Healthy Knees: How Yoga Can Help Prevent ACL Injuries

Rupture of the anterior cruciate ligament (ACL) of the knee is a serious, common, and costly injury. The Centers for Disease Control and Prevention have reported that about 100,000 ACL reconstructions are performed annually. There are many risk factors cited as possible contributors to non-contact ACL injuries: environmental, anatomical, hormonal and neuromuscular, as well as a familial tendency toward injury. In fact, patients with ACL tears were twice as likely to have a relative (first, second, or third degree) with an ACL tear than were participants without an ACL tear.

This is an injury that coaches and athletes dread. Whether or not surgery is recommended, surely there will be time off from sport to recover and rehabilitate. Prevention programs have been developed that address the physical: strength, flexibility, agility, and power. These aspects are certainly important for sports performance and injury prevention, but they are not the only things that matter. In this article, I will discuss how practicing yoga is a valuable adjunct to any sports injury prevention program, specifically for the ACL.

Tears of the ACL

ACL is short for anterior cruciate ligament. Cruciate means “cross-shaped.” The ACL is one of two ligaments that cross the knee joint, connecting the thigh bone (femur) to the shinbone (tibia). There are also collateral ligaments on either side of the knee that add further stability. The ACL prevents the tibia from sliding out in front of the femur and provides rotational stability to the knee.

Tears usually occur when a person pivots with their foot planted, changes direction quickly when running, or participates in any activity that causes the knee to torque or to extend beyond the normal limit. Accidents happen, but most ACL tears are non-contact injuries. This means that something you did without external force caused your injury. Beyond that, you could still have bad luck or bad genes, but it is nice to think you may have some control over whether or not you injure your ACL.   

In addition to physical fitness, improving other traits—including reaction times, sleep quality and self-awareness—will enhance your physical performance. All these things can be developed through yoga practice.

Yoga Improves Physical Fitness

In most sports training programs the emphasis is on physical performance: building strength and endurance, and improving sport-specific movement patterns that will help you perform better. The problem with some of these programs is that they develop the bigger muscle groups but neglect some of the deeper stabilizers that require more joint excursion to reach effectively. If yoga is practiced in combination with other forms of strength training, injury can be minimized in a sport that requires far reaches, lunges or quick reaction times.

Yoga’s balancing poses can help an athlete not only improve his balance, but unconsciously recover from imbalances he may experience moment to moment in his athletic endeavors.  

Reduce Stress Response

Yoga encourages you to relax, slow the breath and focus on the present, shifting the balance from the sympathetic nervous system to the parasympathetic system. Yoga breathing techniques (pranayama) have been shown to improve sleep quality, improve pulmonary function, reduce anxiety and to help modulate the stress response. Although some level of stress is inevitable before a competition, chronic stress has negative consequences on your physical performance and your life! If you learn techniques to stay calm and focused off the field, you are better equipped to access these strategies whenever you need them.   

Yoga Improves Focus

The abilities to focus, maintain sharpened concentration and center your attention are keys to preventing injury. Yoga practice encourages introspection but discourages thought analysis. There is a subtle difference between noticing your thoughts as thoughts and being so immersed in your thoughts that they pull you into your own little world. Many professional athletes have learned how to get out of their own way through meditation, visualization, and positive thinking. In yoga philosophy, there is a term, svadhyaya, which translates as “study of self.” Through self-awareness, you gain insight into your thought patterns and relationships with others and begin to recognize and release tendencies that aren’t useful. Staying focused on the task at hand will keep you safe and strong in sport.   

Yoga Improves Strength

The top exercises recommended in the literature for preventing ACL tears include variations of squats, lunges, planks, bridges and single-leg balancing exercises. These exercises mimic many common yoga poses. Rather than breaking down the components of strengthening, stretching and sport-specific drills, a well-rounded yoga practice can provide most of what you need to stay fit and sports ready.  

Most yoga classes don’t include jumping and landing appropriately, so these skills, in addition to sport-specific drills, should be addressed outside of yoga practice. If you are an athlete with a busy schedule, adding yoga to your regimen can make your workouts more fun, time efficient and effective, with the benefit of improved self-awareness.

Why not give yoga a try? Your knees will thank you for it!

Would you like more on knee safety?  Read Olga Kabel’s #1 Key to Healthy Knees in Yoga: How to Strengthen (and Not Hurt) Your Knees in Yoga Practice. 

Reprinted with permission from Synergy Physical Therapy & Yoga.

YogaUOnline contributor Christine CarrChristine Carr, MSPT, DPT, E-RYT 500

Christine has been a physical therapist for over 20 years and has taught yoga since 2007. She owns a private practice in Evergreen, CO where she utilizes both physical therapy and yoga therapeutics in treating clients. Christine has taught workshops on how to better utilize yoga for healing the body in both the United States and Canada. For more information on Christine or her clinic please visit

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