Which of the following is a modifiable risk factor for ACL injuries?

• A. Poor trunk and hip control leading to valgus collapse
• B. Advanced age
• C. Genetic predisposition
• D. Short training history

Answer: (A)

Dynamic knee alignment during athletic tasks is a key area to target for reducing ACL injury risk. When trunk and hip control is poor, the knee tends to collapse inward into valgus during landing or cutting. That dynamic valgus places more load on the ACL and increases the likelihood of injury. Because this collapse is driven by movement and neuromuscular control, it can be changed through training. Focused programs that build core stability and strengthen the hip abductors and external rotators, along with neuromuscular coaching to improve landing and cutting mechanics, can reduce valgus collapse and lower ACL strain.

In contrast, factors like advanced age and genetic predisposition are inherent and cannot be modified. Short training history reflects conditioning level and can be improved with training, but the most direct, actionable modifiable risk factor to address is improving trunk and hip control to maintain proper knee alignment during dynamic movements.