Anyone who watches football knows that a weekend afternoon can go from riveting to heartbreaking in a flash. One second you’re cheering on your favorite team, then the next thing you know, you’re sitting at the edge of your seat in shock. Kansas City Chiefs fans know this feeling very well—their star running back, Jamaal Charles recently tore his ACL mid-game. That’s not the scariest part, though. What’s alarming is that it was non-contact injury. These freak incidents are a sobering reminder that injuries to the knee ligament can happen unexpectedly and to anyone. So are you susceptible? 

The ACL—anterior cruciate ligament—is one of four connective ligaments in the knee that helps keep the knee stable while performing rotational movements such as running, jumping and shifting from side to side. Injuries to the ligament often occur because of poor athletic technique associated with decelerating (slowing down), pivoting or sliding your feet with excessive force. Athletes with weak hip and gluteal muscles are typically more prone to damage, as they put more stress on their knees.

ACL injuries occur most often in sports that involve running, landing from an elevated point (like jumping) or cutting (rapidly shifting your body from one side to side). “In general, we found that 70 percent of ACL tears are non-contact injuries, which is surprising to some people,” says Meredith Soelberg, PT, DPT, MBA, owner of ELEVATE Physical Therapy & Fitness in Santa Monica, Calif. That means these injuries can happen on the soccer field, basketball court, tennis court and even at the gym or on the dance floor.

Female athletes are at greater risk for ACL tears, with the incidence rate being anywhere from two to 10 times greater than for a male athlete, depending on age. Soelberg says the disparity in the injury rate is due to biomechanics—women often put more stress on their knees because many do not utilize their hip and gluteal muscles as much as men do. “When girls land, one thing we see more often with them is that their knees drop inward,” says Soelberg.

So how can you prevent an ACL injury? Research led by Bert Mandelbaum, MD, orthopedic surgeon at Santa Monica Orthopedic and Sports Medicine Group in Santa Monica, Calif., found that athletes can dramatically decrease the odds of tearing up their knees by performing a specific warm-up regimen that includes slowly jogging, running backwards, walking lunges, plyometrics (hopping and jumping), stretching and hip-strengthening exercise for 20 minutes three times a week. Mandelbaum, who’s worked with sports organizations including the MLB, Special Olympics and FIFA, tested his warm-up regimen on a group of nearly 2,000 female soccer players between the ages of 14 and 18. The results showed a 70 percent decrease in ACL injuries when the athletes regularly performed the warm-up routine.

Then there is the use of smart technology as a line of defense. Soelberg’s ELEVATE offers a program designed to help reduce ACL injuries by using a special software system that records athletes as they run, jump and perform other movements. Physical therapists then analyze the recording and take note of improper movements in the knees and hips so they can customize an exercise plan to correct them.

ELEVATE’s program also includes the use of electromyography, which is an electrode patch placed on the surface of the skin that enables physical therapists to analyze how and which muscles are being over- or under-utilized. All this information offers insight into how the physical therapists can train an athlete to best adjust their movements to protect their knees. And the real benefit comes from the fact that the athlete can eventually employ “high-level, full-speed movements that mimic their sports as best as we can in the movement lab,” says Soelberg.

Soelberg says there’s one quick exercise you can do to find out if you are susceptible to an ACL tear. Have someone take a video of you doing a tuck-jump test (shown in the video below). Jump for 10 seconds in that position. While watching the video, see if your knees bend inward (toward each other) as your feet hit the ground. If they do, like the young woman in the video below, you are at a greater risk. If you land more like the young man in the video below, your chances of injury are lower.


If you’re at higher risk for an ACL injury and are regularly active, consider scheduling an appointment with a physical therapist. Your knee ligaments can be better protected through understanding and developing the proper mechanics. “You can learn a movement pattern that protects your knee,” says Soelberg.

Besides, taking the necessary precautions is well worth it so you can keep enjoying your weekends of pigskin with no rehab appointments to interrupt.



  1. ELEVATE Physical Therapy & Fitness
  2. British Journal of Sports Medicine: Gender influences: the role of leg dominance in ACL injury among soccer players
  3. American Academy of Orthopedic Surgeons and the American Orthopedic Society for Sports Medicine
  4. Santa Monica Sports Medicine Foundation PEP Program
  5. The National Center for Biotechnology Information
  6. The American Journal of Sports Medicine