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Background: Injury to the anterior cruciate ligament is one of the most common knee injuries. Following anterior cruciate ligament reconstruction, strength deficits and reduced quadriceps and hamstring muscle mass are common. Traditional strengthening protocols recommend the use of heavy loads. However, following surgery, heavy-load exercises are contraindicated to protect the joint and graft. Blood flow restriction resistance training is an alternative that optimizes muscle recovery. The aim of this study was to evaluate the effects of blood flow restriction resistance training on muscle mass and strength after ACLR. Methods: The Pubmed, Cochrane Library, and PEDro databases were used to constitute the corpus of this systematic review. The methodological quality of the studies was assessed with the Cochrane Collaboration's analysis grid. Results: Thirty-four articles were identified in the initial search, and five randomized controlled trials were included in this review. Not all studies reported significant results regarding strength and muscle mass. Two of these studies observed a significant improvement in strength associated with blood flow restriction resistance training compared with the control group. A significant increase in muscle mass was observed in one study. Conclusions: The blood flow restriction resistance training method shows superior efficacy to training without occlusion, yet this device has not been shown to be more effective than heavy-load resistance training in terms of muscular strength and muscle mass. Blood flow restriction resistance training shows superior efficacy in both these variables when used with low loads. However, there are still few random controlled trials on this subject, and this review presents their limitations and biases. Future research is needed on guidelines for the application of blood flow restriction resistance training in clinical populations. [ABSTRACT FROM AUTHOR]

The article focuses on advocating for a holistic approach to female athlete health and performance, moving beyond the narrow focus on the menstrual cycle as a key determinant. Topics include the influence of gendered sociocultural factors on performance and access to resources; the psychological challenges faced by female athletes in sports environments; and the need for interdisciplinary support systems to address these complex issues comprehensively.

Arthrogenic Muscle Inhibition (AMI) is a phenomenon observed in individuals with joint injury or pathology, characterized by a reflexive inhibition of surrounding musculature, altered neuromuscular control, and compromised functional performance. After anterior cruciate ligament reconstruction (ACLR) one of the most obvious consequences of AMI is the lack of quadriceps activation and strength. Understanding the underlying mechanisms of AMI is crucial for developing effective therapeutic interventions. The surgical procedure needed to reconstruct the ACL has biochemical et physiological consequences such as inflammation, pain, and altered proprioception. These alterations contribute to the development of AMI. Therapeutic interventions aimed at addressing AMI encompass a multidimensional approach targeting pain reduction, inflammation management, proprioceptive training, and quadriceps activation. Early management focusing on pain modulation through modalities like ice, compression, and pharmacological agents help mitigate the inflammatory response and alleviate pain, thereby reducing the reflexive inhibition of quadriceps. Quadriceps activation techniques such as neuromuscular electrical stimulation (NMES) and biofeedback training aid in overcoming muscle inhibition and restoring muscle strength. NMES elicits muscle contractions through electrical stimulation, bypassing the inhibitory mechanisms associated with AMI, thus facilitating muscle activation and strength gains. Comprehensive rehabilitation programs tailored to individual needs and stage of recovery are essential for optimizing outcomes in AMI. The objective of this clinical viewpoint is to delineate the significance of adopting a multimodal approach for the effective management of AMI, emphasizing the integration of pain modulation, proprioceptive training, muscle activation techniques, and manual therapy interventions. Highlighting the critical role of early intervention and targeted rehabilitation programs, this article aims to underscore their importance in restoring optimal function and mitigating long-term complications associated with AMI. [ABSTRACT FROM AUTHOR]

(1) Background: Shoulder pathologies are mostly found in overhead sports. Many risk factors have been identified, in particular a deficit in the kinetic chain. The aim of this review was to find out whether prevention by strengthening the kinetic chain can have an impact on the rate of shoulder injury in overhead pitching athletes. (2) Methods: A systematic review of the literature was carried out, including studies on the role of the kinetic chain in the prevention of overhead athletes. The studies used were works published over the last 10 years searched on PubMed, Cochrane Library, PEDro and Science Direct. They were also analyzed by methodological quality scales: the PEDro scale and the Newcastle–Ottawa scale. (3) Results: Eight studies met the inclusion criteria. The studies analyzed revealed a significant correlation between the use of the kinetic chain and the prevention of shoulder injuries, associating factors such as muscle strength, physical performance in tests (CMJ, FMS), static and dynamic balance and the ability to transfer energy from the lower to the upper body. (4) Conclusions: It is important to integrate core stability work and lower limb strengthening to minimize excessive stress on the shoulder complex, while optimizing force production and performance. [ABSTRACT FROM AUTHOR]

Introduction: After anterior cruciate ligament reconstruction (ACLR), studies have demonstrated early use of OKC did not seem to affect the graft healing process and laxity. Objective: The main objective was to determine whether quadriceps and hamstring strengthening in a rehabilita- tion program involving early open kinetic chain (OKC) and/or closed kinetic chain (CKC) knee joint exercises had an influence on graft laxity at 1, 3 and 6 after ACLR. The secondary objective was to assess whether the early use of OKC exercise affects intrinsic graft laxity between 1 and 6 months postoperatively. Design: Non randomized, single blinded, prospective case control study Methods: This study included 53 patients following a ACLR with hamstring graft. Participants were retrieved from 2 rehabilitation centers that followed different ACLR rehabilitation programs with regards the use of OKC exercises; the intervention group (n= 25) that performed OKC and CKC exercises in combination and the control group (n=28) that performed only CKC exercises. (1;2) Anterior knee laxity was measured using the GNRB device on the operated limb, and compared to the contralateral control limb. Three evaluations were performed at 1, 3 and 6 months after the ACLR. The difference between both limbs was calculated and used to determine the variation in anterior laxity throughout the first 6 months after surgery. (1;3) Results: No differences were observed in knee laxity at 1 (p = 0.263), 3 (p = 0.263) and 6 months (p = 0.256) follow up between intervention group and control group. No differences were observed in within-group graft laxity between 1 and 6 months after ACLR in intervention group (p = 0.155) and control group (p = 0.690). Conclusion: The initiation of OKC exercises doesn't seem to increase the ACLR graft laxity as compared to the rehabilitation program with only CKC exercises. [ABSTRACT FROM AUTHOR]

Introduction: Motor control deficits persist after anterior cruciate ligament reconstruction (ACLR), and are more than often responsible for bad return to play ability and reinjuries.Current information still lacks on the potential deficits in specific lower limb muscle activation during sport's specific tasks, or even basic tasks such as jumping Objective: The aim of this study was to measure muscular activity of the lower limb in patients performing single leg tasks during their rehabilitation process after ACLR. Design: Non randomized, Prospective, Case control study Methods: This study included 59 participants divided into two groups, a test group (n=31) which included patients after ACLR (5.6 ± 2.1 months) with a hamstring graft and a control group (n=28) including healthy subjects. Partici- pants were asked to perform four tries of both a Single Leg Counter Movement Jump (SLCMJ) and a Single Leg Drop Landing (SLDL), on each leg in a randomized order.1,2 The muscular activity of Vastus Medialis, Gluteus Medius, Soleus and of the Lateral et Medial Gastrocnemii was recorded. Raw EMG data was treated via Root Mean Square and maximum normalized value were used for the analysis and compared between groups. Results: Significant results showed a lower Soleus activity (-26.1%, p-value = 0.01), as well as a higher Vastus Medialis (+17.2, p-value = 0.03) and lower Gluteus Medius (-7.50%, p-value = 0.01) in the test group for the SLCMJ. Similar results were found in the SLDL, adding a lower Medial Gastrocnemius activity (-41.0%, p < 0.01). Other muscle showed non-significant differences between both groups. Conclusion: Neuromotor deficits are present after ACLR and can be linked to specific neuromuscular patterns, which may also help our current strength and function-based return to sport decision making, allowing athletes to return to their practice in better condition and decreased risks of injury. [ABSTRACT FROM AUTHOR]

Background: Return to run (RTR) after anterior cruciate ligament reconstruction (ACLR) is an important step in the return to previous performance. Generally, postoperative time (12-weeks) help clinicians in RTR decision making but it seems important to recover strength, mobility, functional and psychological qualities to optimize the RTR. Objectives: The aim of this study was to analyze the RTR self-perceived quality with physical, functional and psychological parameters at 6 months after ACLR. Design: Cross-sectional study Methods: This study included 130 patients at 6 months after ACLR. The patients performed the international knee documentation committee (IKDC) subjective knee form, the anterior cruciate ligament - return to sport after injury (ACL-RSI) scale, strength and functional assessment. Limb symmetry index (LSI) and peak torque to body weight ratio (PT/BW) were assessed with isokinetic dynamometer for quadriceps (Q) and hamstring (H) in concentric mode at 60°. s-1, 240°. s-1, and eccentric mode at 30°. s-1. Functional assessment was performed with MyJump app and included knee range of motion (ROM), hop tests (single, triple and triple cross over for distance) and single leg vertical drop jump. All participants were assigned in 2 groups : RTR with pain (G1, 33.6%) and pain-free RTR (G2). Results: G2 showed significantly higher quadriceps PT/BW than G1 (1.8 ± 0.4 N.kg -1 vs. 2.3 ± 0.5, p = 0.05), but similar LSI Q (81.1% ± 14.8; 80.2% ± 15.1 ; p = 0.008). ACL-RSI (p = 0.22) and IKDC (p = 0.43) scores were lower in G1 compared to G2. No significant results were found for ROM and hop tests in both groups. Conclusion: These findings indicate that quadriceps strength seems to be a key performance discriminator to allow for safe RTR. Besides, IKDC and ACL-RSI may help athletes and clinicians in RTR decision making. [ABSTRACT FROM AUTHOR]

Introduction: After anterior cruciate ligament reconstruction (ACLR), jump tests allow to help return to sport decision making. Objective: The main objective was to examine countermovement jump (CMJ) measures to identify which parameters can best distinguish between ACLR and control participants. The secondary objective was to determine whether performance alterations between operated and non-operated limb exist during vertical two-legged activities after ACLR Design: Non randomized, single blinded, prospective case control study Methods: This study included 67 patients with hamstring graft and no contact injury at 6 postoperative months (203.5 days ± 32.2) and 47 healthy athletes (25,2 ± 6,6 years old) with no knee injury history. Two groups were formed, an ACLR group (n=67) and a control group (n=47). The evaluation of CMJ by force plate was performed to calculate vertical ground reaction force (vGRF), maximal power (MP) and eccentric rate force development (RFDe) during landing and limb symmetry index (LSI). (1-3) First analysis compared LSI vGRF, LSI MP and LSI RFDe between both groups during CMJ. Secondary analysis compared vGRF, MP and RFDe between operated/non-operated limb in the ACLR group and dominant/non-dominant limb in the control group. Results: At 6 months after ACLR, CMJ measures in the ACLR group were significantly reduced compared to the control group for LSI vGRF (- 8.7% ; p < 0,001), LSI MP (- 10.8% ; p < 0,001) and LSI RFDe (- 8.7% ; p < 0,001). Secondary analysis showed no significant result in control group between dominant/non-dominant limb. ACLR group showed significant results between operated / non-operated limb for vGRF (+1.4 N.kg-1 ; p < 0,001), MP (+2.6 W.kg-1 ; p < 0,001) and RFDe (+ 375.3 N.s-1 ; p < 0,01). Conclusion: Landing performance and deceleration should be better considered at time to return to sport after ACLR. [ABSTRACT FROM AUTHOR]

Recurrent sports injuries present complex challenges that extend beyond the playing field, impacting athletes' physical well-being, mental resilience, and financial stability. This review outlines a comprehensive framework designed to prevent and manage these setbacks, empowering athletes to achieve sustained performance and recovery. This multidimensional issue requires an integrative approach encompassing physical rehabilitation, psychological resilience, and nutritional strategies. Physically, injury prevention relies on tailored rehabilitation programs that address athletes' specific injury histories and sport-related demands. Techniques such as biomechanical assessments and neuromuscular training correct faulty movement patterns, while workload monitoring ensures a balance between training and recovery. Strength and conditioning programs have demonstrated success in reducing injury rates and enhancing musculoskeletal resilience. Psychologically, reinjury anxiety and mental disengagement are key barriers to recovery and performance. Interventions such as goal setting, mindfulness, and cognitive restructuring rebuild confidence and foster readiness to return to play. Addressing psychological well-being is as critical as physical health in promoting sustained performance. Nutrition is equally pivotal, with balanced macronutrient intake supporting energy and tissue repair and micronutrients (magnesium, manganese, vitamin D, selenium, zinc, coenzyme Q10, etc.) bolstering bone health. Anti-inflammatory nutrients and proper hydration reduce muscle strain and aid recovery, while personalized dietary strategies meet the specific demands of individual sports. By integrating these physical, psychological, and nutritional dimensions, this framework empowers athletes, coaches, and medical teams to minimize injury recurrence and enhance long-term performance, ensuring athletes remain competitive and resilient in their sporting pursuits., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Forelli et al.)

Introduction: Anterior cruciate ligament (ACL) reconstruction (ACLR) is the gold standard for treating ACL injuries, particularly in soccer players who are at a high risk of knee injury. While professional athletes often return to sport (RTS) within 7-10 months after ACLR, non-elite players experience significant delays. There is a need to investigate neuromuscular deficits and functional asymmetries in the non-elite group, which may persist even after clearance for RTS. This study aims to evaluate the functional movement patterns, single-leg balance, and isokinetic knee strength in non-elite soccer players preparing to RTS. Additionally, correlations between the aforementioned parameters were explored., Methods: A cohort of 69 male, non-elite soccer players (mean age: 24.32±8.56 years) who underwent ACLR with a hamstring graft was recruited. Functional assessments were conducted at the mean time of nine months post-surgery, and all participants were clinically cleared by the surgeon. The evaluation included the Functional Movement Screen™ (FMS), single-leg balance tests (SLBT) on stable and unstable platforms, and isokinetic strength tests (IST) for knee flexion and extension at 60 deg·s -1 and 180 deg·s -1 . Limb symmetry indices (LSIs) were calculated. Statistical analyses included t-tests, Mann-Whitney U tests, and Spearman correlations., Results: The mean FMS score was 15.45±2.23, indicating moderate functional movement quality. SLBT results revealed no significant (P>0.05) inter-extremity differences in stability indices, regardless of platform setting (stable or unstable). However, significant deficits in quadriceps and hamstring strength were observed in the ACLR extremity. At 60 deg·s -1 , the mean peak torque/body weight (PT/BW) ratio for knee extension was 2.01±0.65 Nm.kg -1 for the ACLR side versus 2.60±0.57 Nm.kg -1 for the contralateral side (P<0.0001). Similar asymmetries were observed at 180 deg·s -1 (1.51±0.44 vs. 1.88±0.35 Nm.kg -1 ; P<0.0001). LSIs for quadriceps were markedly reduced, averaging 76.97±17.72% at 60 deg·s -1 and 79.89±17.11% at 180 deg·s -1 . At 60 deg·s -1 , the mean PT/BW ratio for knee flexion was 1.24±0.34 Nm.kg -1 for the ACLR side versus 1.39±0.32 Nm.kg -1 for the contralateral side (P=0.009) at 180 deg·s -1 (1.03±0.27 vs. 1.16±0.25 Nm.kg -1 ; P=0.003). LSIs for the hamstring were averaging 89.34±13.91% at 60 deg·s -1 and 88.44±14.58% at 180 deg·s -1 . Weak negative correlations were found between FMS scores and stability indices (e.g., r=-0.26 for overall stability index on unstable platform; P=0.031), while moderate positive correlations were observed between PT/BW ratios and FMS scores (r=0.36-0.60; P<0.001)., Conclusions: Significant strength asymmetries in quadriceps and hamstring muscles persist in non-elite soccer players after ACLR. While balance deficits were minimal, weak correlations between FMS scores and stability indices suggest a link between functional movement quality and dynamic control. These findings highlight the need for targeted strength training in rehabilitation and the importance of comprehensive assessments, including functional performance tests, strength evaluations, and balance analysis, to ensure safe RTS. Achieving clinical clearance does not equate to full recovery, emphasizing the necessity for a multidimensional approach to RTS decisions., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. The Bioethics Committee at the Silesian Chamber of Physicians issued approval ŚIL.KB.711.2022.MP. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Biały et al.)

Objectives: To investigate the prevalence, risk factors, and impact of physiotherapy on ankle sprain recurrence among professional and amateur athletes in the West region of Cameroon., Methods: Cross-sectional study from February to July 2024 in the West region of Cameroon sports clubs. Professional and amateur athletes practice their sport at least three times a week. The main outcomes are reported as the prevalence of the first ankle sprain, the prevalence of recurrence, and the factors associated with recurrence (bivariate analysis, significance set at P<0.05; 95% CI)., Results:  Among the 215 participants, the prevalence of first ankle sprain was 72.6% (156). Of these 156 athletes, only 70 received physiotherapy (44.9%) and only 56 athletes had functional recovery before restarting sport (35.9%). The main barrier to physiotherapy intervention was the lack of knowledge. The prevalence of recurrence was 61.5% (96/156), with significant associations found between recurrence and professional athlete status (aOR: 2.48; CI: 1.09-4.29; P<0.001) and hand-on-ball sports participation (aOR: 4.72; CI: 1.08-29.62; p=0.04). Conversely, physiotherapy intervention (aOR: 0.65; CI: 0.26-0. 98; p=0.01), functional recovery before return to play (aOR: 0.41; CI: 0.05-0.84; p<0.001), and moderate sports frequency (aOR: 0.81; CI: 0.28-0.91; p=0.03) demonstrated protective effects against recurrence., Conclusion: Education and awareness campaigns are necessary to promote physiotherapy intervention and reduce the burden of ankle sprain recurrence among athletes in Cameroon and Sub-Saharan Africa., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Cameroon West Regional Ethics Committee issued approval No:636/26/06/2024/CE/CRERSH-OU/VP. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Ghassi et al.)

Background: Hamstring injuries are a major problem in sports involving sprinting, such as soccer, rugby, and track and field, and lead to sports stoppages and psychological, social, and financial repercussions. For several years now, these injuries have been stagnating or even increasing. Preventing these injuries is therefore a fundamental issue for at-risk athletes. The aim of this study was to compare the electromyographic (EMG) activity of the hamstrings in athletes during sprinting, Nordic hamstring exercise (NHE), and high-speed concentric exercise on an isokinetic dynamometer., Methods: A pilot study was conducted on a population of 15 sprint-exposed field athletes (22.54 ± 3.71 years, Tegner score ≥ 6) with no history of hamstring injury in the last six months. The protocol included a warm-up, followed by three repetitions of the NHE, two sets of 10 repetitions on the isokinetic dynamometer at 300°/sec, and a maximal sprint. Exercises were randomized for each subject, and muscle activity was assessed using wireless EMG sensors during each test. EMG data were normalized to the measured maximum voluntary isometric contraction (MVIC), and test results were statistically analyzed to determine which exercise resulted in maximal hamstring activation., Results: Comparison of hamstring muscle activity between exercises showed a significant difference for most of our results (p-value < 0.05). The results show significantly higher mean hamstring activity during sprinting (0.4800 ± 0.19 μV) compared with strengthening exercises. The NHE (0.3201 ± 0.09 μV) was the second most active exercise. In the last place was the high-speed concentric exercise on the isokinetic machine, which produced less activation than the other exercises (0.2487 ± 0.07 μV)., Conclusions:  Sports involving sprinting are at risk of a hamstring injury but it appears that its use in rehabilitation and prevention of hamstring injury is relevant, as it would allow high-intensity muscle activation to prepare the hamstring for this type of loading. However, it is also fundamental to integrate strengthening exercises such as NHE in combination with sprinting in our rehabilitation. Finally, the use of the isokinetic dynamometer does not constitute a first-line choice for hamstring injury management., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Commission nationale de l'informatique et des libertés issued approval 2224821 v 0. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Moiroux-Sahraoui et al.)

Background: Sprinting is a type of running that consists of producing a short and intense effort in order to perform maximal speed in a short period of time. Sprinting is widely investigated because of the multiple and complex mechanisms involved. Sprint studies are now focusing on how to improve performance by focusing their analyses on the mechanic variables. The hamstrings are part of the most important muscle groups during sprinting because of their role of stabilization and propulsion, but they must be able to produce the maximum strength during a short moment, this ability is characterized by rate of torque development (RTD). The main of this study was to investigate the association between hamstring RTD (Nm.s -1 .kg- 1 ) and mechanical variables composed of maximal power output (Pmax) (W.kg -1 ), maximal theoretical velocity (V0) (m.s -1 ), and maximal horizontal force production (F0) (N.kg -1 ) on short sprints in elite sprinters., Methods: For this clinical trial, we used a research method based on data collection. A single group composed of four male and one female elite sprinters (age: 17.2 ± 1.79 years) has been included in this study. The sprinters performed a hamstring strength test, which included five trials of four seconds for each leg. This test required a portable dynamometer, the Kforce®, to collect 100 and 200 milliseconds RTD. Then the subjects were submitted to a sprint test. My Sprint® application has been used to collect the sprint mechanical variables. The sprint test included two trials; a starting block has been used for this test. A linear regression analysis was used between the rates of torque development and mechanical variables composed of maximal power output (Pmax) (W.kg -1 ), maximal theoretical velocity (V0) (m. s -1 ), and maximal horizontal force production (F0) (N.kg -1 )., Results: No significant correlation was observed between 100 and 200 ms hamstring RTD and sprint biomechanical variables: maximal power output (Pmax) (W.kg -1 ), maximal theoretical velocity (V0) (m. s -1 ), and horizontal force production (F0) (N.kg-1). However, 100 and 200 ms RTD collected on the dominant leg tends to be more correlated with maximal theoretical velocity (spearman's rho = 0.80; p-value = 0.13) and Pmax output (spearman's rho = 0.70; p-value = 0.23) while for non-dominant leg, RTD tends to be more correlated with maximal power output (spearman's rho = 0.60; p-value = 0.35) and horizontal force production (spearman's rho = 0.70; p-value = 0.23)., Conclusions: Hamstring RTD is not correlated with sprint biomechanical variables in elite sprinters. Further investigations must be made to study the observed trends in this study., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Commission Nationale de l'informatique et des libertés issued approval 2225099. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Moiroux--Sahraoui et al.)

Purpose The goal of the current study was to ascertain whether there is an association between foot pronation and anterior cruciate ligament (ACL) injury in a group of elite professional soccer players. Methods Two groups of soccer players were studied, all of whom played in the Greek Super League. The ACL group included players who had suffered an ACL injury in the last 2 years. The non-ACL group was composed of players who had never suffered an ACL injury. We used a 3D baropodometric laser scanner to measure pronation or overpronation (navicular drop phenomenon) of the subtalar joint and how this affects the subtalar joint while standing. We assessed ACL laxity using the Genourob Rotab. Results ACL-injured patients, regardless of the mechanism of injury, exhibited greater navicular drop values than a randomly selected group of subjects with no history of ACL injury. Conclusion Greater knee joint laxity and subtalar pronation may be associated with an increased risk of ACL injury. Pronation of the foot appears to be a risk factor for ACL injury. These findings should be integrated into future studies to better define how neuromuscular control related to lower extremity biomechanics is associated with ACL injury., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Kakavas et al.)