If you have a daughter who plays soccer, chances are you have heard people talk about ACL injuries.

And there is a reason for that.

Female soccer players do experience ACL injuries at a significantly higher rate than male soccer players. A large systematic review found the rate of ACL injury in female soccer players was roughly 2.2 times higher than in males. More recent research in adolescent athletes found girls’ soccer had the highest reported per-season ACL injury risk among the female sports studied.

Those numbers should get our attention.

But I don’t think the answer is to make young female athletes afraid of jumping, cutting, sprinting, lifting weights or playing aggressively.

The answer is to prepare them better.

That’s an important distinction.

We Can’t Promise Injury Prevention

I don’t like telling parents that any program is going to “prevent” ACL injuries.

Sport doesn’t work that way.

Soccer is unpredictable. An athlete can get tangled up with another player, step awkwardly, land on someone else’s foot or find herself in a position that no training program could completely protect her from.

There will always be risk.

What we can influence is how physically prepared that athlete is when she steps onto the field.

Can she produce force?

Can she absorb force?

Can she control her body on one leg?

Can she accelerate and, just as importantly, decelerate?

Can she land effectively?

Can she maintain those abilities when she is tired?

Those are trainable qualities.

And that’s where strength and conditioning becomes so important.

Research continues to support this. A recent consensus review found neuromuscular programs that included components such as strength, balance, agility and change-of-direction training reduced ACL injuries in female athletes by as much as 61%.

That’s not a guarantee.

But it’s certainly something we shouldn’t ignore.

Playing More Soccer Is Not the Same as Preparing for Soccer

This is probably one of the biggest misconceptions I see with young athletes.

An athlete plays school soccer.

Then club soccer.

Then indoor soccer.

Then camps.

Then showcases.

Then summer tournaments.

And because she is constantly playing, everyone assumes she is physically prepared.

Those are two different things.

Playing soccer makes you better at soccer. You improve your technical skills, tactical awareness, decision-making and ability to read the game.

But soccer itself does not necessarily give an athlete the progressive strength development she needs.

Think about what actually happens during a game.

Sprint.

Plant.

Cut.

Stop.

Reaccelerate.

Jump.

Land.

Get bumped.

Recover.

Sprint again.

And as the game goes on, she has to continue doing all of those things while fatigue increases.

That requires a tremendous ability to produce and absorb force.

So the question I think parents should be asking isn’t simply:

“How much soccer is she playing?”

It should also be:

“What are we doing to physically prepare her to handle all of that soccer?”

Stronger Doesn’t Mean Bulky. Stronger Means More Capable.

Strength training for a soccer player doesn’t mean we’re trying to turn her into a powerlifter.

We’re trying to increase her physical capacity.

We want stronger quads, hamstrings, glutes, calves and hips.

We want a stronger trunk.

We want better single-leg strength.

We want her to be able to put force into the ground and control the force coming back into her body.

Then we combine that strength with jumping, landing, sprinting, decelerating and changing direction.

Eventually those movements need to become faster and more reactive because that’s what happens in sport.

There is a huge difference between simply doing exercises and actually developing an athlete.

That’s why progression matters.

Doing the same bodyweight circuit every week isn’t a long-term strength program.

Random workouts aren’t a long-term strength program.

Making an athlete exhausted isn’t the same as making her better.

The goal is adaptation.

And Then There Is the Cost Nobody Wants to Talk About

There is also a financial side to this conversation.

We sometimes hear people look at strength and conditioning and think:

“That’s another expense.”

I understand that.

Families are already paying for club fees, travel, tournaments, camps, private lessons, equipment and everything else that comes with youth sports.

But we also need some perspective.

One large United States study examining more than 14,000 ACL reconstructions reported an average ACL reconstruction cost of approximately $24,700.

And surgery isn’t necessarily the end of the financial impact.

There can also be imaging, orthopedic appointments, physical therapy, braces, follow-up visits, return-to-sport testing and other expenses depending on the individual situation and insurance coverage.

An older economic analysis that also considered indirect costs estimated the lifetime societal cost associated with an ACL tear at approximately $38,000 for patients who underwent reconstruction, with even larger costs possible when long-term consequences were included.

Obviously those numbers vary tremendously from athlete to athlete and family to family.

But here’s the point:

Proper training is not expensive when you compare it with the potential cost of being unprepared.

A year of training with a qualified strength and conditioning professional can cost a fraction of what one major orthopedic injury can cost.

And that’s only talking about dollars.

What is a missed season worth?

What is missing a recruiting summer worth?

What is six to twelve months away from the sport an athlete loves worth?

What about the time parents miss from work driving to appointments?

What about the mental side of rehabilitation?

What about losing an entire year of athletic development?

Those don’t show up neatly on an orthopedic bill.

This Is Where Qualifications Matter

I also think it’s important to make a distinction here.

Just putting an athlete in a weight room isn’t enough.

A good sports performance program should be coached by somebody who understands how young athletes develop and how training should progress over time.

That means understanding strength.

Speed.

Power.

Plyometrics.

Landing.

Deceleration.

Change of direction.

Workload.

Recovery.

Growth and maturation.

Exercise selection.

And how all of those pieces fit around practices, games and the athlete’s competitive season.

There should be a reason behind the program.

There should be progression.

There should be coaching.

There should be feedback.

There should be an understanding of when to push and when to pull back.

That’s one of the reasons credentials such as the Certified Strength and Conditioning Specialist (CSCS) matter to me.

A qualified strength and conditioning coach isn’t there simply to supervise workouts.

Our job is to build the physical qualities the athlete’s sport requires.

The soccer coach should be able to focus on developing a better soccer player.

The strength and conditioning coach should focus on developing a stronger, faster, more powerful and more physically prepared athlete.

And when athletic trainers, physical therapists and medical professionals are involved, everyone should stay within their scope and work together.

That’s what a good performance environment looks like.

Don’t Wait Until After the Injury to Start Caring About Strength

Unfortunately, strength training often becomes important to families after something happens.

An athlete tears an ACL.

Then suddenly she is strength training two or three times per week.

She is doing single-leg work.

Hamstring strengthening.

Landing exercises.

Balance work.

Progressive jumping.

Deceleration.

Return-to-running work.

And everyone becomes extremely committed to getting stronger.

Those things are absolutely necessary during rehabilitation.

But I think we should ask a pretty simple question:

Why do we place such a high value on strength after an injury, but sometimes treat it as optional before one?

Again, strength training doesn’t make an athlete injury-proof.

Nothing does.

But building strength, coordination, power and movement capacity before the athlete needs them gives her a bigger physical toolbox when she steps onto the field.

That’s the investment.

Don’t Stop When the Season Starts

This is another area where we get things backwards.

Athletes train hard all summer.

They get stronger.

They jump higher.

They get faster.

Then their season begins and they completely stop strength training because they are “too busy with soccer.”

That’s when they need those qualities the most.

In-season training shouldn’t look like summer training.

Volume should decrease.

Exercises may change.

Sessions can become shorter.

We have to account for practices, matches, soreness, school and fatigue.

But reducing the dose isn’t the same thing as eliminating it.

You don’t spend months developing strength and power only to completely stop training those qualities when competition begins.

The training changes.

The need for physical preparation doesn’t.

What Are We Actually Investing In?

When parents invest in qualified strength and conditioning, they’re not buying an ACL prevention program.

They’re investing in a better-developed athlete.

An athlete who is stronger.

An athlete who can sprint.

An athlete who knows how to stop.

An athlete who can jump and land.

An athlete who has better control on one leg.

An athlete who understands how to use the weight room.

An athlete who has gradually been exposed to greater forces instead of being asked to suddenly handle them during competition.

And, yes, we’re also trying to reduce the likelihood that an injury derails all of that development.

Research suggests properly implemented training can make a meaningful difference in ACL injury risk.

Will it eliminate ACL tears?

No.

But that’s not a reason to do nothing.

It’s a reason to prepare better.

Because when you compare the relatively small investment required to properly develop an athlete with the financial, physical and emotional cost of a major orthopedic injury, strength and conditioning shouldn’t be viewed as an optional extra.

It should be part of playing the sport.

At Impact, our goal isn’t to scare athletes away from ACL injuries.

Our goal is to build athletes who are better prepared for what their sport is going to ask them to do.

Stronger.

Faster.

More powerful.

More coordinated.

More resilient.

Because we would much rather invest in developing those qualities before an injury forces us to.

Brady Hill, MS, CSCS
Impact Fitness & Sports Performance