ACL Tear Prevention: 6 Exercises Every Young Athlete Should Do
ACL tears are one of the most devastating injuries in youth sports — and they’re almost entirely preventable. Every week I see high school athletes who’ve just been told they need surgery, and almost every one of them was doing zero ACL prevention work beforehand. That needs to change.
The research is unambiguous: Hewett et al. (1999) showed that a structured neuromuscular training program reduced ACL injury rates by over 70% in female athletes. A 2012 meta-analysis by Sugimoto and colleagues confirmed that injury prevention programs consistently reduce ACL tears — when athletes actually do them.
That last part is the catch. These programs work. But most youth athletes — and their coaches — don’t know what to do or why it matters. This article fixes that.
Why Young Athletes Are at High Risk
Roughly 200,000 ACL tears happen in the U.S. each year. Female athletes are 2–8 times more likely to tear their ACL than male athletes in the same sport — a gap that’s driven largely by biomechanics, not anatomy. The good news: those biomechanical patterns (knee valgus collapse, poor landing mechanics, weak posterior chain) are trainable.
Young athletes are especially vulnerable during growth spurts, when their nervous system hasn’t fully caught up to their new limb lengths. That’s exactly the window when these exercises matter most — and when most coaches are focused on skill work instead of movement quality.
The six exercises below target the root causes of ACL injury: hamstring weakness, poor single-leg stability, weak hip abductors and adductors, and faulty landing mechanics. Add them to your warmup or strength program 2–3 times per week.
6 ACL Prevention Exercises Every Young Athlete Should Master
1. Nordic Hamstring Curls
This is the single most evidence-backed exercise for ACL prevention. The Nordic hamstring curl builds eccentric hamstring strength — the kind that controls knee deceleration during running and cutting. A 2015 systematic review found it reduces hamstring injury rates by 51%. Strong hamstrings act as a co-contractor to the ACL, protecting it under load.
How to do it: Kneel on a pad with feet anchored (partner holds your ankles, or use a lat pulldown machine). Keeping your body straight from knee to shoulder, slowly lower yourself toward the floor using only your hamstrings to resist. Catch yourself at the bottom, push back up. Start with 3 sets of 5 reps and build over 6–8 weeks.
Coaching cue: Don’t let your hips bend. The goal is a straight-line fall controlled entirely by your hamstrings.
2. Single-Leg Squat (Bulgarian Split Squat)
Most ACL tears happen on one leg. So your training needs to reflect that. Single-leg squat variations expose and fix the side-to-side strength asymmetries that bilateral squats hide. The Bulgarian split squat — rear foot elevated on a bench — is the best version for athletes because it loads hip flexor mobility alongside quad and glute strength.
How to do it: Stand 2–3 feet in front of a bench, place the top of your back foot on it. Lower your back knee toward the floor while keeping your front shin as vertical as possible and your front knee tracking over your second toe. Do 3 sets of 8–10 reps per side. Add a dumbbell in each hand once you’ve mastered the movement.
Watch for: Front knee diving inward on the way down — that’s knee valgus, the exact pattern that tears ACLs. Fix it before adding load.
3. Lateral Band Walks
Weak hip abductors are a primary driver of knee valgus collapse — the inward caving of the knee that happens under load. Lateral band walks are a low-complexity, high-value way to activate and strengthen the gluteus medius, which is the main muscle resisting that collapse.
How to do it: Place a resistance band just above your knees (or around your ankles for more challenge). Stand in a quarter-squat position — slight bend at hips and knees, feet hip-width apart. Step laterally 10–15 steps in each direction, maintaining the squat position throughout. Keep tension in the band the entire time. 3 sets per direction.
Common mistake: Athletes rush this and lose the squat position, turning it into a standing hip hike. Slow it down. Position matters more than distance.
4. Single-Leg Romanian Deadlift (RDL)
This exercise hits three things at once: posterior chain strength, single-leg balance, and hip hinge mechanics. It builds the hip and hamstring strength that keeps athletes upright and controlled during deceleration — which is when most ACL tears happen.
How to do it: Stand on one leg with a slight bend in the standing knee. Hinge at the hip, letting your torso tip forward while your non-standing leg extends behind you. Lower until your torso is roughly parallel to the floor (or as far as your hamstring flexibility allows without rounding your back). Return to standing by driving your hip forward. Hold a dumbbell in the opposite hand for a cross-body variation. 3 sets of 8 per leg.
Cue: Imagine your back foot and torso are one rigid plank — rotate around your hip as the hinge point.
5. Jump Landing Mechanics (Box Jump with Deceleration)
Teaching athletes to land safely is probably the most underutilized ACL prevention tool. The FIFA 11+ program, which has been shown to reduce injury rates by up to 50% in female soccer players, dedicates significant attention to jump-landing mechanics for exactly this reason.
How to do it: Stand in front of a box 12–18 inches high. Jump onto the box, then step down and immediately perform a controlled two-foot landing, absorbing the force through your hips and knees (not just your knees). Land softly — think “quiet feet.” The key is landing in an athletic position: knees bent, hips back, chest up, knees tracking over toes. Progress to single-leg landings once two-foot mechanics are solid.
Red flag: Any inward collapse of the knees on landing. Stop, cue, reset — don’t let athletes groove a bad pattern under fatigue.
6. Copenhagen Adductor Exercise
The adductors are chronically undertrained in most sport programs. They play a direct role in pelvic stability and knee control — and weakness here contributes to groin injuries AND ACL vulnerability. The Copenhagen adductor exercise builds inner thigh strength in a functional, loaded position.
How to do it: Lie on your side with your top leg resting on a bench at knee height (ankle on bench for a modified version). Keeping your body straight, lift your bottom leg to meet your top leg — you’re using your adductors to raise your bottom leg, not just your core. Lower slowly. 3 sets of 8–10 reps per side. This one is harder than it looks — most athletes are shocked by how weak they are here on the first session.
How to Implement These Exercises
The athletes who get the most out of these exercises are the ones who start them before they get hurt — ideally in the off-season or early pre-season. Doing them 2–3 times per week for 6–8 weeks produces measurable improvements in hamstring strength, landing mechanics, and hip stability.
These aren’t complicated exercises, but technique matters. Knee valgus during a single-leg squat, or using your spine instead of your hip during an RDL, can reinforce the same bad patterns you’re trying to fix. That’s why having a sports PT or strength coach watch your mechanics early in the process is worth the time.
For athletes who want a full ACL injury prevention program, or who are already managing knee symptoms, a one-on-one assessment at Helix gives us a chance to identify your specific weak links — hip strength deficits, asymmetries, landing tendencies — and build a targeted plan around them.
Learn These at the Helix Performance Lab
At the Helix Performance Lab, we work with athletes on exactly this kind of foundational movement work — not just after injuries, but before them. Our space is built for athletes: Keiser equipment, open turf, and coaches who understand the difference between training and physical therapy (and when you need both).
If your athlete is in-season and grinding through a sport, or you’ve got a growth spurt kid who looks like a baby giraffe on the field right now, come in. We’ll assess where the risk is and build the program to address it. ACL prevention isn’t magic — it’s consistent, targeted work done before something goes wrong.
For athletes already dealing with knee pain or recovering from a prior ACL injury, see our ACL rehab and return-to-sport program. And if you’re working on overall athletic development alongside injury prevention, check out our sports performance services.
Ready to Take the Next Step?
At Helix Sports Medicine, we provide one-on-one care for athletes and active adults in the Austin and Lakeway area. Whether you’re recovering from an injury, optimizing performance, or looking for expert guidance on injury prevention — we’re here to help.
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