The preventive effects of neuromuscular training on lower extremity sports injuries in adolescent and young athletes: a systematic review and meta-analysis.

Young athletes who train and compete heavily are known to face a real risk of lower extremity injuries, and neuromuscular training programs, which focus on balance, strength, and movement control, have been proposed as a way to reduce that risk. This review pooled results from 24 randomized controlled trials to see how well these programs actually work, and whether factors like age, sex, or how the training was structured made a difference. Overall, neuromuscular training was associated with a 27% reduction in the rate of lower extremity injuries compared to whatever control condition the trials used, with similar reductions seen for knee and ankle injuries specifically. The effects looked strongest in male adolescents aged 12 to 18, and when sessions lasted 20 to 30 minutes, occurred once or twice weekly, and continued for more than six months.

These subgroup patterns are less certain than the main finding and rest on fewer studies, so they should be read as exploratory rather than settled.

If you coach, train, or support a young athlete, you have probably heard that certain warm-up or strength routines can help prevent injuries like sprained ankles or knee problems. This review looked at 24 existing studies testing neuromuscular training, programs built around balance, strength, and movement control exercises, in adolescent and young athletes to see whether they really reduce injury rates. Pooling the results, the training was linked to a 27% lower rate of lower extremity injuries overall, with similar reductions for knee and ankle injuries specifically.

The benefit appeared most consistent in male athletes aged 12 to 18, and in programs run for 20 to 30 minutes, once or twice a week, over more than six months. These breakdowns by age, sex, and training setup come from smaller subsets of the data, so they are less certain than the main finding and shouldn't be read as a precise prescription.

The review doesn't establish exactly why these differences appeared, just that they were observed across the included trials.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This meta-analysis addresses how confident physiotherapists can be that neuromuscular training reduces lower extremity injury rates in adolescent and young athletes, and which program parameters may matter most. Pooling 24 randomized controlled trials, the authors found a 27% reduction in overall lower extremity injury rate (RR 0.73, 95% CI 0.67-0.79), with comparable reductions for mixed lower extremity injuries, knee injuries, and ankle injuries (each RR approximately 0.72-0.73). Moderator analyses suggested the largest risk reductions occurred in male athletes aged 12 to 18, with sessions of 20 to 30 minutes, 1 to 2 sessions weekly, and intervention periods of 6 months or more.

These dosage and demographic findings are subgroup analyses drawn from a subset of the 24 trials rather than the primary pooled result, so they carry more uncertainty and should inform, rather than dictate, programming decisions. The abstract does not report heterogeneity statistics, risk-of-bias ratings, or adverse event data, so the overall certainty of evidence and safety profile cannot be assessed from this summary alone. The review also does not establish why younger, male, or longer-duration programs showed stronger associations, leaving the underlying mechanisms and generalizability to female or older athlete populations unresolved.