Dr. Jonathan Mulford, Orthopaedic Surgeon, NSW Australia Total Knee Replacement, NSW Australia
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Prevent injury and Enhance Performance Program

ACL injury may be reduced by up to 70% by using a specific warm up program.

The PEP program (Prevent injury and Enhance Performance Program) has been shown to decrease ACL injuries in female soccer players. It is likely that it can be extended to both sexes and all sports.

It consists of a warm-up, stretching, strengthening, plyometrics, and sport specific agility training.

Plyometric exercises (such as jumping, and balance drills) helps improve neuromuscular conditioning and muscular reactions which decrease the risk of ACL injury.

Technique during jumping moves is important.

  • Jump straight up and down
  • Avoid excessive side-to-side movement
  • Aim for soft landings
  • Optimally the program should be performed at least 2-3 times per week during the season

Basic Components of the PEP Program

  1. Warm-up (50 metres each):
    • Jog line to line of soccer field (cone to cone)
    • Shuttle run (side to side)
    • Backward running
  2. Stretching (30 s × 2 reps each):
    • Calf stretch
    • Quadricep stretch
    • Figure 4 hamstring stretch
    • Inner thigh stretch
    • Hip flexor stretch
  3. Strengthening:
    • Walking lunges (20 metres × 2 sets)
    • Russian hamstring (3 sets × 10 reps)
    • Single toe-raises (30 reps on each side)
  4. Plyometrics (20 reps each):
    • Lateral hops over 2 to 6 inch cone
    • Forward/backward hops over 2 to 6 inch cone
    • Single leg hops over 2 to 6 inch cone
    • Vertical jumps with headers
    • Scissors jump
  5. Agilities:
    • Shuttle run with forward/backward running (40 yards)
    • Diagonal runs (40 yards)
    • Bounding run (45–50 yards)

More details visit at www.aclprevent.com.

Search youtube.

Gilchrist J, Mandelbaum BR, Melancon H, et al. A randomized controlled trial to prevent noncontact anterior cruciate ligament injury in female collegiate soccer players. Am J Sports Med 2008;36(8):1476-83.

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Sydney Orthopaedic Surgeon, NSW Australia

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