{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T17:46:20Z","timestamp":1792086380557,"version":"4.4.0"},"reference-count":203,"publisher":"International Journal of Sports Physical Therapy","issue":"10","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Non-contact anterior cruciate ligament (ACL) ruptures occur in the blink of an eye: peak ligament strain usually coincides with the first 30\u201350 ms after foot strike, long before reflex feedback can intervene. The model proposed herein integrates findings from previously published studies to formulate a testable framework. The proposed model assigns the decisive protective role to feed-forward hamstring tension and the calcium-dependent stiffening of titin, both of which are fully established before ground contact. Once impact occurs, short-range muscle stiffness and residual force enhancement dominate load absorption, but their buffering capacity is finite; if anterior shear and valgus torque exceed this molecular \u201cspring-damper\u201d threshold within ~60 ms, the ACL ruptures. Reflex-mediated hamstring activity arrives \u226535 ms after impact and transcortical corrections even later, rendering feedback too slow for primary protection. By mapping the cascade from cortical pre-activation to titin nano-mechanics, the model clarifies why pre-contact landing strategies and eccentric-strength training are the cornerstones of injury prevention, and it identifies specific molecular adaptations faster Ca\u00b2\u207a release, larger titin-actin binding capacity, and enhanced short-range stiffness as novel therapeutic targets. The purpose of this clinical commentary is to provide a theoretical model intended to guide future empirical investigations.<\/jats:p>\n                  <jats:sec id=\"level-of-evidence\">\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>5<\/jats:p>\n                  <\/jats:sec>","DOI":"10.26603\/001c.163662","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T17:08:35Z","timestamp":1792084115000},"source":"Crossref","is-referenced-by-count":0,"title":["Sensorimotor and Molecular Mechanisms of Non-Contact ACL Injury: An Integrative Hypothesis"],"prefix":"10.26603","volume":"21","author":[{"given":"Miko\u0142aj","family":"Sta\u0144czak","sequence":"first","affiliation":[{"name":"School of Mathematical and Computer Science, Heriot-Watt University, Edinburgh EH14 4AS, UK"},{"name":"Sports Research Center Nicolaus Copernicus University, Toru\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bram","family":"Swinnen","sequence":"additional","affiliation":[{"name":"Integrated Performance Training, Hasselt, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norbert","family":"Kapi\u0144ski","sequence":"additional","affiliation":[{"name":"University of Warsaw, Poland"},{"name":"Smarter Diagnostics, Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Koz\u0142owski","sequence":"additional","affiliation":[{"name":"Smarter Diagnostics, Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart\u0142omiej","family":"Kacprzak","sequence":"additional","affiliation":[{"name":"BK21 MedConcept, 90-349 \u0141\u00f3d\u017a, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Hagner-Derengowska","sequence":"additional","affiliation":[{"name":"Sports Research Center Nicolaus Copernicus University, Toru\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Trybulski","sequence":"additional","affiliation":[{"name":"Medical Department of the Upper Silesian University in Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"11140","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"issue":"14","key":"ref1","doi-asserted-by":"publisher","first-page":"7563","DOI":"10.3390\/ijms22147563","article-title":"Titin N2A domain and its interactions at the sarcomere","volume":"22","author":"A.O. 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