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PEP Program for ACL Injury Prevention

Recent studies have shown that ACL injury rates can be reduced by up to 70% with a specific warm up program called the PEP program. This program replaces traditional warm ups with exercises focused on balance, power, agility, plyometrics and sport-specific drills. It has been shown to decrease both initial and recurrent ACL injuries. The PEP program should be performed 2-3 times per week during the season and consists of warm up, stretching, strengthening, plyometrics and agility components.

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Chris Fernandez
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128 views1 page

PEP Program for ACL Injury Prevention

Recent studies have shown that ACL injury rates can be reduced by up to 70% with a specific warm up program called the PEP program. This program replaces traditional warm ups with exercises focused on balance, power, agility, plyometrics and sport-specific drills. It has been shown to decrease both initial and recurrent ACL injuries. The PEP program should be performed 2-3 times per week during the season and consists of warm up, stretching, strengthening, plyometrics and agility components.

Uploaded by

Chris Fernandez
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We take content rights seriously. If you suspect this is your content, claim it here.
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ACL INJURY PREVENTION PROGRAMS 286 Pacific Highway

DR LEO PINCZEWSKI, DR JUSTIN ROE Crows Nest


NSW 2065
NSOSMC ph: 9437 5999

Recent studies have documented that the incidence of ACL injury can be reduced by up to 70% with the implementation
of a specific warm up program. We have found that the incidence of injury after 12 months from ACL reconstruction is 1%
per year for the reconstructed knee and 1% per year for the opposite “normal” knee. This is higher than is seen in the
normal population. This incidence is even higher in young patients who have their first injury under 21 years.

The PEP program (Prevent injury and Enhance Performance Program) has been shown to decrease both first time ACL
injuries and further ACL injuries after reconstruction. This program is a highly specific session that replaces the traditional
warm up. It consists of a warm-up, stretching, strengthening, plyometrics, and sport specific agility training. Athletes can
reduce their risk of ACL injuries by performing training drills that require balance, power and agility. Adding plyometric
exercises, such as jumping, and balance drills helps improve neuromuscular conditioning and muscular reactions which
decrease the risk of ACL injury. It is important to use proper technique during jumping moves (jump straight up and down
jumps without excessive side-to-side movement), and aim for soft landings. Optimally the program should be performed at
least 2-3 times per week during the season.

We encourage all patients after ACL reconstruction to familiarise themselves and their trainers with this program to
prevent further injury.

Basic Components of the PEP Program

[Link]-up (50 metres each):


A. Jog line to line of soccer field (cone to cone)
B. Shuttle run (side to side)
C. Backward running
2. Stretching (30 s × 2 reps each):
A. Calf stretch
B. Quadricep stretch
C. Figure 4 hamstring stretch
D. Inner thigh stretch
E. Hip flexor stretch
3. Strengthening:
[Link] lunges (20 metres × 2 sets)
B. Russian hamstring (3 sets × 10 reps)
C. Single toe-raises (30 reps on each side)
4. Plyometrics (20 reps each):
A. Lateral hops over 2 to 6 inch cone
B. Forward/backward hops over 2 to 6 inch cone
C. Single leg hops over 2 to 6 inch cone
D. Vertical jumps with headers
E. Scissors jump
5. Agilities:
A. Shuttle run with forward/backward running (40 yards)
B. Diagonal runs (40 yards)
C. Bounding run (45–50 yards)

Additional details and supplemental replacement exercises available from the developers of the program, The Santa
Monica Orthopaedic and Sports Medicine Research Foundation at [Link].
Video examples of this program can also be found on [Link]
Further Reading: Gilchrist et al. (2008). A Randomized Controlled Trial to Prevent Noncontact Anterior Cruciate Ligament
Injury in Female Collegiate Soccer Players. Published in American Journal of Sports Medicine. 2008; Issue 36; pages 1476-
1483

For further information contact Dr Lucy Salmon (Research Physiotherapist) at NSOSMC on lsalmon@[Link] or 9437 5999

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