Multimodal neuromuscular training reduces ACL injury risk and improves performance in adolescent volleyball playersMultimodal Training May Reduce ACL Injury Risk in Volleyball Players

Frontiers in Medicine Published June 25, 2026 Study authors: Shizhao Chen, Qingzi Liu, Zihui Hong DOI ↗ Editorial oversight: Dr. Lars van Dijk, PhD · Surgical, Procedural & Diagnostic

AI-generated summary of the cited source, checked by automated accuracy review. How we work

Key Takeaway

Consider multimodal neuromuscular training to reduce ACL injury risk and improve performance in adolescent volleyball players.

This narrative review synthesizes evidence regarding the effects of multimodal neuromuscular training (NMT) on adolescent volleyball players. The authors focus on reducing biomechanical injury risks and improving athletic performance, including vertical jump height and dynamic stability.

The synthesis indicates that NMT can reduce overall injury rates by 40% and halve ACL injury risk. Notably, the protective effect against ACL injuries was strongest in females aged 14-18 (OR=0.28), while no such protective effect was observed in females over age 18. Additionally, participants showed improved vertical jump height (Cohen's d = 0.82) and dynamic stability (SMD = 0.63). Females demonstrated greater jump gains compared to males (ES = 1.3 vs. 0.5).

Limitations include the need for more volleyball-specific, maturity-indexed RCTs to confirm these findings. For clinical practice, the authors suggest a dosage of 15-20 minutes per session, three times weekly for at least eight weeks. Maturity-stratified load management is recommended for athletes near peak height velocity.

This review looked at how multimodal neuromuscular training (NMT) affects adolescent volleyball players. The findings suggest that this type of training can reduce overall injury rates by 40% and specifically cut the risk of ACL injuries in half. The protective effect was noted to be strongest in females between the ages of 14 and 18.

In addition to safety, the training showed improvements in athletic performance. Participants saw better dynamic stability and higher vertical jump heights. Notably, female athletes showed greater gains in jumping height compared to their male counterparts.

Because this is a narrative review, the evidence is not yet definitive. The results are specific to volleyball and may not apply to all sports or ages. For example, the protective effect was not observed in females over age 18. More randomized controlled trials are needed to confirm these findings for different age groups.

What this means for you:

Neuromuscular training may lower ACL injury risk for teenage female volleyball players and improve jump performance.

Common questions

Who does this training help the most?

The findings suggest that multimodal neuromuscular training has its strongest protective effect against ACL injuries for female athletes between the ages of 14 and 18. The study noted that this specific protective effect was not observed in females over the age of 18.

How does it improve athletic performance?

The training was linked to improvements in dynamic stability and vertical jump height. Specifically, female athletes showed greater gains in jumping height compared to male athletes during the study period.

What is the recommended way to perform this training?

The review suggests a routine of 15 to 20 minutes per session, performed two to three times per week for at least eight weeks. It also notes that managing the workload based on the athlete's maturity level is important.

Study Details

Study typeSystematic review

EvidenceLevel 1

PublishedJun 2026

View Original Abstract ↓

Adolescent volleyball players face elevated knee injury risk. Anterior cruciate ligament (ACL) injuries and patellar tendinopathy are the two dominant conditions. Approximately 62% of ACL injuries occur during spike landings. During peak height velocity (PHV), patellar tendon strain reaches 7.6%–8.5%, approaching the microstructural damage threshold of 9.0%. This review evaluated whether neuromuscular training (NMT) reduces biomechanical injury risk and improves athletic performance. Multimodal NMT reduced overall injury rates by 40% and halved ACL injury risk (OR=0.54). The protective effect was strongest in females aged 14–18 (OR=0.28) and absent above age 18. NMT also improved vertical jump height (Cohen's d = 0.82) and dynamic stability (SMD = 0.63). Female players showed greater jump gains than males (ES = 1.3 vs. 0.5). Injury prevention and performance benefits share the same mechanistic foundation. Optimal dosing is 15–20 min per session, two to three times per week, for at least eight weeks. Maturity-stratified load management is essential for circa-PHV athletes. Volleyball-specific, maturity-indexed RCTs are needed to confirm these findings.

Multimodal neuromuscular training reduces ACL injury risk and improves performance in adolescent volleyball playersMultimodal Training May Reduce ACL Injury Risk in Volleyball Players

Common questions

Study Details

Intraosseous route for out-of-hospital cardiac arrest linked to lower outcomes than intravenous access

Using a bone needle instead of a vein line lowers survival chances for cardiac arrest patients

Clinical research that matters. Delivered to your inbox.

Multimodal neuromuscular training reduces ACL injury risk and improves performance in adolescent volleyball playersMultimodal Training May Reduce ACL Injury Risk in Volleyball Players

Common questions

Study Details

Intraosseous route for out-of-hospital cardiac arrest linked to lower outcomes than intravenous access

Using a bone needle instead of a vein line lowers survival chances for cardiac arrest patients

Clinical research that matters. Delivered to your inbox.

Related in Emergency Medicine

From Other Specialties