Abstract

PURPOSE: The movement patterns performed by court sport athletes inherently present a risk of injury if performed with compromised technique and body mechanics (2). Repetitive quick changes in direction can cause anterior translation of the tibia relative to femur which places a significant amount of force on the anterior cruciate ligament (ACL). This excessive force exerted on the ACL can cause ligament rupture (3), with females reported to be up to eight times more likely to suffer an ACL injury in comparison to males (1, 4). The purpose of this study was to investigate whether the addition of a neuromuscular training protocol decreases ACL injury risk and increases physical performance in female court sport athletes. METHODS: Twenty female court sport athletes participated in this study (stature: 169 ± 7 cm, mass: 61.3 ± 8.3 kg, age: 22.3 ± 2.0 years, competitive playing experience: 5.4 ± 1.6 years). Participants were split randomly into two groups, a control and an experimental group each comprising of 10 participants. All participants were required to conduct pre-tests involving a 20 m sprint, countermovement jump (CMJ), Illinois agility test and the qualitative analysis of a single leg squat (QASLS), which is an assessment used to profile a participant’s risk of an ACL injury. After the pre-tests the intervention group engaged in a modified version of the Fifa 11+ neuromuscular training programme twice a week over an eight week period. During this eight week period both groups were instructed to continue with their habitual training regimes as delivered to them by their sport coaches. After eight weeks both the control and intervention group participants were recalled to repeat the pre-test protocols. RESULTS: Two-way ANOVA tests demonstrated significant improvements for the intervention group’s CMJ in comparison to the control group following the training intervention (Intervention; +4.16 cm vs Control; –1.69 cm, p = 0.004). In addition there was a significant reduction in QASLS for both legs (p < 0.001) for the intervention group in comparison to control (Right Leg, Intervention; Pre: 3.75 Post: 1.91, Control; Pre: 4.11 Post: 4.08) (Left Leg, Intervention; Pre: 3.72 Post: 0.98, Control; Pre: 4.05 Post: 4.23). No significant differences between the two groups were found for the Illinois agility test and 20 m sprint. However, there was a within-group improvement in 20 m sprint for the intervention group post training (Pre: 3.63 s Post: 3.55 s, p = 0.024). CONCLUSIONS: The results demonstrate a modified Fifa 11+ protocol can be considered an effective neuromuscular training programme for reducing ACL injury risk as determined by the QASLS scores. Moreover, the intervention also demonstrated improvements in sport specific physical performance measures of lower body power and acceleration. PRACTICAL APPLICTIONS: Strength and conditioning practitioners should explore the use of neuromuscular training programmes in sports such as court based sports which have a high prevalence of ACL injury especially in female populations. Considering that neuromuscular training programmes, such as the Fifa 11+ routine, require minimal equipment to conduct and subsequently coaches may find such interventions a pragmatic and realistic tool to increase performance and reduce the risk of ACL injuries in a multitude of different athletes.