Evaluating the Benefits of Neuromuscular vs. Strength-Only Training in Athletes for ACL Re-Injury Prevention

Anterior cruciate ligament (ACL) injuries are one of the most prevalent injuries occurring in athletes. These injuries are highly prevalent in cutting sports such as basketball, football, and soccer. Additionally, there is a significant risk of re-injury for athletes who return to their sports without proper rehabilitation. Neuromuscular training, or NMT, is a more comprehensive form of rehabilitation focused on aspects such as plyometrics, agility training, and balance. The goal of this study is to compare the efficacy of NMT- focused rehabilitation to strength-only rehabilitation. This study was executed as a narrative review gathering various published research articles from Google Scholar and PubMed. The studies showed that NMT is strongly linked to lower re-injury rates compared to conventional rehabilitation programs. Arundale et al. (2018) reports a re-injury rate of 2.5% following an NMT-focused prevention program, while Paterno et al. (2014) reports a 29.5% re-injury rate following a strength-focused program. Additionally, specific improvements in biomechanical outcomes were noted, such as reduced knee abduction movement and improved hop test symmetry. The studies also highlighted predictors of risk of re-injury, such as younger age, female sex, and time-based return to sport as opposed to criteria-based return to sport. Overall, the conclusion is that NMT should be incorporated alongside a strength training program to produce the most optimal outcomes in athletes returning to their sport following an ACL injury.