A Well-Planned Preseason Routine Can Help Reduce Risk Of Injury

Practices, tryouts and games are back on school calendars. That also means an increased risk of one of the most common and serious knee injuries among young athletes: an anterior cruciate ligament tear.

ACL injuries can sideline students for months, disrupt school and sports routines and raise the risk of future knee problems. Fortunately, many ACL injuries are preventable, said Ramez Hoveydai, DO, a non-operative sports medicine physician with ThedaCare Orthopedic Care.

“These injuries often happen during movements athletes can learn to control better – especially landing, cutting, pivoting and slowing down,” he said.

The ACL, or anterior cruciate ligament, is one of the main ligaments inside the knee. It helps keep the shinbone from sliding too far forward and aids in controlling twisting motions. An ACL injury usually means the ligament has been stretched or torn, often during a quick stop, sharp change of direction, awkward landing, pivot or collision.

Prevention Before the First Whistle

ACL injuries are not completely preventable, Dr. Hoveydai said. A well-planned preseason routine can help decrease injury risk.

“The best programs begin neuromuscular training,” he said. “These programs teach athletes how to land, cut, decelerate and balance with better control.”

General guidelines for ACL injury prevention include:

• Practicing soft landing: Athletes should bend at the hips and knees, keep their knees aligned over their toes and avoid landing with stiff legs.
• Building hip, core and hamstring strength: Strong muscles around the hips, trunk and back of the thighs help reduce stress on the knee.
• Warming up with purpose: A 10- to 20-minute warmup that includes dynamic movement, balance, jumping mechanics and sport-specific drills can be more useful than jogging alone. Cool down with static stretches.
• Not doing too much too soon: Sudden increases in training volume, year-round specialization and skipping recovery days can up injury risk.
• Checking shoes and play surfaces: Cleats, court shoes and field conditions should match the sport and surface to reduce slipping or sticking.

ACL injuries can happen in any sport. Risk is generally higher in activities that involve jumping, cutting, pivoting and quick changes of speed, Dr. Hoveydai said. These include soccer, basketball, volleyball, football, lacrosse and gymnastics.

More Common in Females

Girls and young women have higher rates of noncontact ACL injury than boys in similar sports. The reason is not attributable to one single factor. It is usually a combination of anatomy, hormones, strength patterns and movement mechanics.

“This does not mean girls should avoid sports. It means schools, coaches and families should be intentional about prevention,” Dr. Hoveydai said. “This is especially true for middle school and high school athletes entering a new season.”

Other risk factors for an ACL injury include poor landing mechanics, such as the knees collapsing inward or the legs remaining too straight during movement. Weakness in the hips, core or hamstrings can also increase injury risk, as can limited balance, coordination or body control, particularly during periods of rapid growth.

“Athletes with a previous knee injury or those who return to play before fully regaining strength and movement quality may be more vulnerable,” Dr. Hoveydai said. “Risk can also rise with sudden increases in training volume, practices, games or tournaments, especially at the start of a season.”

Fatigue later in practices or games may lead to a breakdown in technique, further increasing the likelihood of injury, he added. In addition, sport specialization without adequate rest or movement variety can contribute to risk, while environmental factors such as uneven playing surfaces, wet conditions or inappropriate footwear traction may also play a role.

Licensed Athletic Trainers

Many school districts in northeast and central Wisconsin have licensed athletic trainers (LATs) on staff for practices and games, contracted through health organizations like ThedaCare. This connection can help students get evaluated quickly and safely in the event of a suspected ACL injury.

“ACL prevention works best when it becomes part of team culture,” Dr. Hoveydai said. “Coaches can build short prevention warmups into practice. Parents can encourage rest, recovery and reporting pain early. Athletes can learn safer landing and cutting habits before the season speeds up.”

And when schools have LATs on staff, students have an important safety net for early evaluation, referral and guided recovery.

Visit ThedaCare Orthopedic Care or call 920-831-5050 for more information. People in need of orthopedic assistance can also visit ThedaCare Orthopedic Walk-in Care in Appleton or Oshkosh for no-appointment-needed care.

About ThedaCare

For more than 115 years, ThedaCare® has been improving the health and well-being of the communities it serves in northeast and central Wisconsin. The organization delivers care to more than 650,000 residents in 17 counties, and employs approximately 7,000 providers and team members at 180 points of care, including 10 hospitals. As an organization committed to being a leader in Population Health, team members are dedicated to empowering people to live their unique, best lives. ThedaCare is a not-for-profit health system with a level II trauma center, comprehensive cancer treatment, stroke and cardiac programs, as well as primary care. ThedaCare also partners with communities to understand needs, find solutions together, and encourage health awareness and action. ThedaCare is part of Froedtert ThedaCare, Wisconsin’s most comprehensive healthcare system.

Date posted: September 15, 2026