Arthrogenic muscle inhibition (AMI) is a neuromuscular impairment commonly observed following anterior cruciate ligament reconstruction (ACLR). This condition, characterized by persistent quadricep inhibition due to altered afferent feedback, significantly impacts neuromuscular recovery, delaying return to running and sport. Despite advancements in rehabilitation strategies, AMI may persist for months or even years after ACLR, leading to muscle strength asymmetries, altered biomechanics, and an increased risk of reinjury. The mechanisms underlying AMI involve both peripheral (joint effusion, mechanoreceptor dysfunction) and central (corticospinal inhibition, neuroplasticity alterations) components, which collectively hinder voluntary muscle activation and movement control. AMI alters gait mechanics, reduces knee stability, and promotes compensatory patterns that increase injury risk. Current return-to-sport protocols emphasize strength symmetry and functional performance but often neglect neuromuscular deficits. A comprehensive assessment integrating neuromuscular, biomechanical, and proprioceptive evaluations is needed at specific stages to optimize rehabilitation and minimize reinjury risk. Future research should explore targeted interventions such as neuromuscular stimulation, cognitive–motor training, and advanced gait analysis to mitigate AMI’s impact and facilitate a safer, more effective return to sport.

Recurrent sports injuries present complex challenges that extend beyond the playing field, impacting athletes' physical well-being, mental resilience, and financial stability. This review outlines a comprehensive framework designed to prevent and manage these setbacks, empowering athletes to achieve sustained performance and recovery. This multidimensional issue requires an integrative approach encompassing physical rehabilitation, psychological resilience, and nutritional strategies. Physically, injury prevention relies on tailored rehabilitation programs that address athletes' specific injury histories and sport-related demands. Techniques such as biomechanical assessments and neuromuscular training correct faulty movement patterns, while workload monitoring ensures a balance between training and recovery. Strength and conditioning programs have demonstrated success in reducing injury rates and enhancing musculoskeletal resilience. Psychologically, reinjury anxiety and mental disengagement are key barriers to recovery and performance. Interventions such as goal setting, mindfulness, and cognitive restructuring rebuild confidence and foster readiness to return to play. Addressing psychological well-being is as critical as physical health in promoting sustained performance. Nutrition is equally pivotal, with balanced macronutrient intake supporting energy and tissue repair and micronutrients (magnesium, manganese, vitamin D, selenium, zinc, coenzyme Q10, etc.) bolstering bone health. Anti-inflammatory nutrients and proper hydration reduce muscle strain and aid recovery, while personalized dietary strategies meet the specific demands of individual sports. By integrating these physical, psychological, and nutritional dimensions, this framework empowers athletes, coaches, and medical teams to minimize injury recurrence and enhance long-term performance, ensuring athletes remain competitive and resilient in their sporting pursuits.

Purpose: This study aimed to evaluate neuromuscular control and muscle activation patterns in individuals following anterior cruciate ligament (ACL) reconstruction, compared to healthy controls. Methods: A cross-sectional comparative study was conducted following STROBE guidelines, including 16 participants (ACL group: n = 9; control group: n = 7). Participants performed the single-leg squat (SLS) test and the single-leg drop landing (SLDL) test. Neuromuscular control was assessed using the Qualitative Analysis of Single-Leg Loading Score (QASLS), while gluteus medius and vastus medialis activation were recorded using surface electromyography. Results: The ACL group showed significantly higher QASLSs in the SLS test (p = 0.0113), indicating poorer movement quality, while no difference was found in the SLDL test (p = 0.5484). Gluteus medius activation was lower in the ACL group during the SLS test (p = 0.0564), and vastus medialis activation was higher but not significantly different (p = 0.095). Conclusions: These findings highlight persistent neuromuscular deficits post-ACL-reconstruction, particularly in SLS tasks, reinforcing the need for targeted rehabilitation strategies focusing on hip stabilization and quadriceps motor control to optimize movement quality and reduce reinjury risk.

Background: Anterior cruciate ligament (ACL) injuries are a major concern in female soccer players, with change of direction (COD) movements being a key contributor to non-contact injuries. Traditional injury prevention programs have shown limited effectiveness in addressing individual biomechanical deficits. This study aimed to evaluate the effects of a 10-week unilateral strength training program on COD mechanics and ACL injury risk factors. Methods: Eleven female soccer players participated in a pre–post intervention study. Movement mechanics was assessed using the Cutting Movement Assessment Score (CMAS) at 45°, 75°, and 90° angles. The training program included unilateral lower limb strengthening exercises designed to enhance neuromuscular control and reduce biomechanical risk factors. Risk profiles were analyzed before and after the intervention. Statistical analyses included paired t-tests and effect size calculations. Results: Significant improvements in CMAS scores were observed at all COD angles (p < 0.05), with the largest effect at 90° (Cohen’s d = 2.1). The percentage of high-risk players decreased from 82% to 0%, while the proportion of low-risk players increased from 36% to 73%. Improved knee alignment, foot placement, and trunk stability were key contributors to the observed movement enhancements. Conclusions: Unilateral strength training may effectively improve COD mechanics and reduces biomechanical risk factors associated with ACL injuries in female soccer players. Our findings suggest that individualized training interventions can influence current injury prevention strategies.

Background: Return to running (RTR) after anterior cruciate ligament reconstruction (ACL-R) remains challenging due to persistent neuromuscular deficits. This study examines gastrocnemius activation and running biomechanics in ACL-R patients.Methods: Fifteen ACL-R patients and fifteen healthy controls were assessed using surface electromyography during isometric testing and treadmill running (10 km.h⁻¹). Spatiotemporal parameters, including ground contact time, flight time, step width, cadence, stride length, and vertical stiffness, were analyzed.Results: ACL-R patients exhibited lower gastrocnemius activation during isometric testing (medial: 48.5% vs. 55.9% MVIC, p = 0.01; lateral: 42.1% vs. 47.5% MVIC, p = 0.03) and during running (medial: 45.2% vs. 53.1% MVIC, p < 0.01; lateral: 39.7% vs. 44.8% MVIC, p = 0.04). They also demonstrated altered running biomechanics, including longer ground contact time (0.29 vs. 0.26 s, p = 0.02, d = − 0.5), shorter stride length (1.32 vs. 1.41 m, p = 0.03, d = 0.9), reduced vertical stiffness (21.8 vs. 25.6 kN.m⁻¹, p = 0.03, d = 0.5), and slightly increased step width (0.14 vs. 0.13 m, p = 0.05, d = 0.4). A significant negative correlation was observed between medial gastrocnemius activation during running and ground contact time (rs = −0.56, p = 0.02, ES = −0.6). Lateral gastrocnemius activation was positively correlated with stride length (rs = 0.49, p = 0.03, ES = 0.5), and medial gastrocnemius activation showed a moderate positive correlation with vertical stiffness (rs = 0.52, p = 0.04, ES = 0.5). Cadence did not show a statistically significant correlation with either medial or lateral gastrocnemius activation (rs = 0.36, p = 0.08, ES = 0.4 and rs = 0.45, p = 0.09, ES = 0.4, respectively).Conclusion: Gastrocnemius dysfunction persists after ACL-R, affecting running mechanics. These findings suggest that current rehabilitation protocols may need to incorporate plantar flexor training to optimize running mechanics post-ACL-R.

(1) Background: Shoulder pathologies are mostly found in overhead sports. Many risk factors have been identified, in particular a deficit in the kinetic chain. The aim of this review was to find out whether prevention by strengthening the kinetic chain can have an impact on the rate of shoulder injury in overhead pitching athletes. (2) Methods: A systematic review of the literature was carried out, including studies on the role of the kinetic chain in the prevention of overhead athletes. The studies used were works published over the last 10 years searched on PubMed, Cochrane Library, PEDro and Science Direct. They were also analyzed by methodological quality scales: the PEDro scale and the Newcastle–Ottawa scale. (3) Results: Eight studies met the inclusion criteria. The studies analyzed revealed a significant correlation between the use of the kinetic chain and the prevention of shoulder injuries, associating factors such as muscle strength, physical performance in tests (CMJ, FMS), static and dynamic balance and the ability to transfer energy from the lower to the upper body. (4) Conclusions: It is important to integrate core stability work and lower limb strengthening to minimize excessive stress on the shoulder complex, while optimizing force production and performance.