Do healthy athletes exhibit at-risk biomechanics for anterior cruciate ligament injury during pivoting movements?

A consistent injury mechanism involving multiple joints has been highlighted in athletes experiencing anterior cruciate ligament (ACL) rupture. However, if and to what extent healthy athletes incur an unsafe biomechanical profile during high-dynamics movements is unknown. The present study aimed to investigate the occurrence of the ACL risk profile in a competitive pivoting sports population.Thirty-four athletes (22.8 ± 4.1 y) performed a frontal deceleration and a change of direction at 90°. Full-body kinematics was collected through 15 wearable inertial sensors (Awinda, Xsens). Nine ACL risk factors were defined based on four categories: limited lower limb flexion, valgus collapse, foot rotation and trunk rotation. A movement trial was considered 'at-risk' in the presence of at least 5 simultaneous risk factors. The rate of athletes with at-risk movements was assessed and multivariate regression for associated outcomes was conducted.The overall rate of injury profile occurrence was 9-12%. The injury profile was identified at least in one trial in 24 athletes (71%) and three trials in 5 athletes (15%). Significant associations were found for higher approaching speed (OR = 4.3) and female sex (OR = 4.8). A large occurrence of the typical ACL injury biomechanical profile was noticed. Large screenings are advisable to identify at-risk athletes and promote preventative strategies.