3 Essential ACL Injury Prevention Exercises for Female Athletes

STACK Expert Rick Scarpulla prescribes three exercises to help female athletes prevent ACL injuries.

In my previous article, I discussed some of the causes of ACL injuries in female athletes. However, it's critical to talk about how we can prevent ACL injuries.

ACL Injury Prevention Exercises

I can't stress enough that correctly strengthening the surrounding muscle groups is the best prevention technique. At Ultimate Advantage, we work with many female athletes and we specialize in ACL prevention. We've narrowed our prevention program down to three primary exercises, which have helped our athletes stay healthy on the field.

The Parallel Box Squat

This is our favorite exercise to prevent ACL injuries. Why the Box Squat over a full Squat? The answer is simple: A full Squat activates the quads more than the hamstrings, and female athletes are already quad dominant. The Box Squat solves this problem by developing the backside of the body.

When box squatting you actually sit on the box and relax your hips before firing up. This release and firing cycle emphasizes the hamstrings and glutes much more effectively.

Remember that squatting to a box and doing a Box Squat are completely different. Here's how to do it correctly:

Coaching Points

  • Keep your back straight and lean at a slightly forward angle when on the box. However, you shouldn't bend over.
  • Drive your knees outward when lowering (eccentric) and standing (concentric).
  • Disengage your hips before your knees, which will keep your knees behind your toes and minimize quad engagement.

The Box Squat should fit into your program just like any other big strength-training movement. We have our athletes do it two times per week, always varying loads and rep schemes. We may work with heavy weight for low reps or use a lighter weight while focusing on speed. Here's a general overview of three types of Box Squat days:

  • Once every two weeks we do a heavy max set of 1-3 reps.
  • On lighter days, we use a weight that allows the athlete to perform two reps in approximately 2.5 seconds. We do 8 sets of this.
  • We also do volume work every other week, performing three to 4 sets of 8-12 reps.

Physioball Squeeze

Another exercise we like is the Physioball Squeeze. This develops groin strength and improves hip stability, which is critical for keeping the knee stable.

Our version of the Physioball Squeeze is not the exercise you see people doing to tone up their inner thighs. We put our athletes in an athletic position while squeezing the ball, which is a more effective way to improve stability.

Coaching Points

  • Stand over a physioball and pull it up into your groin area.
  • Disengage your hips and drive your butt back so your upper body is slightly leaning forward.
  • Squeeze the ball with your thighs.

This exercise is meant to complement the Box Squat and should not be one of your primary lifts. We stick to 4 sets of 15 reps, twice per week.

Bench or Box Jumps

The final piece of the puzzle is to simply learn how to jump and land properly. Jumping with perfect form teaches your muscles how to fire to maintain stability, while also strengthening your glutes and hamstrings.

Coaching Points

  • Jump onto a box or bench.
  • Land softly with your feet shoulder-width apart.
  • Drive your knees outward when taking off and landing.
  • As you progress, hop down from the bench and immediately hop back up.

Again, this is meant to complement your other work. We generally do 3-4 sets of 10 to 15 reps, depending on the athlete's conditioning level. If the volume (total reps) is low, we'll do it twice per week. If the volume is high, we will limit it to once per week.

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