Conclusions
All recent ACL prevention investigations have found that a neuromuscular training program, such as PEP, may significantly reduce the incidence of severe ACL injuries in the female athlete. A prophylactic training program that focuses on developing neuromuscular control of the lower extremity, although strengthening exercises, plyometrics, and sport-specific agilities may address the proprioceptive and biomechanical deficits that are demonstrated in the high-risk female athletic population.
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References
FIFA: Women’s Soccer Statistics, 2004. http://www.fifa.com/ en/womens/statistics/index.html
Harmon KG, Ireland ML: Gender differences in noncontact anterior cruciate ligament injuries. Clin Sports Med 2000, 19:287–302.
Arendt E, Dick R: Knee injury patterns among men and women in collegiate basketball and soccer NCAA data and review of literature. Am J Sports Med 1995, 23:694–701.
Lindenfeld T, Schmitt D, Hendy M, et al.: Incidence of injury in indoor soccer. Am J Sports Med 1994, 22:364–371.
Malone T, Hardaker W, Garrett W: Relationship of gender to anterior cruciate ligaments in intercollegiate basketball players. J South Orthop Assoc 1993, 2:36–39.
Lohmander LS, Ostenberg A, Eglund M, et al.: High prevalence of knee osteoarthritis, pain, and functional limitations in female soccer players twelve years after anterior cruciate ligament injury. Arthritis Rheum 2004, 50:3145–3152.
Galey S, Konieczko EM, Arnold CA, et al.: Immunohistological detection of relaxin binding to anterior cruciate ligaments. Orthopedics 2003, 26:1201–1204,
Liu SH, al-Shaikh R, Panossian V, et al.: Primary immunolocalization of estrogen and progesterone target cells in the human anterior cruciate ligament. J Orthop Res 1996, 14:526–533.
Sciore P, Frank CB, Hart DA: Identification of sex hormone receptors in human and rabbit ligaments of the knee by reverse transcription-polymerase chain reaction: evidence that receptors are present in tissue from both male and female subjects. J Orthop Research Soc 1998, 16:604–10.
Hama H, Yamamuro T, Takeda T: Experimental studies on connective tissue of the capsular ligament. Influences of aging and sex hormones. Acta Orthop Scand 1976, 47:473–479.
Samuel CS, Butkus A, Coghlan JP, et al.: The effect of relaxin on collagen metabolism in the nonpregnant rat pubic symphysis: the influence of estrogen and progesterone in regulating relaxin activity. Endocrinology 1996, 137:3884–3890.
Griffin LY, Agel J, Albohm MJ, et al.: Noncontact anterior cruciate ligament injuries: risk factors and prevention strategies. J Am Acad Orthop Surg 2000, 8:141–150.
Torg JS, Quedenfeld TC, Landau S: The shoe-surface interface and its relationship to football knee injuries. J Sports Med 1974, 2:261–269.
Heidt RS Jr., Dormer SG, Cawley PW, et al.: Differences in friction and torsional resistance in athletic shoe-turf surface interfaces. Am J Sports Med 1996, 24:834–842.
Ekstrand J, Nigg B: Surface-related injuries in soccer. Sports Med 1989, 8:56–62.
Delfico A, Garrett W: Mechanisms of injury of the ACL in soccer players. Clin Sports Med 1998, 17:779–785.
Kirkendall DT, Garrett WE Jr.: The anterior cruciate ligament enigma. Injury mechanisms and prevention. Clin Orthop Rel Res 2000, 372:64–68.
Markolf KL, Burchfield DM, Shapiro MM, et al.: Combined knee loading states that generate high anterior cruciate ligament forces. J Orthop Res 1995, 12:930–935.
Caraffa A, Cerulli G, Projetti M, et al.: Prevention of anterior cruciate ligament injuries in soccer. A prospective controlled study of proprioceptive training. Knee Surg Sports Traumatol Arthrosc 1996, 4:19–21.
Ettlinger CF, Johnson RJ, Shealy JE: A method to help reduce the risk of serious knee sprains incurred in alpine skiing. Am J Sports Med 1995, 23:531–537.
Heidt RS Jr., Sweeterman LM, Carlonas RL, et al.: Avoidance of soccer injuries with preseason conditioning. Am J Sports Med 2000, 28:659–662.
Hewett TE, Lindenfeld TN, Riccobene JV, et al.: The effect of neuromuscular training on the incidence of knee injury in female athletes. A prospective study [comment]. Am J Sports Med 1999, 27:699–706.
Lloyd DG: Rationale for training programs to reduce anterior cruciate ligament injuries in Australian football. J Orthop Sports Phys Ther 2001, 21:645–654.
Mandelbaum B, Silvers H, Watanabe D, et al.: Effectiveness of a neuromuscular and proprioceptive training program in preventing the incidence of ACL injuries in female athletes: twoyear follow up. Am J Sports Med 2005, in press.
Gilchrist J, Mandelbaum B, Melancon H, et al.: A Randomized Controlled Trial to Prevent Non-contact ACL Injury in Female Collegiate Soccer Players. American Orthopaedic Society for Sports Medicine Specialty Day. San Francisco; March 23, 2004.
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Giza, E., Silvers, H.J. & Mandelbaum, B.R. Anterior cruciate ligament tear prevention in the female athlete. Curr Sports Med Rep 4, 109–111 (2005). https://doi.org/10.1007/s11932-005-0053-1
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DOI: https://doi.org/10.1007/s11932-005-0053-1