Tuck Jump Assessment for Reducing Anterior Cruciate Ligament Injury Risk

FEMALE ATHLETES demonstrate a 4 to 6 times higher incidence of non-contact anterior cruciate ligament (ACL) injury than male athletes participating in the same landing and pivoting sports.1-3 This greater risk of ACL injury, coupled with a dramatic increase in participation (doubling each decade), has led to a significant rise in the number of ACL injuries in female athletes. This gender disparity in non-contact ACL injury risk, combined with evidence that the primary cause may be neuromuscular in nature, have lead to the development of neuromuscular interventions designed to prevent injury.4-9 Initial interventions aimed at reducing the incidence of ACL injuries in female athletes were developed based on empirical evidence from coaching and training female athletes and from performance enhancement research.4,10 More current techniques, developed from identified injury mechanism (dynamic knee valgus11) and objective analysis of training methods,12-19 may further reduce traumatic ACL injuries in female athletes.5-7 The programs that have demonstrated ACL injury reduction are comprehensive, and include multiple training components that may induce the neuromuscular changes. The purpose of this report is to discuss the current evidence related to modifiable ACL injury mechanisms during landing and to present a novel “clinician-friendly” assessment and training technique that can be used to identify these mechanisms in high-risk female athletes. Key Points Use of the tuck jump assessment to identify neuromuscular imbalances may provide direction for targeted treatment for those at high risk for ACL injury. Improvement in neuromuscular techniques may be assessed and continually monitored with repeated measurement using the tuck jump assessment. Multiple factors may underlie the differences in ACL injury risk in male and females, neuromuscular control may be the most important and modifiable factor that can be addressed with plyometric training.