Context: Many factors, including anatomy, neuromuscular control, hormonal regulation, and genetics, are known to contribute to the noncontact anterior cruciate ligament (ACL) injury risk profile. The neurocognitive and neurophysiological influences on the noncontact ACL injury mechanism have received less attention despite their implications to maintain neuromuscular control. Sex-specific differences in neurocognition may also play a critical role in the elevated female ACL injury risk. This report serves to frame existing literature in a new light to consider neurocognition and its implications for movement control, visual-motor function, and injury susceptibility.
Evidence acquisition: Sources were obtained from PubMed, MEDLINE, Web of Science, and LISTA (EBSCO) databases from 1990 onward and ranged from diverse fields including psychological and neuroscience reviews to injury epidemiology and biomechanical reports.
Study design: Clinical review.
Level of evidence: Level 5.
Results: Neurological factors may contribute to the multifactorial ACL injury risk paradigm and the increased female injury susceptibility.
Conclusion: When developing ACL injury prevention programs, considering neurocognition and its role in movement, neuromuscular control, and injury risk may help improve intervention effectiveness.