The evidence-backed structure
The programmes that reduce ACL injury rates in young female athletes share the same architecture: a structured warm-up of roughly 15–20 minutes replacing the usual jog and stretch, performed before training two to three times a week throughout the season.
Each session includes running mechanics, lower-body strength, plyometrics with landing feedback, balance work, and agility with deliberate deceleration practice.
Component 1, strength
- Nordic hamstring curls, progressed from partial to full range.
- Single-leg Romanian deadlifts and split squats.
- Glute bridges and hip abduction work.
- Calf raises, both straight and bent knee.
Component 2, plyometrics and landing
Technique feedback is not optional. Programmes delivered without coaching cues on knee position produce much smaller effects than those with them.
- Drop-and-stick landings with a three-second hold.
- Lateral bounds with a controlled landing.
- Repeated hops progressing from double to single leg.
- Jump-and-turn landings for rotational control.
Component 3, balance and agility
- Single-leg balance with perturbation or ball catches.
- Planned change of direction with a taught deceleration pattern.
- Reactive agility with a visual cue, added once the planned version is clean.
Making it happen
The main barrier is not knowledge, it is compliance. Programmes succeed when they replace the existing warm-up rather than being added to a full session, when a coach leads them, and when the whole squad does them together.
For individual athletes, doing the same 15 minutes before training and before matches, plus one standalone strength session a week, captures most of the benefit.
The wider risk picture
- Monitor total weekly load, fatigue is a consistent risk multiplier.
- Protect sleep, and treat 8–10 hours as part of the programme.
- Ensure adequate energy intake, especially during growth and heavy training blocks.
- Adjust plyometric volume during rapid growth phases.
- Address existing knee pain rather than training around it.
Realistic expectations
No programme eliminates risk. What the evidence supports is a substantial reduction in non-contact ACL injuries in squads that perform prevention work consistently, a meaningful change for a young athlete facing an injury that costs the better part of a year.