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Updated: Feb 8, 2026

Author Spotlight: Investigating Early Events and Long-Term Effects of ACL Injuries for Osteoarthritis Progression
Published on: September 29, 2023
A novel approach to enhance ACL injury prevention programs
Alli Gokeler1,2,3, Romain Seil4, Gino Kerkhoffs5,6,7
1Luxembourg Institute of Research for Orthopedics, Medicine and Science in Sports, 76 rue d'Eich, L-1460, Luxembourg, Luxembourg. a.gokeler@rug.nl.
Abstract:
Efficacy studies have demonstrated decreased anterior cruciate ligament (ACL) injury rates for athletes participating in injury prevention programs. Typically, ACL injury prevention programs entail a combination of plyometrics, strength training, agility and balance exercises. Unfortunately, improvements of movement patterns are not sustained over time. The reason may be related to the type of instructions given during training. Encouraging athletes to consciously control knee movements during exercises may not be optimal for the acquisition of complex motor skills as needed in complex sports environments. In the motor learning domain, these types of instructions are defined as an internal attentional focus. An internal focus, on one's own movements results in a more conscious type of control that may hamper motor learning. It has been established in numerous studies that an external focus of attention facilitates motor learning more effectively due to the utilization of automatic motor control. Subsequently, the athlete has more recourses available to anticipate on situations on the field and take appropriate feed forward directed actions. The purpose of this manuscript was to present methods to optimize motor skill acquisition of athletes and elaborate on athletes' behavior.
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