We’ve previously discussed using a neuromuscular warm-up to prevent injuries. One of the major studies done was reported on here. Mandelbaum et al 2005 performed a long-term follow-up.

52 female soccer and basketball team coaches viewed a 20min video of the warm up in 2000 and 45 in 2001. The program is freely available here. It involves jogging, shuttle runs, backward jogging, hamstring exercises, plyometrics, agility runs and stretching.

In the first year of the study, an 88% reduction in the intervention group was reported. In year two, a 74% reduction was found. Overall, it was determined that the rate of ACL tear was 4.74/1000 for those with the warm-up compared to 18.3/1000 without.

Different coaches, applying the program the program to different sports found rates reduction varying from 60-89%. Hennings and Griffis reported an 89% reduction in ACL injury while Caraffa reported an 87% reduction. It was also noted by some of the coaches that knee injuries among the intervention group was as high 300% lower than the average. This program was adopted by several Vermont ski patrol groups and they found that it reduced ACL injury by 62% (keeping in mind the program was designed for soccer and basketball). Given this current set of data, one can safely say that this program does reduce the likelihood of an ACL tear. The major reasons for such tears appear to be poor landing technique (lack of proper hip and knee coordinated flexion for a soft landing- which is trained by the plyometrics), lack of hamstring strength, lack of muscular flexibility and cutting too quickly. By addressing 3 of these issues directly in the warm up and having athletes cut over 3 steps rather than 1, the rate of injury was effectively cut. If you are an athlete or a coach of athletes, consider incorporating the PEP warm up into your pre-season and in-season warm up. Fewer ACL tears is more than enough reason to.