雅思阅读 190: Preventing the Knee's Rupture（预防膝关节的断裂）

改编由 Frontiers in Public Health / PMC sports medicine reviews。雅思阅读 Section 3 难度，约 1050 词。 素材来源：https://pmc.ncbi.nlm.nih.gov/articles/PMC11236273/

Reading Passage

A. The anterior cruciate ligament, or ACL, is a band of fibrous tissue deep inside the knee that stops the shin bone from sliding too far forward relative to the thigh bone. It is small, unglamorous and, for athletes in cutting sports — basketball, soccer, handball and volleyball in particular — one of the most feared structures in the body. When the ACL tears, the usual mechanism is not a collision with another player but a moment of bad mechanics: a plant-and-cut, an awkward landing, a sudden deceleration. The knee wobbles inward, the ligament snaps, and the athlete's season — and often career — is over. Surgery, reconstruction and a year of rehabilitation follow, and the risk of never returning to pre-injury performance is substantial. The injury also carries an economic cost: missed seasons, medical bills and long-term knee arthritis. Female athletes in these sports are four to six times more likely to suffer this injury than male athletes playing at the same level, a disparity that has driven three decades of research into why, and whether it can be prevented.

B. The old view held that ACL injuries were simply bad luck — an unavoidable consequence of competitive sport. That view has been overturned. Careful motion-capture studies showed that athletes who went on to tear their ACLs had, months earlier, shown characteristic movement patterns: their knees collapsed inward (a position called dynamic valgus), they landed with stiff rather than bent legs, and their quadriceps muscles fired too early relative to the hamstrings. Crucially, these patterns were learnable — they reflected neuromuscular habits, not bone structure. If the way an athlete moved could be changed, the injury could be prevented. The result was the development of neuromuscular training (NMT) programmes, warm-up routines that combine plyometric jumps, balance exercises, agility drills and strength work, all designed to retrain the way the body lands, cuts and decelerates. The insight was simple: the knee does not know it is about to be injured; it just follows a habit, and habits can be rewritten.

C. The evidence that these programmes work is now strong. A 2026 systematic review and meta-analysis pooling many randomised trials found that neuromuscular training reduced the overall risk of ACL injury by more than half, with an odds ratio of 0.46. The effect was even larger in athletes under eighteen, where the odds ratio fell to 0.37 — a finding with obvious implications for youth sport, because adolescence is precisely when ACL injury rates begin to climb. Importantly, the reduction is greatest for non-contact injuries — the plant-and-cut and landing mechanism that NMT was designed to address — and smaller or absent for contact injuries sustained during tackles, which no warm-up routine can prevent. The programmes also reduce injuries to the hamstrings and other knee structures at the same time, making them a broadly useful tool rather than a narrow intervention. Cost-benefit analyses suggest that for every dollar spent on NMT, several dollars are saved on surgery and rehabilitation.

D. Not every programme works equally well. A consistent finding in the literature is that single-component interventions — a handful of balance exercises, or a weekly strength session on its own — have failed to reduce ACL injury rates significantly. What works is a multicomponent programme delivered regularly over months, integrated into the team's regular warm-up. The best-known examples, such as the PEP programme and the FIFA 11+, require only about twenty minutes per session, two to three times per week, and use no equipment beyond a few cones and exercise mats. Coaches who simply read the manual and perform the drills without emphasising quality of movement get disappointing results; those who focus on correct landing technique, progressive difficulty and feedback to individual athletes see the largest reductions. Compliance — actually doing the programme, week after week, season after season — is the single biggest barrier. Teams that start enthusiastically in pre-season often abandon the routine under match pressure by mid-season. Research suggests that programmes are most effective when a designated coach is assigned responsibility, rather than when the routine is left to the players' own initiative. Accountability, in other words, matters as much as the exercises themselves. A programme that no one enforces will not prevent an injury that no one expects. This is why prevention fails more often from neglect than from bad science. The evidence is clear; the challenge is organisational, not scientific. That is the harder nut to crack, and the one that will determine whether the science is translated into actual injuries prevented.

E. The challenge is not only preventing the first injury but preventing the second. Athletes who return to sport after ACL reconstruction surgery face a risk of re-tear, either of the same graft or of the uninjured knee, that remains elevated for years. Neuromuscular training plays a central role in rehabilitation, not just because it rebuilds strength but because it retrains the movement patterns that broke down during the original injury. There is also a growing understanding that the gender gap — why women tear their ACLs so much more often — is not simply a matter of hormones or anatomy. It reflects differences in how male and female athletes land, cut and recruit their muscles, differences that neuromuscular training is specifically designed to correct. The prevention tools already exist. The task now is not to discover new exercises but to convince coaches, schools and national sporting bodies that twenty minutes of structured warm-up, repeated thousands of times, is worth every minute. The athletes who benefit most are the ones who never know they were at risk. The best injury prevention is invisible; the players who never tear an ACL are simply the ones who went through the drills week after week and were never tested.

Questions 1-4

Choose the correct heading for paragraphs B, C, D and E from the list of headings below.

List of Headings i. From "bad luck" to learnable movement patterns ii. Anatomy of the knee and the ACL iii. The evidence that neuromuscular training works iv. Why some programmes fail and others succeed v. Preventing re-injury and closing the gender gap vi. The history of knee surgery vii. Why female athletes should avoid sport

1. Paragraph B: ____
2. Paragraph C: ____
3. Paragraph D: ____
4. Paragraph E: ____

Questions 5-8

Choose the correct letter, A, B, C or D.

5. How does a typical non-contact ACL injury happen? A. Another player tackles the athlete from behind. B. The knee collapses inward during a landing or cutting movement. C. The ligament is cut by a sharp object. D. It happens only during swimming.

6. What did the 2026 meta-analysis find about neuromuscular training? A. It had no effect on ACL injury risk. B. It reduced ACL injury risk by more than half. C. It only worked for professional athletes. D. It increased hamstring injuries.

7. Why do single-component interventions fail? A. They are too expensive. B. What works is a multicomponent programme delivered regularly over months. C. They require surgery. D. They only work for older athletes.

8. Why is compliance the biggest barrier? A. The programmes require expensive equipment. B. The exercises are painful to perform. C. The benefits depend on doing the programme regularly over many weeks. D. Coaches are not allowed to run warm-ups.

Questions 9-13

Do the following statements agree with the claims of the writer?

Write:

• TRUE if the statement agrees with the information
• FALSE if the statement contradicts the information
• NOT GIVEN if there is no information on this

9. Female athletes in cutting sports are four to six times more likely to tear their ACL than male athletes.
10. Neuromuscular training works best for contact injuries during tackles.
11. The best-known prevention programmes require about twenty minutes per session.
12. Athletes who have already torn one ACL face no elevated risk of re-injury after surgery.
13. The PEP programme uses specialised weightlifting equipment.

Questions 14-15

Complete the summary below using NO MORE THAN TWO WORDS from the passage.

Athletes who later tear their ACL show characteristic patterns such as knees collapsing inward, called (14) __________, and landing with stiff legs; these are learnable (15) __________ that can be retrained.

答案与解析

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