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A review of electromyographic activation levels, timing differences, and increased anterior cruciate ligament injury incidence in female athletes
  1. T E Hewett1,
  2. B T Zazulak2,
  3. G D Myer1,
  4. K R Ford1
  1. 1Cincinnati Children’s Hospital, Sports Medicine Biodynamics Center, Cincinnati, OH, USA
  2. 2Department of Rehabilitation Services, Yale-New Haven Hospital, New Haven, CT, USA
  1. Correspondence to:
 Dr Hewett
 Cincinnati Children’s Hospital, Sports Medicine Biodynamics Center, Cincinnati, OH 45229, USA;


Deficits in dynamic neuromuscular control of the knee may contribute to the higher incidence of anterior cruciate ligament (ACL) injury in female athletes. There is evidence that neuromuscular training alters muscle firing patterns, as it decreases landing forces, improves balance, and reduces ACL injury incidence in female athletes. The purpose of this review is to summarise the evidence for altered muscular activation and timing relative to ACL injury risk in female athletes.

  • ACL, anterior cruciate ligament
  • EMG, electromyographic
  • anterior cruciate ligament
  • knee
  • injury
  • electromyographic activation
  • female athletes

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  • Competing interests: none declared

  • Patient consent was obtained for the publication of figure 1.