Mechanism and prevention of anterior cruciate ligament injuries in sport

Review of the anterior cruciate ligament (ACL) injury prevention literature has shown that exercise/training can be used to reduce ACL injury risk and injury rates in general athletic populations. However, a large gap still exists in the literature, with little to no research testing the effectiveness of these prophylactic training protocols in community level training environments. Results from this thesis have shown that when prophylactic training protocols were implemented in community level training environments; they were not effective in reducing surrogate biomechanical measures of ACL injury risk like peak knee joint loading and muscular support. We must begin to better understand the biomechanical mechanisms by which prophylactic training protocols act if we can more effectively translate positive laboratory based findings to community level training environments. To identify these causal mechanisms, we have developed a novel computational method capable of identifying causal links between an athlete's whole-body kinematics and knee joint kinetics during dynamic simulations of human movement. The generalised kinematic strategy identified during sidestepping, where one half of non-contact ACL injuries have been shown to occur was to reposition an athlete's whole-body centre of mass medially, towards their desired direction of travel. Through the development and use of these methods, the ability to identify short, concise and effective training protocols is possible; increasing the probability of translating ACL focused research into injury prevention practice in community level training environments.