018 - ACL Injuries & Change of Direction: Are You Moving Like a Walking Time Bomb?
Non-contact ACL injuries don’t just happen—they’re predictable. Faulty movement patterns during change-of-direction (COD) tasks increase risk, and new qualitative assessments (CMAS & E-CAST) can help identify athletes before disaster strikes.
The Hidden Risks in COD Movements
Knee valgus, lateral trunk flexion, limited knee flexion & narrow stance width = ACL injury red flags.
Females are at higher risk due to biomechanical & neuromuscular factors during COD.
Unplanned movements (reacting to visual cues or opponents) expose weaknesses that planned drills miss.
Tactical Fixes: How to Identify & Reduce ACL Injury Risk
1. Use CMAS & E-CAST to Screen for High-Risk Athletes
2D video-based analysis = practical, cost-effective assessment tool.
Athletes scoring CMAS ≥ 7 or high E-CAST scores need corrective training ASAP.
2. Train for Real-World, Unplanned COD Movements
Reactive COD drills mimic sport-specific demands & reveal risky movement habits.
Slowly integrate unplanned movements during rehab to prevent re-injury.
3. Fix Deficiencies with Targeted Neuromuscular Training
Strengthen trunk control, correct knee valgus & improve knee flexion mechanics.
Progress athletes through controlled plyometrics & cutting maneuvers.
Reassess with CMAS/E-CAST to track improvements & refine training.
Thick Necks, Strong Knees, No Weak Links
A blown ACL isn’t just bad luck—it’s bad movement mechanics.
A high-risk athlete left unscreened is an injury waiting to happen.
And if we’re not integrating movement assessments into training, we’re playing ACL roulette.
Test before they tear. Screen before they snap.
Reactive movements expose weaknesses—train for unpredictability.
Fix the movement. Save the knee. Build long-term durability.
Train Smarter. Stay Thick.
Andreyo E, Unverzagt C, Dos'Santos T, Dawes JJ. Clinical Utility of Qualitative Change of Direction Movement Assessment in ACL Injury Risk Evaluation. Int J Sports Phys Ther. 2024;19(10):1263-1278. Published 2024 Oct 1. doi:10.26603/001c.123483