Can Targeted Strength Training Reduce the Risk of Anterior Cruciate Ligament Injury?
- Julian Simpson
- Jul 21
- 3 min read
Can Targeted Strength Training Reduce the Risk of Anterior Cruciate Ligament Injury?
Effect of Strength Training on Preventing Knee Problems
Anterior cruciate ligament (ACL) injury is one of the most frequent sports injuries of the knee joint.
ACL injury often leads to long-term consequences, including early onset and/or progression of osteoarthritis, preventing ACL injury by investigating the injury mechanisms and risk factors is important.
One of the main areas we look to as Chiropractors is knee valgus loading, and how we can prevent knee pain and injuries by strengthening the knee and hip joints
Medial or lateral muscle groups of the thigh influence the frontal plane loading of the knee joint
The Greater strength of medial thigh muscles (e.g., vastus medialis and semitendinosus/semimembranosus) -Relative to lateral thigh muscles (e.g., vastus lateralis and biceps femoris) was associated with a lower knee valgus moment during a single-leg landing
Medial muscles of the lower extremity are involved in generating the knee valgus moment to resist the external varus load, while the medial muscles are involved in generating the varus moment in counteracting the external valgus load
Let's discuss the strength training program protocol for the knee:
Programs | Weeks 1–4 | Weeks 5–8 | |
Warm-up | 1.3 km jogging | 15 min | 15 min |
Strength training programs targeting medial quadriceps/ hamstrings for intervention group | 1. Wide leg press 2. Barbell wide squat 3. Leg extension 4. Leg curl with internally rotated foot | • 1 set: - 60% of 1RM - 12 repetitions - For 60 s • Total 3 sets • 60 s rest | • 1 set: - 40% of 1RM - 20 repetitions - For 20 s • Total 5 sets • 20 s rest |
5. Ball squat 6. Plank's leg raise with internally rotated foot | • 1 set: - 12 repetitions - For 60 s • Total 3 sets • 60 s rest | • 1 set: - 20 repetitions - For 20 s • Total 5 sets • 20 s rest | |
7. Bridge with ball | • 1 set: - Hold for 60 s • Total 3 sets • 60 s rest | • 1 set: - Hold for 30 s with each limb only • Total 3 sets • 60 s rest |
Stretches recommended are:
Stretches | 1. Quadriceps 2. Hamstrings 3. Calf muscles 4. Hip muscles | 30 s each | 30 s each |
What happens after 8 weeks of the exercise:
8 weeks of targeted strength training reduced the peak knee valgus moment, peak hip internal rotation moment, and dynamic coronal plane excursion and increased gluteus medius activity and the Vastus Medialis
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Jeong J, Choi DH, Shin CS. The Effect of Strength Training Targeting Medial Thigh Muscles on Neuromuscular and Biomechanical Risk Factors for Anterior Cruciate Ligament Injury: A Randomized Controlled Trial. Sports Med Open. 2025 Jan 23;11(1):5. doi: 10.1186/s40798-025-00812-1. PMID: 39847165; PMCID: PMC11757840.