Training program reduces ACL injuries in girls

A July 8 U.S. News report said a targeted training program may help young female soccer players reduce their risk of ACL and other lower-body injuries. The report, based on research published in the *Journal of the American Academy of Orthopaedic Surgeons*, described an eight-week version of FIFA’s 11+ Kids program for girls ages 8 to 11. Researchers said the program focused on strength, balance and coordination rather than simply adding more soccer-specific drills. Girls who play soccer face a higher risk of leg and ankle injuries than boys, the U.S. News report said, citing researchers’ background notes about differences in strength and balance. Senior researcher Dr. Shari Liberman, an orthopedic surgeon at Houston Methodist, said in a news release that youth female soccer players have “unique risk factors” not always addressed in traditional training models. (usnews.com) ### What exactly did the new study test? The study described by U.S. News followed 14 girls ages 8 to 11 who completed the eight-week FIFA 11+ Kids program alongside their regular soccer training. Researchers compared them with 12 girls who continued usual team training without the added program. Results showed the girls in the FIFA program improved dynamic balance and had better glute-to-quadriceps strength ratios, according to the report. (usnews.com) Those measures are tied to leg and ankle stability, and the authors said the findings suggest early training focused on movement quality could help prevent future injuries. ### Why are coaches and clinicians focused on neuromuscular training? A 2024 review in *JBJS Reviews* said neuromuscular training typically combines plyometrics, balance work, agility and dynamic stabilization to improve basic movement patterns. The review said that type of training has consistently been shown to reduce ACL injury risk, particularly in sports with frequent cutting and pivoting such as women’s soccer. (usnews.com) The same review said ACL ruptures affect more than 120,000 people annually in the United States and that athletes in high-risk sports such as women’s soccer can face annual ACL rupture risk approaching 4% to 5%. It also said prevention programs work best when coaches, physical therapists, athletic trainers and physicians are involved in implementation. ### How much does frequency matter? (pmc.ncbi.nlm.nih.gov) A prospective cohort study in *BMJ Open Sport & Exercise Medicine* followed 671 amateur female soccer players with an average age of 15.7 over one season. The study found that using an ACL injury-prevention program at least two times per week was associated with a lower risk of ACL injuries than using it once a week or less. (pmc.ncbi.nlm.nih.gov) The hazard ratio in that study was 0.15, which the authors and later reviewers described as an 85% reduction in risk. The same paper found that a stakeholder-engaged “knowledge-to-action” approach increased implementation compared with simply handing coaches educational material. ### If the evidence is strong, why aren’t these programs universal? A 2026 systematic review in *Frontiers in Public Health* examined 13 studies involving 2,847 athletes and found that implementation quality was consistently tied to program effectiveness. (bmjopensem.bmj.com) The review said barriers included time constraints, competing priorities and lack of ongoing support, while professional supervision and organizational commitment improved compliance. That review also found better compliance in stakeholder-engaged models than in education-only approaches, with reported compliance ranging from 73.5% to 85.6% in supported programs. The authors said implementation quality may be as important in real-world injury prevention as the specific program chosen. ### What should parents and youth clubs watch next? (frontiersin.org) The Journal of the American Academy of Orthopaedic Surgeons paper cited by U.S. News used a small sample and, according to the report, researchers said larger studies are still needed to confirm effectiveness. For now, the clearest evidence points to structured programs that build balance, strength, coordination and movement control — and that are done consistently during the season, not just once in a while. (frontiersin.org) (usnews.com)