A simple exercise program that teaches girls how to land correctly as they play, run and jump on the soccer field decreased the incidence of serious knee injuries in these athletes by 77 percent, according to a study.

The findings are significant because female athletes are up to eight times more likely than men to tear a band of tissue in their knees called the anterior cruciate ligament, or ACL; and these injuries, which destabilize the knee, often lead to the development of osteoarthritis (OA) later in life.

For the study, Swedish researchers split 1,506 girls between the ages of 13 and 19 into two groups – one received the intervention program, the other did not.

A physical exercise program, called HarmoKnee, was designed for the players and combined with education of the athletes, their parents and their coaches about injury risk.

The program aimed to improve motor skills, body control, balance and muscle activation through a combination of exercises that are known to all soccer players and coaches. What was new, researchers say, was combining those exercises with a focus on performing each exercise in a proper manner. 

“The program includes warm-up exercises such as jogging and high-knee skipping, muscle activation, balance training with different jumping exercises, strength and core stability such as sit-ups,” says Liisa Byberg, PhD, the lead author who works in the Department of Surgical Sciences at Uppsala University, in Sweden.

There were three knee injuries in the intervention group that received the training and 13 in the control group that did not – a 77 percent reduction.  

“We believe that our study shows that it is possible to prevent many of these injuries,” Byberg says.

What’s more, among girls in the intervention group, the injuries that did occur were less severe than the ones in the control group. 

All three injured players in the intervention group regained full activity within six months, while only four of the 13 injured in the control group did the same. Researchers theorize that could be due in part to increased strength from the exercises providing more knee stability.

The study was published in the Archives of Internal Medicine.

Dr. Mitchell H. Katz, MD, director of the county health department in San Francisco, wrote the editorial accompanying the study.

“Probably at least part of my interest is that I have a 6-year-old girl who plays soccer, and I know from the literature that girls are more prone to knee injuries while playing soccer than boys are. I want her to be active but I also don’t want her to have a severe injury,” Dr. Katz says.

Dr. Katz says he liked this study because it’s a straightforward program that makes sense.

“People often say before you exercise, you should stretch out. But that doesn’t mean that all stretching is the same. If you don’t do the right exercise, you wont get the right effects. Part of what I thought was so strong about this particular study is they compared it to the routine exercises the girls were doing. They showed that if you want to prevent injury, you need to carefully figure out what causes the injury. You need to figure out how is the best way with exercise to prevent it,” Dr. Katz says.

While this study is soccer specific, Dr. Katz thinks there is an opportunity to expand the results to other sports and help a wider group of athletes.