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Using hip strength as a predictor for ACL injury, could give you a leg up on the competition

Long have anterior cruciate ligaments (ACL’s) been the season ending injury of athletes in any code. The ACL is a ligament in your knee responsible for stopping the bone in the bottom half of your leg (tibia) from sliding forward when the knee is bent. This is often how an ACL is injured with a foot planted on the ground and a twisting motion of the knee.

As most people who have suffered an ACL rupture will tell you, you become well acquainted with your therapist during the rehabilitation of the injury. As a result, therapist’s are always looking for a way to reduce the risk of these injuries occurring.

How, when and why an ACL ruptures has been thoroughly researched to understand how to prevent this injury from occurring. Imagine if there were a set of tests that your physiotherapist could perform to determine not only your risk of injury but get you started on a course of treatment to reduce the risk of an ACL rupture occurring. We may be closer than you think.

A recent study (Khyambashi et al., 2016) has found that an athlete’s hip strength could be a predictor of non-contact ACL injuries in competitive athletes. These researchers took 501 competitive athletes (138 female and 363 male) participating in various sports. Prior to the season starting the researchers tested the athlete’s hip strength doing two movements, external rotation and abduction (both where isometric contractions).

“Measures of preseason isometric hip abduction and external rotation strength independently predicted future noncontact ACL injury status in competitive athletes”

(Khyambashi et al., 2016)

Hip Abduction

Over the course of their respective sporting season 15 non-contact ACL injuries where confirmed (roughly 3%). These athletes demonstrated significantly lower strength measures in the above hip movements. This indicates a correlation between hip strength and ACL injuries, but why?

Your body joints are connected in what we call a kinetic chain. This often means that if one body part is weak, tight or sore that another body part may be taking the force and compensating. The weakness at your hips can increase the reliance on the muscles surrounding the knee and that load may be more than they can handle, increasing your risk of an ACL injury. At Evolve Health we look at the body as a whole, assessing and taking in the entire kinetic chain to ensure no contributing factors to the injury are missed.

Some exercises to include in your training schedule could be:


Crab walks

Sidelye leg raises with and without resistance bands

Some alternative training methods that focus on hip and core strength:



With preseason’s starting in the next couple of months it is worth discussing how to incorporate some hip strengthening into your warm-ups, cool-downs and training drills to reduce the risk of injury. We are always available at Evolve Health to discuss injury prevention and provide exercise programs for athletes of all shapes and sizes.

And remember,

Live Smart. Evolve.


Khayambashi, K., Ghoddosi, N., Straub, R. K., & Powers, C. M. (2016). Hip muscle strength predicts noncontact anterior cruciate ligament injury in male and female athletes: a prospective study. The American journal of sports medicine, 44(2), 355-361.

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