Document Title: Hewett-AJSM-Nov99

Article Title: The effect of neuromuscular training on the incidence of knee injury in female athletes: A prospective study

Authors: Timothy E. Hewett, Thomas N. Lindenfeld, Jennifer V. Riccobene, Frank R. Noyes.

Publication: The American Journal of Sports Medicine

ISSN: 03635465

Date: November-December 1999.

(Figures included. Reference-denoting numbers appear in the same point size as document text.)

Volume: 27

Issue: 6

Pages: 699-706

Key Words: Knee, female athlete, neuromuscular training, Sportsmetrics, injury-prevention.

Hewett et al. follow up diligently on Chandy and Grana's 1985-vintage recommendations of functional evaluation and training of knee-surrounding musculature. This study found that female athletes tend to have proportionally weak hamstrings, and that they tend to land jumps with inadequate knee flexion. Emphasis is placed on the importance of hamstring-strengthening exercises and plyometric (ballistic-jumping) training. These recommendations have been embodied in the renowned Cincinnati Sportsmetrics training programme, with the result that female athletes who underwent said training experienced 2 to 8 times less ACL injuries (as compared to female athletes who did not undergo the training).

ABSTRACT

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 non-contact), 2 of 366 trained female athletes sustained serious knee injuries (0 non-contact), and 2 of 434 male athletes sustained serious knee injuries (1 non-contact). 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 non-contact 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.

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