Background Soccer is one of the highest risk sports for anterior cruciate ligament (ACL) injuries. These injuries have serious long-term consequences and cause substantial socio-economic costs. The preventive effect of an exercise program is highly dependent on its components and the level of compliance. In Belgium, it is unknown whether non-elite soccer teams implement neuromuscular training to prevent ACL injuries.

Objective Is preventive neuromuscular training incorporated during practice in non-elite Belgian soccer?

Design Prospective cohort study.

Setting Non-elite soccer teams.

Patients (or Participants) Twelve hundred and five athletes (86 teams) and 799 female athletes (78 teams), aged between 18 and 35, participated to this study.

Interventions (or Assessment of Risk Factors) Survey data of athletes were collected twice during the season 2014–2015 (male athletes) and season 2015–2016 (female athletes).

Main Outcome Measurements Using an online survey (www.letselpreventie.be), information concerning type, duration and frequency of implemented exercises or barriers to neuromuscular training during the preseason and season were gathered.

Results During the preseason, only 12% of the athletes indicated to perform balance exercises (jump-landing) and plyometric exercises with a frequency of two sessions per week and a duration of at least 10 minutes per exercise. During the season, this percentage was reduced to 4%. Fifty-five to 77% (preseason) and 65 to 82% (season) of the athletes respectively indicate not to perform any neuromuscular training at all. Most important barriers to neuromuscular training were: ‘I don’t need it’, ‘I have no time’, ‘stretching and warming-up are sufficient’ and ‘I don’t know which exercises to perform’.

Conclusions Most non-elite soccer teams do not implement neuromuscular training for preventing ACL injuries. These results highlight the need for educating coaches and athletes to implement neuromuscular training during practice.