## 2 Prevention of NC-ACLs
### Targeting NC-ACL Modifiable Risk Factors  
The correct alignment of the hip and knee joints during sports activities is crucial to avoid injury, with proper posture upon landing being a modifiable risk factor for NC-ACLs. The glutel muscles act as essential regulators of pelvic stability, ensuring proper hip and knee alignment [40]. A combination of weak hip muscles and excessive hip flexion can significantly limit the glutel muscles' ability to stabilize the hip joint during ground contact [41]. [PERSON] et al. [42] described a strength training program focused on major leg muscles to improve landing in female athletes. In this strength-training program [42], the exercises focused on isolated muscle groups rather than compound movements. The program targeted major leg muscles, such as the quadriceps, hamstrings, gluteus medius, and gluteus maximus, primarily through exercises using resistance bands. The exercises were generally structured with a three-limb support base to minimize balance effects, suggesting a focus on double-leg stability. Despite increased muscle strength in the training group, no significant changes in knee and hip kinetics and kinematics during a stop-jump test were found. Based on these findings, the authors concluded that strength training alone might not be enough to reduce the risk of NC-ACLs in these athletes. This could indicate that strength exercises need to be combined with other types of training, such as neuromuscular exercises, to achieve a holistic preventive effect. Further studies might benefit from investigating which additional elements, like proprioceptive or plyometric exercises, could enhance the efficacy of strength training alone. Anterior pelvic tilt can further accentuate the dynamic valgus of the knee [41]. Tightness of hip flexors and erector guinea muscles, along with weakness of the abdominal and glutel muscles, are thought to contribute to increased anterior pelvic tilt, thereby increasing the risk of NC-ACLs [40]. [PERSON] et al. [43] recommended that athletes with decreased core muscle control should perform core stability and proprioceptive exercises, as well as training to enhance landing techniques, to reduce the risk of NC-ACLs. This finding suggests that interventions aiming to strengthen core stability might be particularly beneficial for female athletes, who are more prone to NC-ACL injuries. Moreover, the trunk musculature may also affect hamstring function, thereby potentially influencing the likelihood of NC-ACLs [44]. The hamstrings play a critical role in reducing anterior, varus-valgus, and internal-external displacement moments applied to the knee [45]. Hamstring strengthening training is thus indicated to reduce the risk of NC-ACLs [40]. A low hamstring to quadriceps (H:Q) isokinetic strength ratio (i.e., the quadriceps muscle outperforms the hamstrings) increases the risk of excessive anterior tibial translation during dynamic activities like landing or changing direction [46]. This poses greater shearing forces on the ACL, and if the hamstrings are not able to counterbalance such displacement forces, ACL injury may occur [40]. [PERSON] et al. [47] investigated the role of a specific resistance training program on the H:Q strength ratio in female soccer players. The authors found that a 6-week hamstring-focused training program increased the H:Q strength ratio, potentially reducing the risk of NC-ACLs in this cohort. Likewise, other studies have also shown that improving the H:Q strength ratio may reduce the risk of NC-ACLs in female athletes [48; 49]. Muscle fatigue is an additional parameter to consider among risk factors for NC-ACLs [40]. [PERSON] et al. [50] showed that hamstring fatigue reduces the ability to control knee stability during movements. Targeted activities such as lower extremity closed kinetic chain exercises, mini-squats, single leg-hops, and sideways shuffles in a low squat position improve muscle resistance and may prevent fatigue. Moreover, [PERSON] et al.