ACL INJURIES – SCREENING AND PREVENTION TECHNIQUES

Torn ACLs are a serious and all-too-common injury, especially among athletes in cutting, pivoting, and jumping sports like soccer, basketball, and football. But what if we told you that many ACL injuries are preventable? At our sports medicine podiatry practice, we take ACL risk seriously and use a comprehensive screening approach that looks at the entire lower body, not just the knee.

Here’s a deeper look at some of the key physical traits and movement patterns we assess during an ACL screening:

Pelvis Morphology

Your pelvic structure—including its width, tilt, and alignment—can influence how forces are distributed down the leg. A wider pelvis, especially in female athletes, may contribute to a greater inward angling of the thigh (known as a high Q-angle), which can put more stress on the ACL during movement.

Increased Femoral Anteversion

This refers to the twisting of the femur (thigh bone), which can cause the knees and feet to turn inward. Excessive femoral anteversion alters normal hip and knee alignment and can increase ACL injury risk, especially during pivoting or landing movements.

Internal Rotators of the Hip

We evaluate the internal rotation strength and mobility of muscles like the tensor fasciae latae (TFL) and adductors. Overactive or tight internal rotators can contribute to poor hip control, causing the knee to collapse inward, a significant risk factor for ACL injury.

Glute Max and Glute Medius Strength

These powerhouse hip muscles are essential for stabilizing the pelvis and controlling thigh movement. Weak glutes are strongly associated with knee valgus (the inward collapse of the knee) during athletic movements, which places excessive strain on the ACL. We assess the strength and activation patterns of these muscles during functional tests.

Hamstring Strength

The hamstrings work to resist forward movement of the shin, helping to protect the ACL. When the hamstrings are weak relative to the quadriceps, the ACL is forced to take on more of the load during running and jumping. Strength testing helps identify this imbalance.

Hamstring Flexibility

Tight hamstrings can restrict proper movement mechanics and limit hip extension. This can alter the way an athlete runs, jumps, and lands, potentially increasing ACL stress. We assess hamstring flexibility with functional range-of-motion tests.

Quadriceps Strength

Strong quads are essential, but imbalances between the quads and hamstrings can be problematic. If the quads overpower the hamstrings, the tibia (shinbone) is pulled forward too forcefully, increasing ACL strain. We measure quadriceps strength and examine the strength ratios between the front and back of the thigh.

Quadriceps Flexibility

Tight quads can limit hip and knee movement, altering gait and jumping mechanics. Tightness can also affect pelvic positioning and contribute to compensations elsewhere in the kinetic chain that affect ACL loading.

Knee Position and Movement Control

We closely observe how the knees align and move during tasks like squats, single-leg hops, and drop-jumps. Do the knees collapse inward? Are they stable? Poor control or faulty mechanics here can signal high risk for ACL injury, especially in sports that require rapid deceleration.

Ligament Laxity (Hyperextension of the Knee)

Some individuals naturally have more joint laxity or “looseness” in their ligaments. We test for knee hyperextension and general joint flexibility to see whether the ACL may be more vulnerable to overstretching or tearing during high-intensity activity.

Limb Length Discrepancy

Even a slight difference in leg lengths can affect gait, posture, and loading patterns through the pelvis, knees, and ankles. Over time, this can lead to compensations that increase ACL strain. We assess for discrepancies through physical exam and gait observation.

Foot Type

Your foot structure—whether you have high arches, flat feet, or somewhere in between—can influence how the rest of your body aligns during movement. Certain foot types can promote excessive inward collapse (pronation), which travels up the leg and affects the knee.

Forefoot Pronation

We evaluate the front part of your foot to see how it collapses or rotates during weight-bearing activities. Excessive forefoot pronation can destabilize the entire kinetic chain and contribute to the inward collapse of the knee during athletic movements, again increasing ACL risk.

Why It Matters

All these factors are interconnected. Your body is a system, and a minor issue in your foot or hip can create a cascade of compensations that lead to excessive strain on your ACL.

By identifying muscle imbalances, joint laxity, poor movement patterns, and anatomical risks, we can intervene before injury happens. That might include a personalized strength and conditioning plan, custom orthotics, flexibility work, or movement retraining.

If you or your athlete is involved in high-risk sports—or has a history of ACL injuries—it’s worth taking a proactive approach. Our ACL screening protocol is designed to give you answers, reduce risk, and support long-term performance.

Curious about your ACL risk profile?

Schedule a screening today and take the first step toward safer, stronger movement. Call our offices located in Marlton, N.J. or Ridley Park, PA. or reach out via our contact form today to schedule your complete biomechanical assessment and comprehensive examination at (610) 522-9200.