AJSM signin
HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
 QUICK SEARCH:   [advanced]


     

Sign In to gain access to subscriptions and/or personal tools.
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Hewett, T. E.
Right arrow Articles by Noyes, F. R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Hewett, T. E.
Right arrow Articles by Noyes, F. R.
Related Collections
Right arrow Female Athletes
Right arrow Rehabilitation/Training
The American Journal of Sports Medicine 27:699-706 (1999)
© 1999 American Orthopaedic Society for Sports Medicine

The Effect of Neuromuscular Training on the Incidence of Knee Injury in Female Athletes

A Prospective Study

Timothy E. Hewett, PhD*, Thomas N. Lindenfeld, MD, Jennifer V. Riccobene and Frank R. Noyes, MD

Cincinnati Sportsmedicine Research and Education Foundation and Deaconess Hospital, Cincinnati, Ohio

* Address correspondence and reprint requests to Timothy E. Hewett, PhD, Cincinnati Sportsmedicine Research and Education Foundation, 311 Straight Street, Cincinnati, OH 45219

To prospectively evaluate the effect of neuromuscular training on the incidence of knee injury in female athletes, we monitored two groups of female athletes, one trained before sports participation and the other not trained, and a group of untrained male athletes throughout the high school soccer, volleyball, and basketball seasons. Weekly reports included the number of practice and competition exposures and mechanism of injury. There were 14 serious knee injuries in the 1263 athletes tracked through the study. Ten of 463 untrained female athletes sustained serious knee injuries (8 noncontact), 2 of 366 trained female athletes sustained serious knee injuries (0 noncontact), and 2 of 434 male athletes sustained serious knee injuries (1 noncontact). The knee injury incidence per 1000 athlete-exposures was 0.43 in untrained female athletes, 0.12 in trained female athletes, and 0.09 in male athletes (P = 0.02, chi-square analysis). Untrained female athletes had a 3.6 times higher incidence of knee injury than trained female athletes (P = 0.05) and 4.8 times higher than male athletes (P = 0.03). The incidence of knee injury in trained female athletes was not significantly different from that in untrained male athletes (P = 0.86). The difference in the incidence of noncontact injuries between the female groups was also significant (P = 0.01). This prospective study demonstrated a decreased incidence of knee injury in female athletes after a specific plyometric training program.




This article has been cited by other articles:


Home page
BMJHome page
K. Pasanen, J. Parkkari, M. Pasanen, H. Hiilloskorpi, T. Makinen, M. Jarvinen, and P. Kannus
Neuromuscular training and the risk of leg injuries in female floorball players: cluster randomised controlled study
BMJ, August 13, 2008; 337(jul01_2): a295 - a295.
[Abstract] [Full Text] [PDF]


Home page
Am J Sports MedHome page
J. Gilchrist, B. R. Mandelbaum, H. Melancon, G. W. Ryan, H. J. Silvers, L. Y. Griffin, D. S. Watanabe, R. W. Dick, and J. Dvorak
A Randomized Controlled Trial to Prevent Noncontact Anterior Cruciate Ligament Injury in Female Collegiate Soccer Players
Am. J. Sports Med., August 1, 2008; 36(8): 1476 - 1483.
[Abstract] [Full Text] [PDF]


Home page
Br. J. Sports. Med.Home page
J Parkkari, K Pasanen, V M Mattila, P Kannus, and A Rimpela
The risk for a cruciate ligament injury of the knee in adolescents and young adults: a population-based cohort study of 46 500 people with a 9 year follow-up
Br. J. Sports Med., June 1, 2008; 42(6): 422 - 426.
[Abstract] [Full Text] [PDF]


Home page
Br. J. Sports. Med.Home page
G Panics, A Tallay, A Pavlik, and I Berkes
Effect of proprioception training on knee joint position sense in female team handball players
Br. J. Sports Med., June 1, 2008; 42(6): 472 - 476.
[Abstract] [Full Text] [PDF]


Home page
Am J Sports MedHome page
J. D. Chappell and O. Limpisvasti
Effect of a Neuromuscular Training Program on the Kinetics and Kinematics of Jumping Tasks
Am. J. Sports Med., June 1, 2008; 36(6): 1081 - 1086.
[Abstract] [Full Text] [PDF]


Home page
J. Am. Podiatr. Med. Assoc.Home page
W. L. Jenkins, S. G. Raedeke, and D.S. B. Williams III
The Relationship Between the Use of Foot Orthoses and Knee Ligament Injury in Female Collegiate Basketball Players
J Am Podiatr Med Assoc, May 1, 2008; 98(3): 207 - 211.
[Abstract] [Full Text] [PDF]


Home page
Am J Sports MedHome page
D. C. Herman, P. S. Weinhold, K. M. Guskiewicz, W. E. Garrett, B. Yu, and D. A. Padua
The Effects of Strength Training on the Lower Extremity Biomechanics of Female Recreational Athletes During a Stop-Jump Task
Am. J. Sports Med., April 1, 2008; 36(4): 733 - 740.
[Abstract] [Full Text] [PDF]


Home page
Am J Sports MedHome page
T. W. Kernozek, M. R. Torry, and M. Iwasaki
Gender Differences in Lower Extremity Landing Mechanics Caused by Neuromuscular Fatigue
Am. J. Sports Med., March 1, 2008; 36(3): 554 - 565.
[Abstract] [Full Text] [PDF]


Home page
Br. J. Sports. Med.Home page
Y. Thijs, D. Van Tiggelen, T. Willems, D. De Clercq, and E. Witvrouw
Relationship between hip strength and frontal plane posture of the knee during a forward lunge
Br. J. Sports Med., November 1, 2007; 41(11): 723 - 727.
[Abstract] [Full Text] [PDF]


Home page
Br. J. Sports. Med.Home page
L. Abernethy and C. Bleakley
Strategies to prevent injury in adolescent sport: a systematic review
Br. J. Sports Med., October 1, 2007; 41(10): 627 - 638.
[Abstract] [Full Text] [PDF]


Home page
Am J Sports MedHome page
M. Hagglund, M. Walden, and J. Ekstrand
Lower Reinjury Rate With a Coach-Controlled Rehabilitation Program in Amateur Male Soccer: A Randomized Controlled Trial
Am. J. Sports Med., September 1, 2007; 35(9): 1433 - 1442.
[Abstract] [Full Text] [PDF]


Home page
Br. J. Sports. Med.Home page
A. Junge and J. Dvorak
Injuries in female football players in top-level international tournaments
Br. J. Sports Med., August 1, 2007; 41(suppl_1): i3 - i7.
[Abstract] [Full Text] [PDF]


Home page
Br. J. Sports. Med.Home page
H. J. Silvers and B. R Mandelbaum
Prevention of anterior cruciate ligament injury in the female athlete
Br. J. Sports Med., August 1, 2007; 41(suppl_1): i52 - i59.
[Abstract] [Full Text] [PDF]


Home page
Am J Sports MedHome page
B. T. Zazulak, T. E. Hewett, N. P. Reeves, B. Goldberg, and J. Cholewicki
Deficits in Neuromuscular Control of the Trunk Predict Knee Injury Risk: A Prospective Biomechanical-Epidemiologic Study
Am. J. Sports Med., July 1, 2007; 35(7): 1123 - 1130.
[Abstract] [Full Text] [PDF]


Home page
J Am Acad Orthop SurgHome page
J. B. Frank, G. J. Jarit, J. T. Bravman, and J. E. Rosen
Lower Extremity Injuries in the Skeletally Immature Athlete
J. Am. Acad. Ortho. Surg., June 1, 2007; 15(6): 356 - 366.
[Abstract] [Full Text] [PDF]


Home page
ptjournalHome page
M. A. Risberg, I. Holm, G. Myklebust, and L. Engebretsen
Neuromuscular Training Versus Strength Training During First 6 Months After Anterior Cruciate Ligament Reconstruction: A Randomized Clinical Trial
Physical Therapy, June 1, 2007; 87(6): 737 - 750.
[Abstract] [Full Text] [PDF]


Home page
AMERICAN JOURNAL OF LIFESTYLE MEDICINEHome page
A. D. Faigenbaum
State of the Art Reviews: Resistance Training for Children and Adolescents: Are There Health Outcomes?
American Journal of Lifestyle Medicine, May 1, 2007; 1(3): 190 - 200.
[Abstract] [PDF]


Home page
Am J Sports MedHome page
A. M. W. Chaudhari, T. N. Lindenfeld, T. P. Andriacchi, T. E. Hewett, J. Riccobene, G. D. Myer, and F. R. Noyes
Knee and Hip Loading Patterns at Different Phases in the Menstrual Cycle: Implications for the Gender Difference in Anterior Cruciate Ligament Injury Rates
Am. J. Sports Med., May 1, 2007; 35(5): 793 - 800.
[Abstract] [Full Text] [PDF]


Home page
Am J Sports MedHome page
T. Krosshaug, A. Nakamae, B. P. Boden, L. Engebretsen, G. Smith, J. R. Slauterbeck, T. E. Hewett, and R. Bahr
Mechanisms of Anterior Cruciate Ligament Injury in Basketball: Video Analysis of 39 Cases
Am. J. Sports Med., March 1, 2007; 35(3): 359 - 367.
[Abstract] [Full Text] [PDF]


Home page
ptjournalHome page
J. L Owen, S. Campbell, S. J Falkner, C. Bialkowski, and A. T Ward
Is there evidence that proprioception or balance training can prevent anterior cruciate ligament (ACL) injuries in athletes without previous ACL injury?
Physical Therapy, October 1, 2006; 86(10): 1436 - 1440.
[Full Text] [PDF]


Home page
Am J Sports MedHome page
L. Y. Griffin, M. J. Albohm, E. A. Arendt, R. Bahr, B. D. Beynnon, M. DeMaio, R. W. Dick, L. Engebretsen, W. E. Garrett Jr, J. A. Hannafin, et al.
Understanding and Preventing Noncontact Anterior Cruciate Ligament Injuries: A Review of the Hunt Valley II Meeting, January 2005
Am. J. Sports Med., September 1, 2006; 34(9): 1512 - 1532.
[Abstract] [Full Text] [PDF]


Home page
Br. J. Sports. Med.Home page
O Faude, A Junge, W Kindermann, and J Dvorak
Risk factors for injuries in elite female soccer players
Br. J. Sports Med., September 1, 2006; 40(9): 785 - 790.
[Abstract] [Full Text] [PDF]


Home page
JBJSHome page
R. P. Pfeiffer, K. G. Shea, D. Roberts, S. Grandstrand, and L. Bond
Lack of Effect of a Knee Ligament Injury Prevention Program on the Incidence of Noncontact Anterior Cruciate Ligament Injury
J. Bone Joint Surg. Am., August 1, 2006; 88(8): 1769 - 1774.
[Abstract] [Full Text] [PDF]


Home page
Am J Sports MedHome page
C. E. Quatman, K. R. Ford, G. D. Myer, and T. E. Hewett
Maturation Leads to Gender Differences in Landing Force and Vertical Jump Performance: A Longitudinal Study
Am. J. Sports Med., May 1, 2006; 34(5): 806 - 813.
[Abstract] [Full Text] [PDF]


Home page
Am. J. Physiol. Endocrinol. Metab.Home page
S. J. Warden, L. K. Saxon, A. B. Castillo, and C. H. Turner
Knee ligament mechanical properties are not influenced by estrogen or its receptors
Am J Physiol Endocrinol Metab, May 1, 2006; 290(5): E1034 - E1040.
[Abstract] [Full Text] [PDF]


Home page
Am J Sports MedHome page
D. Argo, S. W. Trenhaile, F. H. Savoie III, and L. D. Field
Operative Treatment of Ulnar Collateral Ligament Insufficiency of the Elbow in Female Athletes
Am. J. Sports Med., March 1, 2006; 34(3): 431 - 437.
[Abstract] [Full Text] [PDF]


Home page
Am J Sports MedHome page
G. D. Myer, K. R. Ford, S. G. McLean, and T. E. Hewett
The Effects of Plyometric Versus Dynamic Stabilization and Balance Training on Lower Extremity Biomechanics
Am. J. Sports Med., March 1, 2006; 34(3): 445 - 455.
[Abstract] [Full Text] [PDF]


Home page
Am J Sports MedHome page
T. E. Hewett, K. R. Ford, and G. D. Myer
Anterior Cruciate Ligament Injuries in Female Athletes: Part 2, A Meta-analysis of Neuromuscular Interventions Aimed at Injury Prevention
Am. J. Sports Med., March 1, 2006; 34(3): 490 - 498.
[Abstract] [Full Text] [PDF]


Home page
AAP Grand RoundsHome page
D. Bernhardt
Balance Training to Prevent Sports Injuries
AAP Grand Rounds, February 1, 2006; 15(2): 22 - 23.
[Full Text] [PDF]


Home page
Am J Sports MedHome page
T. E. Hewett, G. D. Myer, and K. R. Ford
Anterior Cruciate Ligament Injuries in Female Athletes: Part 1, Mechanisms and Risk Factors
Am. J. Sports Med., February 1, 2006; 34(2): 299 - 311.
[Abstract] [Full Text] [PDF]


Home page
Am J Sports MedHome page
T. C. Sell, C. M. Ferris, J. P. Abt, Y.-S. Tsai, J. B. Myers, F. H. Fu, and S. M. Lephart
The Effect of Direction and Reaction on the Neuromuscular and Biomechanical Characteristics of the Knee During Tasks That Simulate the Noncontact Anterior Cruciate Ligament Injury Mechanism
Am. J. Sports Med., January 1, 2006; 34(1): 43 - 54.
[Abstract] [Full Text] [PDF]


Home page
Br. J. Sports. Med.Home page
S M Lephart, J P Abt, C M Ferris, T C Sell, T Nagai, J B Myers, and J J Irrgang
Neuromuscular and biomechanical characteristic changes in high school athletes: a plyometric versus basic resistance program
Br. J. Sports Med., December 1, 2005; 39(12): 932 - 938.
[Abstract] [Full Text] [PDF]


Home page
Am J Sports MedHome page
C. A. Emery, W. H. Meeuwisse, and S. E. Hartmann
Evaluation of Risk Factors for Injury in Adolescent Soccer: Implementation and Validation of an Injury Surveillance System
Am. J. Sports Med., December 1, 2005; 33(12): 1882 - 1891.
[Abstract] [Full Text] [PDF]


Home page
Am J Sports MedHome page
J. W. Orchard, T. E. Hewett, G. D. Myer, K. R. Ford, S. G. McLean, A. J. van den Bogert, and P. Succop
Letters to the Editor * Authors' Response
Am. J. Sports Med., December 1, 2005; 33(12): 1930 - 1930.
[Full Text] [PDF]


Home page
Am J Sports MedHome page
O. Faude, A. Junge, W. Kindermann, and J. Dvorak
Injuries in Female Soccer Players: A Prospective Study in the German National League
Am. J. Sports Med., November 1, 2005; 33(11): 1694 - 1700.
[Abstract] [Full Text] [PDF]


Home page
J Am Acad Orthop SurgHome page
J. D. Willson, C. P. Dougherty, M. L. Ireland, and I. M. Davis
Core Stability and Its Relationship to Lower Extremity Function and Injury
J. Am. Acad. Ortho. Surg., September 1, 2005; 13(5): 316 - 325.
[Abstract] [Full Text] [PDF]


Home page
Am J Sports MedHome page
B. Yu, S. B. McClure, J. A. Onate, K. M. Guskiewicz, D. T. Kirkendall, and W. E. Garrett
Age and Gender Effects on Lower Extremity Kinematics of Youth Soccer Players in a Stop-Jump Task
Am. J. Sports Med., September 1, 2005; 33(9): 1356 - 1364.
[Abstract] [Full Text] [PDF]


Home page
ptjournalHome page
G. D Myer, H. I Brunner, P. G Melson, M. V Paterno, K. R Ford, and T. E Hewett
Specialized Neuromuscular Training to Improve Neuromuscular Function and Biomechanics in a Patient With Quiescent Juvenile Rheumatoid Arthritis
Physical Therapy, August 1, 2005; 85(8): 791 - 802.
[Abstract] [Full Text] [PDF]


Home page
Am J Sports MedHome page
B. R. Mandelbaum, H. J. Silvers, D. S. Watanabe, J. F. Knarr, S. D. Thomas, L. Y. Griffin, D. T. Kirkendall, and W. Garrett Jr
Effectiveness of a Neuromuscular and Proprioceptive Training Program in Preventing Anterior Cruciate Ligament Injuries in Female Athletes: 2-Year Follow-up
Am. J. Sports Med., July 1, 2005; 33(7): 1003 - 1010.
[Abstract] [Full Text] [PDF]


Home page
Br. J. Sports. Med.Home page
R Bahr and T Krosshaug
Understanding injury mechanisms: a key component of preventing injuries in sport
Br. J. Sports Med., June 1, 2005; 39(6): 324 - 329.
[Abstract] [Full Text] [PDF]


Home page
Br. J. Sports. Med.Home page
T Krosshaug, T E Andersen, O-E O Olsen, G Myklebust, and R Bahr
Research approaches to describe the mechanisms of injuries in sport: limitations and possibilities
Br. J. Sports Med., June 1, 2005; 39(6): 330 - 339.
[Abstract] [Full Text] [PDF]


Home page
Br. J. Sports. Med.Home page
T E Hewett, B T Zazulak, G D Myer, and K R Ford
A review of electromyographic activation levels, timing differences, and increased anterior cruciate ligament injury incidence in female athletes
Br. J. Sports Med., June 1, 2005; 39(6): 347 - 350.
[Abstract] [Full Text] [PDF]


Home page
Br. J. Sports. Med.Home page
S G McLean, K Walker, K R Ford, G D Myer, T E Hewett, and A J van den Bogert
Evaluation of a two dimensional analysis method as a screening and evaluation tool for anterior cruciate ligament injury
Br. J. Sports Med., June 1, 2005; 39(6): 355 - 362.
[Abstract] [Full Text] [PDF]


Home page
J Bone Joint Surg BrHome page
R. Ramesh, O. Von Arx, T. Azzopardi, and P. J. Schranz
The risk of anterior cruciate ligament rupture with generalised joint laxity
J Bone Joint Surg Br, June 1, 2005; 87-B(6): 800 - 803.
[Abstract] [Full Text] [PDF]


Home page
Br. J. Sports. Med.Home page
E Giza, K Mithofer, L Farrell, B Zarins, T Gill, and S Drawer
Injuries in women's professional soccer * Commentary
Br. J. Sports Med., April 1, 2005; 39(4): 212 - 216.
[Abstract] [Full Text] [PDF]


Home page
Am J Sports MedHome page
J. Agel, E. A. Arendt, and B. Bershadsky
Anterior Cruciate Ligament Injury in National Collegiate Athletic Association Basketball and Soccer: A 13-Year Review
Am. J. Sports Med., April 1, 2005; 33(4): 524 - 531.
[Abstract] [Full Text] [PDF]


Home page
Am J Sports MedHome page
T. E. Hewett, G. D. Myer, K. R. Ford, R. S. Heidt Jr, A. J. Colosimo, S. G. McLean, A. J. van den Bogert, M. V. Paterno, and P. Succop
Biomechanical Measures of Neuromuscular Control and Valgus Loading of the Knee Predict Anterior Cruciate Ligament Injury Risk in Female Athletes: A Prospective Study
Am. J. Sports Med., April 1, 2005; 33(4): 492 - 501.
[Abstract] [Full Text] [PDF]


Home page
CMAJHome page
C. A. Emery, J. D. Cassidy, T. P. Klassen, R. J. Rosychuk, and B. H. Rowe
Effectiveness of a home-based balance-training program in reducing sports-related injuries among healthy adolescents: a cluster randomized controlled trial
Can. Med. Assoc. J., March 15, 2005; 172(6): 749 - 754.
[Abstract] [Full Text] [PDF]


Home page
BMJHome page
O.-E. Olsen, G. Myklebust, L. Engebretsen, I. Holme, and R. Bahr
Exercises to prevent lower limb injuries in youth sports: cluster randomised controlled trial
BMJ, February 26, 2005; 330(7489): 449.
[Abstract] [Full Text] [PDF]


Home page
Am J Sports MedHome page
F. R. Noyes, S. D. Barber-Westin, C. Fleckenstein, C. Walsh, and J. West
The Drop-Jump Screening Test: Difference in Lower Limb Control By Gender and Effect of Neuromuscular Training in Female Athletes
Am. J. Sports Med., February 1, 2005; 33(2): 197 - 207.
[Abstract] [Full Text] [PDF]


Home page
JBJSHome page
T. E. Hewett, G. D. Myer, and K. R. Ford
Decrease in Neuromuscular Control About the Knee with Maturation in Female Athletes
J. Bone Joint Surg. Am., August 1, 2004; 86(8): 1601 - 1608.
[Abstract] [Full Text] [PDF]


Home page
Am J Sports MedHome page
O.-E. Olsen, G. Myklebust, L. Engebretsen, and R. Bahr
Injury Mechanisms for Anterior Cruciate Ligament Injuries in Team Handball: A Systematic Video Analysis
Am. J. Sports Med., June 1, 2004; 32(4): 1002 - 1012.
[Abstract] [Full Text] [PDF]


Home page
Br. J. Sports. Med.Home page
R G DeMont and S M Lephart
Effect of sex on preactivation of the gastrocnemius and hamstring muscles
Br. J. Sports Med., April 1, 2004; 38(2): 120 - 124.
[Abstract] [Full Text] [PDF]


Home page
Am J Sports MedHome page
G. Myklebust, I. Holm, S. Maehlum, L. Engebretsen, and R. Bahr
Clinical, Functional, and Radiologic Outcome in Team Handball Players 6 to 11 Years after Anterior Cruciate Ligament Injury: A Follow-up Study
Am. J. Sports Med., November 1, 2003; 31(6): 981 - 989.
[Abstract] [Full Text] [PDF]


Home page
JBJSHome page
E. M. Wojtys, L. J. Huston, H. J. Schock, J. P. Boylan, and J. A. Ashton-Miller
Gender Differences in Muscular Protection of the Knee in Torsion in Size-Matched Athletes
J. Bone Joint Surg. Am., May 1, 2003; 85(5): 782 - 789.
[Abstract] [Full Text] [PDF]


Home page
Am J Sports MedHome page
R. Fagenbaum and W. G. Darling
Jump Landing Strategies in Male and Female College Athletes and the Implications of Such Strategies for Anterior Cruciate Ligament Injury
Am. J. Sports Med., March 1, 2003; 31(2): 233 - 240.
[Abstract] [Full Text] [PDF]


Home page
Am J Sports MedHome page
J. J. Elias, A. F. Faust, Y.-H. Chu, E. Y. Chao, and A. J. Cosgarea
The Soleus Muscle Acts as an Agonist for the Anterior Cruciate Ligament: An In Vitro Experimental Study
Am. J. Sports Med., March 1, 2003; 31(2): 241 - 246.
[Abstract] [Full Text] [PDF]


Home page
Am J Sports MedHome page
W. P. H. Charlton, T. A. St. John, M. G. Ciccotti, N. Harrison, and M. Schweitzer
Differences in Femoral Notch Anatomy between Men and Women : A Magnetic Resonance Imaging Study
Am. J. Sports Med., May 1, 2002; 30(3): 329 - 333.
[Abstract] [Full Text] [PDF]


Home page
JBJSHome page
E. M. Wojtys, J. A. Ashton-Miller, and L. J. Huston
A Gender-Related Difference in the Contribution of the Knee Musculature to Sagittal-Plane Shear Stiffness in Subjects with Similar Knee Laxity
J. Bone Joint Surg. Am., January 1, 2002; 84(1): 10 - 16.
[Abstract] [Full Text]