Anterior Cruciate Ligament Injuries in Soccer Players : An Overview

Soccer is known as a sport with high risk of anterior cruciate ligament (ACL) injury. Until 1980s, an ACL injury was a career-ending injury for a soccer player, but afterwards with the technological advancement in the field of medical sciences it could be treated or cured to a greater extent. Prevalence of this injury is two times greater among female soccer players in comparison to their male counterparts. Many theories have been postulated to explain the reasons for greater occurrence of ACL injuries among female soccer players but the biomechanical elucidation is considered to be the most justified one. The theories are divided into intrinsic and extrinsic aspects depending on the involved factors. Intrinsic factors include variables as such limb alignment, joint laxity, ligament size, notch dimensions, wider pelvis, increased genu valgum, and increased tibial torsion while, extrinsic factors are body movement, shoe-surface interface, muscle strength, coordination, level of skill through conditioning and flexibility. ACL injuries are of three categories (Grade I, Grade II and Grade III) which occur mainly during non-contact episode of the game, e.g., during the landing, kicking, or during stance phases of high-risk postures such as sidestepping. The gender differences observed in knee joint kinematics and forces during these movements are thus viewed as important contributors to ACL injury potential. Primary prevention of ACL injury among soccer player is possible by appropriate intervention strategies, e.g, a variety of training protocols, proper education of the athletes, and bracing. Current studies focus on neuromuscular training as a preventive measure, with programs that include strength, flexibility, plyometrics, sports-specific agility drills, speed enhancement, balance and athlete education.