Lower extremity injuries account for over 60% of all sport-related injuries in female athletes, with up to 50% of female athletes experiencing a lower extremity injury in any given season. These injuries carry significant financial costs—ranging from thousands to tens of thousands of dollars per injury—and long-term health consequences including post-traumatic osteoarthritis, reduced function, and decreased quality of life. Given this substantial burden, researchers conducted the most comprehensive systematic review to date, analyzing prevention strategies specifically for female, woman, and girl athletes to determine what actually works to keep athletes healthy and on the field.

Key Research Findings

A major systematic review and meta-analysis examined injury prevention strategies for female, woman, and girl athletes across 82 studies involving over 154,000 athletes. Here’s what we learned:

The Numbers That Matter

• ACL Injuries: Neuromuscular training (NMT) programs reduce ACL injuries by 61% (high certainty evidence)
• Ankle Sprains: NMT programs may reduce ankle sprains by 39% (moderate certainty evidence)
• Overall Lower Extremity: NMT programs showed a 19% reduction in general lower extremity injuries (low certainty evidence)

What Works: The Winning Formula

Neuromuscular Training Programs were the most effective intervention, with these key components:

• Minimum dose: 10 minutes, 2 times per week
• Progression: From bilateral to single-leg exercises
• Components: Balance, lower extremity strength, agility, and change of direction exercises
• When: As part of warm-up routines

The Research Scope

• 82 studies analyzed (48 randomized controlled trials, 16 quasi-experimental, 16 cohort studies)
• 154,561 total athletes (84,915 female/woman/girl athletes)
• 31 studies focused exclusively on female/woman/girl athletes
• 19 different sports represented

What We Still Need to Learn

The research revealed significant gaps:

• Limited evidence for protective equipment (knee/ankle braces, shin guards)
• Sparse data on policy/rule changes for injury prevention
• Minimal research on adult and para-sport female athletes
• No studies included female para-sport athletes

Bottom Line for Athletes and Coaches

The evidence strongly supports implementing structured neuromuscular training programs as part of regular training routines. These programs are:

• Low burden to implement
• Cost-effective
• Proven effective for reducing serious injuries like ACL tears
• Suitable for widespread adoption across female sports

Practical Application

Given the relatively low time commitment (just 20 minutes per week minimum) and high impact on injury prevention, these findings support:

• Mandatory implementation of NMT programs in female sports
• Policy changes at organizational levels to support widespread adoption
• Coach education on proper NMT program implementation
• Further research on protective equipment and policy interventions

Summary

This landmark research provides clear, evidence-based guidance for protecting female athletes from injury. The overwhelming conclusion is that neuromuscular training programs are not just helpful—they’re essential. With the ability to reduce ACL injuries by nearly two-thirds and ankle sprains by more than one-third, these programs represent one of the most effective interventions in sports medicine. The beauty lies in their simplicity: just 20 minutes per week of structured exercises can dramatically change an athlete’s injury risk profile. For coaches, parents, and sports organizations, the message is clear—implementing neuromuscular training isn’t just good practice, it’s a responsibility. The evidence is strong, the time commitment is minimal, and the potential to save athletes from career-threatening injuries is enormous. The question isn’t whether to implement these programs, but how quickly we can make them standard practice across all female sports.