Optimization of the anterior cruciate ligament injury prevention paradigm: novel feedback techniques to enhance motor learning and reduce injury risk

Primary anterior cruciate ligament (ACL) injury prevention programs effectively reduce ACL injury risk in the short term. Despite these programs, ACL injury incidence is still high, making it imperative to continue to improve cur- rent prevention strategies. A potential limitation of current ACL injury prevention training may be a deficit in the transfer of conscious, optimal movement strategies rehearsed during training sessions to automatic movements required for athletic activities and unanticipated events on the field. Instructional strategies with an internal focus of attention have traditionally been utilized, but may not be optimal for the acquisition of the control of complex motor skills required for sports. Conversely, external-focus instructional strategies may enhance skill acquisition more efficiently and increase the transfer of improved motor skills to sports activities. The current article will present in- sights gained from the motor-learning domain that may enhance neuromuscular training programs via improved skill development and increased reten- tion and transfer to sports activities, which may reduce ACL injury incidence in the long term.