## 2 Prevention of NC-ACLs
### Strategies to Prevent the Occurrence of NC-ACLs  
The effectiveness of NC-ACL prevention programs has been a topic of intense debate in recent years, with studies producing conflicting results. One of the main challenges in determining the efficacy of these programs is the difficulty of conducting adequately powered studies, given the relatively low incidence of ACL injuries in the general population. Additionally, the implementation timing of the preventive programs among athletes can vary from presesacon to the start of the season, as well as the frequency and duration of the program. Intrinsic factors such as the athlete's skill level, age group, and type of sport played can further influence the results [46]. Thus, understanding these variables is crucial for designing effective prevention strategies. Neuromuscular training programs have been extensively studied for their helpful reduction in the incidence of NC-ACLs by addressing key risk factors associated with injury mechanics. For instance, [PERSON] et al. (2011) [53] found that a structured neuromuscular warm-up in high school athletes led to a significant reduction in lower extremity injuries, specifically in NC-ACL injuries. [PERSON] et al. (2007) [52] demonstrated that high-risk athletes showed reduced knee abduction moments, indicating improved dynamic stability following targeted neuromuscular training; [PERSON] et al. (1999) [34] also reported a notable reduction in knee injuries in female athletes participating in a neuromuscular program focusing on pyometrics and dynamic knee control. [PERSON] et al. (2007) [43] highlighted that core stability, enhanced through neuromuscular training, plays a crucial role in maintaining knee alignment and reducing valgus collapse during high-risk maneuvers, which are strongly linked to ACL injury risk. In a similar vein, [PERSON] et al. (2008) [30] observed that neuromuscular programs could modify kinetic and kinematic profiles in female athletes, leading to safer movement patterns during jumping tasks. Despite these challenges, critical analysis of data from multiple studies offers valuable insights into defining effective NC-ACL prevention approaches. In particular, neuromuscular training programs have been extensively studied for their potential to reduce NC-ACL rates [25; 26; 30; 34; 37; 43; 49; 52; 53]. [PERSON] et al. [29] identified [PERSON] as the first author to investigate the higher ACL injury rates observed in female athletes in 1990. They hypothesized that ACL tears primarily resulted from knee position and muscle activation patterns during dynamic movements. The quadriceps muscle, especially in the last degrees of knee extension, applies a significant force that pulls the tibia forward, placing strain on the ACL. Basedon this theory, [PERSON]'s intervention program aimed to modify athletes' technique to promote more knee and hip flexion during cutting, landing, and deceleration maneuvers. This program resulted in an 89% reduction in ACL injuries and laid the groundwork for numerous subsequent ACL injury prevention programs. Building on this background, [PERSON] et al. [34] conducted a specific neuromuscular training program to prevent knee injuries in soccer players. The six-week training included exercises for flexibility, strength, and jumping power. The trained soccer players presented no NC-ACLs, compared to six in the untrained group, indicating that the neuromuscular prevention program effectively mitigated the risk of NC-ACLs in these athletes. The success of [PERSON] et al. 's neuromuscular program suggests that training interventions should not only target strength but also neuromuscular control. This could indicate a shift towards incorporating these multifaceted programs in young athletes' preseason training to condition their neuromuscular responses before high-intensity sports seasons. Moreover, the findings encourage further exploration into how long-term training can contribute to sustained injury reduction. Similarly, a study by [PERSON] et al.