Abstract
Side-step cutting is an action associated with non-contact anterior cruciate ligament (ACL) injury with a plethora of negative economical, health, and psychological implications. Although ACL injury risk factors are multifactorial, biomechanical and neuromuscular deficits which contribute to “high-risk” and aberrant movement patterns are linked to ACL injury risk due to increasing knee joint loads and potential ACL loading. Importantly, biomechanical and neuromuscular deficits are modifiable; thus, being able to profile and classify athletes as potentially “high-risk” of injury is a crucial process in ACL injury mitigation. The Cutting Movement Assessment Score (CMAS) is a recently validated field-based qualitative screening tool to identify athletes that display high-risk postures associated with increased non-contact ACL injury risk during side-step cutting. This article provides practitioners with a comprehensive and detailed overview regarding the rationale and implementation of the CMAS. Additionally, this review provides guidance on CMAS methodological procedures, CMAS operational definitions, and training recommendations to assist in the development of more effective non-contact ACL injury risk mitigation programmes.
Highlights
An anterior cruciate ligament injury (ACL) is considered one of the most significant and debilitating injuries an athlete can experience, with an abundance of negative economic [1,2,3], psychological [1,4], and health [1,5] implications
These multiplanar knee joint loads are often used as surrogates of non-contact ACL injury risk [29,32,39,40], and are amplified during change of directions (COD), landings, and decelerations when aberrant and “high-risk” neuromuscular control and biomechanical deficits are displayed [1,31,32,33,41,42,43]
The Cutting Movement Assessment Score (CMAS) is applicable to side-step cuts of 30–90◦ with published literature using the CMAS during 60–90◦ [76], 70◦ [94], and 90◦ cuts [55], and in unpublished observations, we have used the CMAS during 45◦ cuts
Summary
An anterior cruciate ligament injury (ACL) is considered one of the most significant and debilitating injuries an athlete can experience, with an abundance of negative economic [1,2,3], psychological [1,4], and health [1,5] implications. ACL strain [34,35,36,37,38] These multiplanar knee joint loads are often used as surrogates of non-contact ACL injury risk [29,32,39,40], and are amplified during COD, landings, and decelerations when aberrant and “high-risk” neuromuscular control and biomechanical deficits are displayed (e.g., lateral trunk flexion, knee valgus, etc.) [1,31,32,33,41,42,43]. Neuromuscular control and biomechanical deficits are modifiable through appropriate training and conditioning [31,32,33,41,42,44,45], which may reduce knee joint loading during high-impact actions and subsequent risk of non-contact ACL injury [1,43,44,45,46]. The mechanism of ACL injury, from a knee joint loading perspective, has been stated as “multiplanar” [6]; highlighting the importance of reducing multiplanar joint loading during high-risk activities to mitigate ACL injury risk [9,47,48]
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