Awareness of Anterior Cruciate Ligament Injury-Preventive Training Programs Among Female College Athletes

Tanaka MJ, Jones LC, & Forman JM.  J Athl Train. 2020 55(4) Online ahead of print. doi: 10.4085/1062-6050-150-19.

Full Text Freely Available

Take-Home Message

NCAA female athletes have limited awareness and experience with anterior cruciate ligament (ACL) injury prevention programs despite being willing to perform them.


Females are at an increased risk for an ACL injury. Compliance with an ACL injury prevention program can prevent 50 to 80% of ACL injuries; however, it remains unclear how well college teams have implemented these programs.  The authors of this study surveyed NCAA Division I and III female athletes to see who had experience or awareness of injury prevention programs.  The authors asked athletic trainers to share links to the 12-question survey with women’s teams and posted links on social media. Athletes from 31 institutions in 19 states completed the survey.

Overall, only 15% of the 440 current athletes had performed an ACL injury prevention program. Furthermore, only about one-third of the athletes knew about ACL injury prevention programs. For the athletes who reported having performed an ACL injury prevention program – the majority were supervised by an athletic trainer (39%), coach (27%), or both (11%).  Almost 90% of the athletes indicated that they would perform a daily program if it would decrease their ACL injury risk. It seemed that athletes in high-risk sports, at Division I programs, who knew a teammate with an ACL injury, or who had a history of an ACL injury were more likely to be aware and have performed an ACL injury prevention program.


This study is interesting because the authors demonstrate that implementation and awareness are very low among NCAA female athletes despite their apparent willingness to participate.  This complements prior findings that only 1 in 5 high school coaches have implemented injury prevention programs. These new findings add to the story by showing that the athletes are willing to perform these programs, but we need to do a better job of getting the word out about the existence of these programs. It would be interesting to see if the willingness to perform a program affected compliance and adherence.  It was great to see that athletes in higher-risk sports were more likely to have performed or be aware of ACL injury prevention programs.  However, the overall implementation and awareness were quite poor.  It would be fascinating to see whether these athletes were recently performing these programs or if they performed them a long time ago (for example, in high school). Regardless, this study and previous research highlight that we need to do more to educate coaches, athletes, and other stakeholders about the feasibility and necessity of adopting injury prevention programs. It is time to deploy one of the most effective tools in our prevention toolbox.  

Questions for Discussion

Why do you think awareness and implementation are so poor? What efforts do you think that we can do to improve this?

Written by: Nicole M. Cattano
Reviewed by: Jeffrey Driban

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