Oslo Sports Trauma Research Center

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Information about project titled 'Risk factors for ACL-injuries in elite female football players'

Risk factors for ACL-injuries in elite female football players

Details about the project - category Details about the project - value
Project status: Published
Project manager: Tron Krosshaug
Supervisor(s): Roald Bahr, Thor Einar Andersen
Coworker(s): Eirik Kristianslund, Agnethe Nilstad, Kathrin Steffen, Grethe Myklebust, Kam Ming Mok


Non-contact anterior cruciate ligament (ACL) injuries represent a major problem in team sports such as handball and football. The incidence of non-contact ACL injuries is particularly high in female team sport athletes, and female football players have a 2-3 times higher risk of sustaining an ACL injury compared to male players. To prevent the occurence of ACL injuries from happening, we need to understand the complexity of risk factors and injury mechanisms.


The objective of the present study is to increase our knowledge with regard to risk factors for ACL-injuries in elite female football players. In this prospective cohort study we will investigate whether various biomechanical, neuromuscular and anatomical factors can predict the risk of sustaining a future ACL-rupture. By using a cross-sectional design, we also will explore the risk factors by comparing ACL-injured and non-injured players at baseline.



All teams in the elite female football league (N=12 teams, approx 220 players per season) have agreed to participate in this study. The teams will be tested at the Norwegian School of Sport Sciences in February and March 2009. Similar screening tests will be conducted for new teams and players each season for the following seasons (2010-14). In February 2011, all the players tested in 2009 will be invited for re-testing to assess the potential change in test variables.

After the baseline testing, ACL-injuries will be recorded for all team activities throughout the 2014 season. In addition, a complete injury registration will be conducted in the 2009 football season to describe the injury patterns in elite female football players.


Screening tests      

The test stations include marker-based 3D motion analysis of vertical drop jumps and cutting maneuvers to to calculate knee, hip and ankle joint kinematics and kinetics.

In addition, a series of anatomical and neuromuscular screening tests are included; knee joint laxity, generalized joint laxity, foot pronation, hip anteversion, anthropometric measures, maximal muscle strength of the quadriceps, hamstrings and hip abductors, balance tests, hamstrings flexibility and clinical assessement of frontal plane knee control. We have also included a questionnaire to assess history of previous injuries, low back pain and knee function, as well as a blood sample to investigate the relationship between genetic variants and ACL injury.


The results from this study will help identifying potential risk factors for ACL injuries in female athletes. With this information we can improve injury prevention programs and target those to the population at risk.