Clinician observing a teenage athlete’s landing mechanics during a drop vertical jump screening for ACL injury risk
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Preparing Future Nurses for Modern Sports Injury Prevention

BySports Medicine Weekly
Table of Contents

Introduction

Sideline care is only the first step. After athletic trainers and emergency responders manage an acute injury, much of the work that follows, including diagnosis, return-to-play decisions and overuse prevention, happens in primary care, orthopedic and school-based clinics. Clinicians there need to read movement, recognize growth-related vulnerabilities and resist pressure to clear athletes too early. Here is what that work involves and how nurses entering the field can prepare for it.

Orthopedic Red Flags in the Clinic

  • Concussion. The 2022 Amsterdam consensus supports structured clinic assessment, including symptom, cognitive, balance and vestibular-ocular screening, followed by graduated return-to-learn and return-to-sport steps.
  • Joint stability. Standardized tests such as the Lachman, drawer and valgus/varus stress tests, with imaging when indicated, help identify ligament injury, cartilage damage and avulsions.
  • Neurovascular status. After a dislocation or fracture, checking pulses, sensation and capillary refill helps rule out vascular injury and compartment syndrome.

A missed growth-plate injury or a poorly rehabilitated sprain can become a long-term problem that limits function for years.

How Non-Contact ACL Tears Happen

A non-contact anterior cruciate ligament (ACL) tear happens in a fraction of a second: the foot plants, the femur rotates inward and the knee collapses into valgus. In a prospective study of female athletes, greater knee valgus loading during landing predicted who later tore an ACL.

Much of that risk is modifiable. A meta-analysis of meta-analyses found that injury prevention training cut ACL injuries by about 50% overall and non-contact ACL injuries in female athletes by 67%. Prevention in the clinic typically includes:

  • Movement screening during preparticipation exams, such as a drop vertical jump, to spot knees that cave inward on landing.
  • Referral for neuromuscular training that builds hamstring strength, hip and trunk control and safer landing mechanics.
  • Load management, since sudden jumps in sprint volume, throwing counts or training frequency raise the risk of bone stress and muscle injuries.

Protecting Growing Skeletons

During growth spurts, bones can lengthen faster than muscles and tendons adapt, increasing traction where tendons attach to growth centers called apophyses. Pinpoint tenderness at the tibial tubercle below the kneecap suggests Osgood-Schlatter disease; pain at the back of the heel suggests Sever’s disease. Tight calves or hamstrings and morning stiffness often appear alongside. Management usually means relative rest, activity modification and temporarily reducing high-impact jumping, which also lowers the risk of an avulsion injury.

Criteria-Based Return to Play

Tissue healing is only the starting point. In the Delaware-Oslo ACL cohort, 5.6% of athletes who passed return-to-sport criteria (scores above 90 on quadriceps strength symmetry, hop tests and self-reported function) were reinjured, compared with 38.2% of those who did not pass. Each month of delayed return, up to nine months after surgery, reduced the reinjury rate by 51%.

Clinicians, physical therapists and athletic trainers should also assess deceleration and agility under fatigue, plus psychological readiness, since fear of reinjury can change how an athlete moves. These measures are explored further in our look at objective testing for return-to-sport decisions, and they explain why cleared to play is not the same as ready to play.

A Path From Other Careers Into Nursing

Meeting demand for outpatient orthopedic and adolescent care requires more clinicians. For people with a bachelor’s degree in another field, a direct-entry MSN program offers an accelerated route into nursing that combines coursework, simulation labs and supervised clinical hours. Career changers from kinesiology, exercise physiology or collegiate athletics bring a working knowledge of biomechanics, and the degree can serve as a foundation for later nurse practitioner preparation. Once in advanced practice, a strong grounding in tissue healing and pathophysiology helps clinicians manage overuse injuries and coordinate rehabilitation. Read more about how FNPs support injury prevention in primary care.

Key Takeaway

Modern sports injury prevention depends on clinic-based skills: recognizing red flags, screening movement, protecting growing athletes and clearing return to play on objective criteria rather than the calendar. Nurses who build those skills help athletes return stronger and stay healthy.

FAQ

Can ACL injuries be prevented?
Many can. Neuromuscular prevention programs have been shown to cut ACL injury risk by about half.

What is Osgood-Schlatter disease?
A growth-related irritation where the patellar tendon attaches below the kneecap, common in active adolescents during growth spurts.

What is a direct-entry MSN?
An accelerated graduate program that prepares people with a non-nursing bachelor’s degree to become registered nurses.

Sponsored article. Researched and written independently by the Sports Medicine Weekly editorial team. Sports Medicine Weekly LLC does not endorse any product or service described on this site. Content published in Sports Medicine Weekly is for informational purposes only and is not a substitute for professional medical advice. Always seek the advice of your healthcare provider regarding any medical condition.

Resources

  • Patricios JS, et al. Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport, Amsterdam, October 2022. Br J Sports Med. 2023;57(11):695–711. doi:10.1136/bjsports-2023-106898
  • Hewett TE, et al. Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: a prospective study. Am J Sports Med. 2005;33(4):492–501. doi:10.1177/0363546504269591
  • Webster KE, Hewett TE. Meta-analysis of meta-analyses of anterior cruciate ligament injury reduction training programs. J Orthop Res. 2018;36(10):2696–2708. doi:10.1002/jor.24043
  • Grindem H, et al. Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction: the Delaware-Oslo ACL cohort study. Br J Sports Med. 2016;50(13):804–808. bjsm.bmj.com/content/50/13/804
  • Mayo Clinic. ACL injury: symptoms and causes. mayoclinic.org

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