How to Prevent
ACL Tears:
The 5 Exercises
That Actually Work

If there is one exercise with the most compelling single-study evidence for ACL injury prevention, this is it. A landmark RCT published in the British Journal of Sports Medicine found that the Nordic Hamstring Curl reduced hamstring injuries by 51% and was strongly associated with reduced ACL incidence in football players — because hamstring strength is a critical co-stabilizer of the knee against anterior tibial translation.

The movement is simple in concept, brutal in execution. Kneeling with your feet anchored (under a bench, held by a partner, or in a GHD machine), lower your body toward the floor as slowly as possible while keeping your hips locked out. Your hamstrings are working eccentrically against your entire bodyweight. Catch yourself with your hands at the bottom, push back to start, and repeat. Most athletes cannot complete a single clean rep when they first attempt this — which tells you everything about how undertrained this muscle group typically is.

The eccentric loading component is the critical element. It trains the hamstrings to absorb force during deceleration — precisely the phase when ACL tears most commonly occur.

The single-leg RDL is the most effective exercise for simultaneously training glute medius activation, hip hinge mechanics, and single-leg proprioception — the three factors most directly responsible for controlling knee valgus during landing and cutting. It does all three things at once, which is why it belongs in every athlete’s ACL prevention toolkit.

Standing on one leg, hinge forward from the hip while extending the opposite leg behind you. The goal is a flat back, a slight bend in the standing knee, and the hip of the lifted leg staying level — not rotating outward. The standing knee must track directly over the second toe throughout the movement. Many athletes will immediately notice their knee collapsing inward or their hip dropping — that’s exactly the pattern the exercise is correcting.

Start with bodyweight or a very light load in the opposite hand (contralateral loading is preferable as it adds a rotational challenge). Progress to a kettlebell or dumbbell as control improves. This movement should feel like hip work, not knee work — if the knee is burning, you’re not hinging from the hip adequately.

Underrated and universally underprogrammed, the lateral band walk directly activates the gluteus medius in the frontal plane — the exact plane in which it must fire to prevent knee valgus. A resistance band placed just above the knees or at the ankles creates an adduction force that the glute med must constantly resist during the stepping pattern, producing a training stimulus that free weights simply cannot replicate in this movement plane.

The monster walk adds a forward and backward component to the lateral work, creating a multi-directional hip stability challenge that more closely resembles actual sport movement. Both exercises look deceptively simple; performed with real tension on the band and conscious control of knee position, they are remarkably demanding for most athletes the first time they attempt them with a proper load.

Research from the Journal of Orthopaedic & Sports Physical Therapy consistently ranks these exercises as among the highest glute med activation exercises available — surpassing many machine-based or barbell movements for isolated posterior hip recruitment in the frontal plane.

You cannot train an athlete to land safely without actually having them land and practice making it safer. The box jump stick landing drill bridges the gap between isolated strengthening exercises and the real-world task of absorbing force from a jump — and it is the most direct way to ingrain the biomechanical patterns that protect the ACL under dynamic loading.

Step or jump off a box (start low: 20–30cm) and land on both feet simultaneously, absorbing the force through a soft knee bend aiming for 60–80 degrees of knee flexion. Hold the landing position for two to three seconds — the “stick.” During that hold, the coach or athlete evaluates: are the knees tracking over the toes? Is the trunk upright or collapsing forward? Are the hips dropping to one side? Correct any deviations before moving to the next rep.

The neuromuscular learning that occurs through this drill is precisely what’s absent in the fractions of a second before most ACL tears. You are essentially practicing getting it right, over and over, until the correct pattern becomes automatic. The Sportsmetrics program, which has shown up to 88% reduction in ACL injuries in female athletes across multiple studies, is built primarily around this principle.

Most athletes who tear their ACL do so when they didn’t expect it. A misstep, an unexpected contact, a sudden surface change. Perturbation training — introducing unpredictable, external disruptions while the athlete maintains single-leg balance — directly trains the reactive stabilization capacity that determines whether the knee holds or gives way in these moments.

Stand on one leg with a slight knee bend. A partner introduces gentle but unpredictable perturbations: a light push to the shoulder, a tap on the hip, a pull on a resistance band, or a perturbation board or wobble cushion underfoot. The athlete must stabilize rapidly. As competence improves, the perturbations become more forceful, more unexpected, and eventually more sport-specific — being bumped during a simulated cutting movement, for example.

Studies from the Oslo Sports Trauma Research Center show that proprioception and reactive stabilization training is one of the strongest predictors of reduced ACL recurrence in athletes returning from reconstruction. But it belongs in prevention programs too, because the reactive neuromuscular response is trainable and transferable. The athlete who can catch themselves in a moment of instability is significantly less likely to tear a ligament in that moment.