21/01/2026
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βΌοΈ Rupturing the anterior cruciate ligament (ACL) is a devastating injury for any athlete, often requiring 6β12 months of intensive rehabilitation and carrying a high risk of recurrence.
βΌοΈ To better prevent these injuries, a comprehensive systematic review published in Sports Medicine (2025) analyzed 5,612 ACL injury situations across 20 different sports to identify the specific mechanisms and situational patterns at play.
βΌοΈ The study emphasizes that there is no βone-size-fits-allβ scenario for ACL injuries; instead, the mechanism of injury is deeply tied to the unique physical demands and playing characteristics of each sport.
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βΌοΈ The researchers proposed a new categorization system to help clinicians and coaches develop more targeted prevention and rehabilitation strategies.
βΌοΈ Change of Direction (COD)
Most prevalent in team sports, ranging from 26% to 70% of injuries. These typically involve rapid deceleration or a sudden cut.
βΌοΈ Landing after a Jump
This is the dominant mechanism in overhead sports like volleyball, badminton, and netball, accounting for 57% to 82% of ACL ruptures.
βΌοΈ Direct Contact to the Knee
This is the leading cause of ACL injuries in combat sports (53β83%) and is also a significant factor in aggressive contact sports like American football and rugby.
βΌοΈ Gear-Induced Mechanisms
Specific to winter and board sports such as skiing and snowboarding, these injuries occur because equipment attached to the feet acts as an extended lever arm, creating massive rotational forces.
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βΌοΈ β½ Football (Soccer)
The most common situational pattern is defensive pressing actions (26β40%), rather than offensive play. Most injuries are non-contact or indirect contact, often occurring during high-speed deceleration or while tackling.
βΌοΈ π Basketball
Injuries predominantly occur during offensive play (88%), specifically when attacking the basket, performing a jump stop, or landing after a rebound.
βΌοΈ π American Football and Rugby
These sports show a higher prevalence of indirect or direct contact injuries. In rugby, being tackled is the most common situation (33%), while in American football, offensive linemen are particularly at risk due to blocking maneuvers.
βΌοΈ πΏ Alpine Skiing
Injuries often involve the slip and catch mechanism, where the inside edge of the ski catches the snow unexpectedly, or valgusβexternal rotation during a forward fall.
βΌοΈ π€Ό Combat Sports (Judo / Wrestling)
Most injuries occur while being attacked or during takedowns. In judo, direct contact to the knee or improper throwing techniques are major contributing factors.
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βΌοΈ Because mechanisms differ across sports, training and prevention strategies must also be sport-specific.
βΌοΈ π For COD Sports
Focus on horizontal deceleration training, quadriceps strength, and cognitive motor drills that improve decision-making under match-like chaos.
βΌοΈ 𦡠For Landing Sports
Prioritize ankle and calf muscle strength to improve shock absorption, and practice landing techniques even when in a state of fatigue.
βΌοΈ π€Ό For Contact Sports
Implement trunk control drills to maintain posture during collisions and refine tackling or blocking mechanics to avoid high-risk knee positions.
βΌοΈ πΏ For Gear-Based Sports
Educate athletes on proper fall techniques such as βwhen youβre down, stay down,β and ensure routine evaluation of ski and binding settings.
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βΌοΈ While video analysis provides precise insights, much of the data relies on athlete self-reports, which can be subject to recall bias.
βΌοΈ More research is needed to determine how these mechanisms differ based on s*x and whether the injury is a primary or secondary (recurrent) rupture.
βΌοΈ By moving away from a general approach and focusing on the chaos of sport-specific environments, the study aims to lower the high incidence of these life-altering knee injuries.
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β οΈDisclaimer: Sharing a study or a part of it is NOT an endorsement. Please read the original article and evaluate critically.β οΈ
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