• Emory DPT Sustainability

Amy Arundale, PT, PhD, DPT, SCS: ACL Prevention - Sustainable Environments for Adolescents in Sport

By Eric Holshouser, SPT, PE


Dr. Arundale graduated with a Doctor of Physical Therapy degree from Duke University in 2011, and later completed a PhD in Biomechanics from the University of Delaware in 2017. Also in 2017, she was awarded the APTA Emerging Leader Award and the Sports Section of the APTA New Horizons Award. She is passionate about injury prevention and return to sport for adolescent athletes. She currently serves as a Physical Therapist for the Brooklyn Nets


In this interview, Dr. Arundale discusses her research on primary and secondary ACL injury prevention, and its relation building a sustainable future.



Q: With regards to sustainability, why is it important to create environments that prevent ACL injuries?

Many adolescents participate in sports throughout the world, and knee injuries, specifically ACL injuries, are common in activities that require jumping, cutting and pivoting. These injuries have a lasting impact on individuals throughout their lifetime with financial, social, environmental and health costs. ACL injuries are responsible for accelerating osteoarthritis, which contributes to increased healthcare costs throughout a person’s lifetime. In addition to the financial cost, a large amount of environmental and social costs are associated with ACL injuries, incurred through surgery, healthcare services and participation limitations[BS1] . ACL injuries increase risk for future injuries, which beyond physical impairments, can have mental health implications. Mental health is a very important, and often under-recognized issue related to these injuries. Fear after injury can be a major factor limiting many individuals beyond the short term course of the injury. There are many benefits of exercise and remaining healthy, so we need to do a better job with primary and secondary prevention of ACL injuries.


Q: How can physical therapists help prevent these injuries?

A large body of evidence indicates that ACL injury rates can be significantly reduced with proper education and training programs. Establishing healthy behaviors in children early in sport is important to prevent future injuries. Early education is key to maintaining a healthy lifestyle, in particular implementing physical literacy programs and incorporating diversity of movement. Physical therapists have a great opportunity to foster increased physical and mental resiliency with children, as they learn about and better understand their bodies, especially the more athletic they become. Creating a supportive environment is necessary to facilitate children’s learning, enabling them to gain skills to help each other. For example, a common problem with young athletes is the medial collapse of their knees during activity, placing additional stress on the ligaments. Awareness of this risk factor could become common knowledge among adolescents through training programs, and they could correct each other for proper form. Additionally, adolescents should understand that control of their body may change over time, even month- to- month. This awareness can help them become more resilient during a challenging time of life.


Q: What are some benefits of incorporating these programs in adolescent sports?

ACL prevention programs can have many benefits, in particular fostering the development of mental and physical resiliency that will translate into adulthood and keep people healthy and moving correctly throughout life. This awareness can spread to successive generations further promoting movement health in society. Each injury that is prevented can help society and individuals avoid the many long-term triple bottom line costs of injury. Most primary and secondary prevention does not require equipment, thus having minimal financial or resource cost. Beyond preventing knee injuries, ACL injury prevention programs improve people’s balance, strength and proprioception, which can pay dividends in many areas of life, including preventing other lower extremity injuries.


This interview was conducted and edited by Eric Holshouser, Emory University SPT. .


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