropp H, Odenrick P (1988) Effect of ankle disc training on postural control in patients with functional disability of the ankle joint. Int J Sports Med 9:141–144Google Scholar
  11. 11.
    Herveou C, Messean L (1982) Tecnica di rieducazione e di educazione propriocettiva. Marrapese Editors. RomeGoogle Scholar
  12. 12.
    Morris D (1981) The soccer tribe. Jonathan Cape, LondonGoogle Scholar
  13. 13.
    Roaas A, Nilson S (1979) Major injuries in Norwegian football. Br J Sports Med 13:3–5Google Scholar
  14. 14.
    Sullivan A, Gross RH, Grana WH, Garcia-Moral CA (1989) Evaluation of injuries in youth soccer. Am J Sports Med 8:325–327Google Scholar
  15. 15.
    Zetterstroem R, Fridén T, Lindstrand A, Moritz U (1992) Muscle training in chronic anterior cruciate ligament insufficiency: a comparative study. Scand J Rehabil Med 24:91–97Google Scholar

Copyright information

© Springer-Verlag 1996

Authors and Affiliations

  • A. Caraffa
    • 1
  • G. Cerulli
    • 1
  • M. Projetti
    • 1
  • G. Aisa
    • 1
  • A. Rizzo
    • 1
  1. 1.Orthopedic Clinic “R”, S. Maria HospitalUniversity of PerugiaTerniItaly

Personalised recommendations