ABSTRACT
Although intrinsic and extrinsic risk factors for anterior cruciate ligament [ACL] injury have been investigated extensively, the neuromuscular and the biomechanical risk factors associated with this injury in female athletes are not yet well understood. This systematic review summarizes all the relevant biomechanical and neuromuscular risk factors associated with ACL injury. We used electronic databases of PubMed MEDLINE [1966- 2012], SCIENSEDIRECT [1982 - 2012] and Sport Discus [1985- 2012] for literature searching to identify the studies on ACL injury risk factors. We found a total of 152 articles. 52 of these studies had focused on neuromuscular and biomechanical risk factors. Investigation of the articles showed four neuromuscular imbalances: ligament dominance, quadriceps dominance, leg dominance, and trunk dominance. Existing evidence suggests that these four neuromuscular imbalances may be associated with the underlying ACL injury mechanisms. Also, review of the studies indicated that ACL injuries are more likely to occur during multi-planar rather than single-planar mechanisms of injury. Screening and detection of these imbalances are important in order to identify athletes at risk of ACL injury. Identification of faulty movement patterns would allow for implementation of specific interventions, targeted at prevention of these problems