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How age influences the effectiveness of ACL injury prevention programs in female athletes

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Summary of a meta-analysis article investigating how age influences the effectiveness of anterior cruciate ligament injury prevention programs in female athletes.


Female athletes (aged 14 to 22 years).


Systematic review with meta-analysis of 14 studies.

Outcome measures

Reduction in ACL injuries.

Main results

  • Athletes performing neuromusculoskeletal training had fewer ACL injuries than athletes in control groups (OR: 0.54; 95%CI: 0.35-0.83).
  • The ACL injury risk reduction was greater in female athletes who were younger than 18 years of age than above the age of 18 (OR: 0.28, 95%CI: 0.18-0.42).
  • Mid-teens (14-18 years of age) benefited more from neuromuscular training than late-teens (18-20) and early adults (above 20 years of age).

Take home message

For a clinician & coach
Athletes below the age 18 can reduce 72% ACL injuries when performing neuromuscular training. Their outcomes are significantly better than athletes above 18 years of age (16% rate).
For a parent
Neuromuscular ACL injury prevention programs are most effective in girl athletes younger than 18.
For an athlete
If you are a girl, ACL injury prevention is effective, especially if you are under 18 years of age.

Original article

Myer GD, Sugimoto D, Thomas S, Hewett TE. The influence of age on the effectiveness of neuromuscular training to reduce anterior cruciate ligament injury in female athletes: a meta-analysis. The American journal of sports medicine. 2013 Jan;41(1):203-15.

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