Abstract: While many anterior cruciate ligament (ACL) prevention programs have been
published, few have achieved significant reductions in injury rates and improvements in
athletic performance indices; both of which may increase compliance and motivation of
athletes to participate. A supervised neuromuscular retraining program (18 sessions) was
developed, aimed at achieving both of these objectives. The changes in neuromuscular indices
were measured after training in 1000 female athletes aged 13–18 years, and the noncontact
ACL injury rate in 700 of these trained athletes was compared with that of 1120 control
athletes. There were significant improvements in the drop-jump test, (p < 0.0001, effect size
[ES] 0.97), the single-leg triple crossover hop (p < 0.0001, ES 0.47), the t-test
(p < 0.0001, ES 0.64), the multi-stage fitness test (p < 0.0001, ES 0.57), hamstring strength
(p < 0.0001), and quadriceps strength (p < 0.01). The trained athletes had a significant
reduction in the noncontact ACL injury incidence rate compared with the controls (1 ACL
injury in 36,724 athlete-exposures [0.03] and 13 ACL injuries in 61,244 exposures [0.21],
respectively, p = 0.03). The neuromuscular retraining program was effective in reducing
noncontact ACL injury rate and improving athletic performance indicators.