Reducing ACL injury risk through unilateral strength training

As strength and conditioning coaches and therapists, improving speed, agility, and strength is just a portion of what we focus on. Our most important job is to reduce the chances of athlete injury as much as we possibility can.

ACL injuries are prevalent, especially as young athletes face an increased volume of sport-specific time through practice, training, or game days, with shrinking rest periods. We do our best to empower our athletes to advocate for themselves, but we also stay up on the latest research to do our best to “bulletproof” them in training. While we can’t eliminate injuries entirely, we do use evidence-based programming to reduce them as far as we can.

Single leg training (also know as unilateral training) is one of the tools in our toolbox to reduce the chances of athlete injury. Specifically, individualized training interventions that are based on the unique needs of each athlete is our most important tool in our tool box.

Let’s get into it!

Why do athletes injure their ACL?

Why this is could be is any number of reasons:

  1. Lack of neuromuscular control, awareness, or reflexes

  2. Lack of trunk stability

  3. Anatomical or hormonal differences between genders (women are 4-8x more likely to injure their ACL)

  4. Lack of access to quality training

  5. Cultural discouragement to train (women in particular)

  6. Freak contact injury

And while we don’t know the exact mix of factors as they are almost impossible to isolate, and the research is mixed, we do know what areas we can influence:

  1. Access to quality training

  2. Empowering our athletes to own the benefits of training

  3. Increased neuromuscular awareness (agility, change of direction, and more)

  4. Increased trunk stability

Why we use unilateral training to shore up weaknesses

Single leg training has been proven to significantly lower the ACL risk profile of athletes (2). In Can Unilateral Strength Training Optimize Change of Direction Mechanics and Mitigate Anterior Cruciate Ligament Injury Risk in Female Soccer Players, the authors discover that single leg training dramatically lowered the risk. Cutting and change of direction angles improved across the board. The authors observed improved knee alignment, foot placement, and trunk stability.

While that study only looked at female soccer players, these training interventions and conclusions can be expect across all genders.

We’re combining a single leg RDL with the Power Plate. The vibrations increase the blood flow and the intensity.

What does single leg training look like in a typical training program?

In a given training day, there is at least one single-leg movement in every athlete’s program.

Usually, our athletes will see a mix of:

  1. Single Leg Plyometrics (jumps, landings, etc.)

  2. Single Leg Deadlift variations

  3. Split Squats

  4. Copenhagen Planks

  5. Split Jerks

And when our athletes are training those movements, these knee-stabilizing muscle groups are benefiting:

  1. Hamstrings

  2. Quadriceps

  3. Hip Flexors

  4. Hip External Rotators and Abductors

We’ve deployed a variety of knee monitoring assessments over the years as well.

At the same time, I want to be totally clear. Our athletes haven’t been immune to injury. But, through our assessment processes and our individualized training interventions, we are making it less likely every day.

You could benefit from our expertise, too.

We’ve been training athletes in central Indiana and across the United States remotely for 7 years. Drop us your details, and let’s figure out together how to tackle your goals!

References

  1. Mancino F, Kayani B, Gabr A, Fontalis A, Plastow R, Haddad FS. Anterior cruciate ligament injuries in female athletes: risk factors and strategies for prevention. Bone Jt Open. 2024 Feb 5;5(2):94-100. doi: 10.1302/2633-1462.52.BJO-2023-0166. PMID: 38310925; PMCID: PMC10838619.

  2. Rogalski, A., Moiroux-Sahraoui, A., Stergiou, M., Pieulhet, M., Douryang, M., & Forelli, F. (2025). Can Unilateral Strength Training Optimize Change of Direction Mechanics and Mitigate Anterior Cruciate Ligament Injury Risk in Female Soccer Players? A Preliminary Pre-Post Intervention Study. Sports (Basel, Switzerland), 13(5), 135. https://doi.org/10.3390/sports13050135

Coach J