ACL Injury and AT Legislation in CA
- Lauren Redler, MD
- 7 hours ago
- 5 min read
Forum members - please see below forwarded from Jo Hannafin about supporting mandating ACL Injury Prevention Legislation in CA. See instructions below if you would like to help!
Hi ACL Coalition friends,
I'm writing to share information about a California bill to make ACL injury education and prevention mandatory in non-scholastic youth sports. I've shared information about the bill in the attached PDFs. If you are willing and interested in supporting this legislation, there is an urgent opportunity to act. Read below.
Note: We completely respect those who are prohibited or uncomfortable in advocating legislation. If that is the case, please accept this email as information only.
The bill is being led by Beth Garsaw-Shimi, mother to a 14-year-old that suffered an ACL injury last year. At the moment, Beth is trying to secure a bill sponsor and has focused on Sen. Angelique Ashby. Beth has drafted a letter that she needs to send by tomorrow morning — the last day to submit a bill in this session. I realize this is last minute, but we have two ways you can support:
Add your name and affiliation to the letter (click here). If you do so, you are welcome to list National ACL Injury Coalition in your affiliations.
Call Senator Ashby's office or email the chief of staff to share your affiliation and support of the bill (contact info below)
Phone: (916) 651-4008
Chief of Staff: Cassidy Denny
One or both of these two options would need to happen tonight or the first thing tomorrow. I realize this is very short notice, but we only recently found out about this effort and I just spoke with Beth. As an Aspen Institute employee, I am restricted from lobbying legislation but told Beth that I would share the opportunity with others who may not be prohibited as such.
Here is a fact sheet of helpful details:
ASSEMBLY BILL: CALIFORNIA YOUTH ACL INJURY PREVENTION AND EDUCATION ACT
SUMMARY
This bill establishes minimum statewide standards for anterior cruciate ligament (ACL) and
lower extremity injury education, prevention, medical oversight, and injury tracking for
non-school youth sports organizations offering high-risk sports.
All provisions take effect January 1, 2027, allowing organizations time to prepare for
compliance. Youth sports organizations may adopt stricter safety standards if desired.
BACKGROUND
● ACL injury rates among youth athletes have increased steadily over the past two
decades, with adolescents and young adults experiencing some of the fastest growth.
● Female youth athletes are up to 8 times more likely than males to sustain ACL injuries in
comparable high-risk sports.
● ACL injuries often require surgery, extended rehabilitation, time away from school and
sports, and increase the risk of reinjury and early-onset osteoarthritis.
● Structured neuromuscular training programs incorporating strength, balance, agility, and
plyometric exercises reduce ACL injury risk by 50–80% when implemented consistently.
● Early intervention, beginning around age 8 and continuing through adolescence,
improves neuromuscular control during periods of rapid growth and reduces long-term
injury risk.
● Despite proven prevention strategies, youth sports organizations vary widely in
education, safety standards, and injury tracking practices. Existing California laws
address concussion, heat illness, and opioid education but do not establish consistent
ACL injury prevention requirements.
BILL DETAILS
This bill would require youth sports organizations offering high-risk sports to:
1. Annual Education
○ Coaches, referees, and administrators must complete annual training on:
■ ACL injury signs, symptoms, and prevention strategies
■ Concussion and head injury management
■ Heat-related illness recognition and response
■ Opioid awareness
2. ACL Injury Prevention Programming
○ Implement evidence-based, nationally recognized programs in consultation with
an Athletic Trainer, licensed Physical Therapist, or sports medicine physician.
○ Programs must include:
■ Strength training (lower extremities & core)
■ Neuromuscular training (balance, coordination, stability)
■ Plyometric training (jumping and landing mechanics)
○ Duration: 15–20 minutes per session, 2–3 times per week, starting in preseason
and continuing through the regular season.
○ Programs must be age-appropriate, starting at approximately 8 years old.
3. Information Sharing with Parents and Athletes
○ Provide educational materials and an injury information sheet to youth athletes
and parents/guardians before participation.
○ Materials must include:
■ Nature, signs, and consequences of ACL/lower extremity injuries
■ Best practices for removal from activity and return-to-play protocols
■ Local providers offering voluntary ACL injury prevention screening
○ Parents/guardians and athletes must sign and return the sheet before
participation.
4. Professional Disclosure
○ Provide each youth athlete’s parent/guardian with:
■ Full name of all Athletic Trainers, PTs, and other licensed sports medicine
professionals
■ License/certification type and issuing entity
■ Complaint filing instructions with licensing authority, organization, league,
or governing body
5. Medical Coverage and Emergency Authority
○ Ensure at least one Athletic Trainer, licensed PT, or sports medicine physician is
present at games/tournaments when reasonably available.
○ These professionals have independent authority to remove injured athletes.
6. Safety and Facilities
○ Make reasonable efforts to ensure access to restrooms during events.
○ Inspect safety equipment and playing conditions to prevent injuries.
7. Injury Removal, Reporting, and Tracking
○ Immediate removal for suspected ACL or lower extremity injuries.
○ Parents/guardians must be notified of injury time, observed symptoms, and
treatment provided.
○ Injuries reported to leagues/governing bodies must be de-identified and
aggregated, retained ≥5 years, and used to compile annual reports by sport and
injury type.
○ Athletes may return only after evaluation and written clearance by a licensed
provider, completing a graduated return-to-play protocol of at least 7 days.
8. Annual Declaration of Compliance
○ Youth sports organizations must submit annual compliance declarations to their
leagues/governing bodies.
○ Declarations and aggregated injury data must be posted online or distributed to
parents.
9. Higher Safety Standards
○ Organizations may adopt and enforce rules exceeding minimum requirements to
further protect youth athletes.
COMMITTEE FAQs
Q: Which organizations are covered?
A: Non-school youth sports organizations offering high-risk sports. Public schools and
governmental entities are excluded.
Q: Is medical coverage required at every event?
A: No. Medical coverage is required at games and tournaments when reasonably available,
with flexibility based on venue and staffing.
Q: Are privacy concerns addressed?
A: Yes. All injury data reported at the league/governing body level is de-identified and
aggregated. No personal identifiers are included.
Q: Why track injuries?
A: Aggregated injury data informs prevention strategies, parent education, and evidence-based
policymaking, without expanding liability.
Q: Does this apply to schools?
A: No. Public schools, districts, and government entities acting in a governmental capacity are
excluded.
Q: Are small or volunteer-run leagues able to comply?
A: Yes. The bill relies on nationally recognized programs, low-cost education modules, and
flexible implementation based on available medical professionals.
Q: Why focus on early adolescence?
A: Early intervention (≈age 8) corrects neuromuscular imbalances during periods of rapid
growth, reducing long-term injury risk.
Q: Are leagues required to provide medical treatment?
A: No. The bill establishes removal authority and referral to licensed providers, not direct care.
Q: Does the bill create new state agencies or programs?
A: No. Compliance is managed by youth sports organizations and leagues.
Q: Are there state or local costs?
A: Minimal. Responsibilities primarily fall on organizations using existing resources.
Q: Does this expose the state to liability?
A: No. The bill does not create a private right of action or expand civil liability.
Q: Can organizations go beyond minimum requirements?
A: Yes. Organizations are explicitly permitted to adopt higher safety standards.
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