With sport having evolved to the entity it is today, we are seeing an increased number of participation injuries worldwide. These injuries range from simple overuse issues, such as low back soreness, to season-ending injuries, such as fractures to bones. While every type of injury requires specific attention regarding the cause(s) and ways to appropriately attempt to prevent or limit such injuries, the scope of this article is intended to address one in particular: NON-CONTACT ANTERIOR CRUCIATE LIGAMENT (ACL) INJURIES.

 

In the United States alone there are more then 80,000 reported ACL injuries each year. These range from mild, first-degree sprains to third-degree sprains, to complete ruptures from the bone. Aside from the obvious physical implications accompanying this injury, there also are mental frustrations, experience missed, and both time and monetary investments to take into account.

 

Missing out on a competitive season while being sidelined from injury is especially frustrating for the athlete. While the athlete mainly focuses on just not being able to play, we know that nothing surpasses the importance of actually competing in terms of athletic and skill development.

 

As for recovering from an ACL rupture, in terms of competition time missed, an athlete can expect to be sidelined three to six months. If that time is lost during the competitive season, that lost experience can mean the difference between a collegiate scholarship and athletic career or not. Lastly, for a young athlete who suffers this type of injury, their parents are looking at medical billing in the range of $17,000 to $25,000.

 

It is imperative that athletes and parents alike are educated and equipped so that steps may be taken to lessen the severity of a sustained ACL injury or avoid one altogether. In what follows, I will briefly explain the function of the ACL, review the most recognized mechanisms pertaining to noncontact ACL injuries, and suggest proven practices that will aid in prevention of these types of injuries.

 

The ACL originates from the lateral (outside) aspect of the femur (thigh bone), runs through the femoral notch (a bony landmark on the femur), and attaches to another bony landmark on the tibia (large, lower leg bone). Its primary functions are to prevent side-to-side mobility, rotation, and anterior translation (forward movement) of the tibia in relation to the femur.

 

Regarding contact injuries to the ACL, the cause is a strike to the lateral side of the leg or knee. Regarding noncontact ACL injuries, a single common cause hasn’t been identified. However, the multiple reasons that contribute to them have been identified, and a portion of them can be prohibited through proper training. So what are the manageable mechanisms and what must be addressed in a prudent training regimen?

 

·         Strength

·         High-risk movements, positions and postures

·         Sport-specific balance

·         Unconditioned musculature programming components crucial to ACL health

·         Professional testing to identify individual risk and assess improvement

·         A comprehensive and progressive strength regimen

·         A comprehensive and progressive movement training regimen

 

           

When looking at the mechanisms that lead to noncontact ACL injuries, one can discern that developing appropriate levels of strength will aid in correcting all of them to some extent. By becoming stronger, the athlete can better coordinate and control his or her musculoskeletal system, decreasing the level of risk associated with individual movements, positions, and postures. Also, the stronger an athlete is, the more balance and endurance he will have as strength is a component of balance and conditioning. Finally, increasing strength levels in an athlete doesn’t just strengthen the muscles but the supporting connective tissues, tendons and ligaments, as well.

 

Generally speaking, an appropriate strength regimen will prescribe exercises that address and balance all major muscle groups with extra attention devoted to the problem areas associated with ACL injuries: specifically the posterior chain (lower back, gluteals, hamstrings, calves, and the remainder of the “core” musculature). Once the proper exercise prescription is in place, the performance professional should then ensure that the athlete is safely progressing over the course of time via:

·         Performing more repetitions with a given weight

·         Performing the same repetition range with a heavier weight

·         Increasing volume

·         Decreasing respite periods between exercises

 

 

As listed in the PROGRAMMING COMPONENTS section, testing and watching how the athlete moves in a closed and controlled setting will help a professional determine what that individual must correct. As each component is addressed and corrected, the likelihood of that athlete sustaining an ACL injury in the open and uncontrolled athletic arena diminishes. A practical ACL movement training program will address the following components:

·         Proper deceleration techniques

·         Proper planting, cutting, & pivoting techniques

·         Body control in all three anatomical planes (balance & stability)

·         Landing techniques (if necessary)

·         Conditioning the musculature in a sport-specific manner

 

CONCLUSION

 

ACL injuries are prevalent amongst today’s growing athletic arena. Thankfully, the allied health fields have noticed and spent countless hours and dollars on research to equip professionals with all of the information they need to combat this trend. It has been scientifically publicized that if proper testing is accompanied by proper strengthening and movement training, the severity of experienced ACL injuries are reduced at worst and prevented all together at best. That is why Pinnacle Sports/Edge Sports Performance has developed a specific ACL Prevention program and continues to address this matter in its daily programming. After all, keeping athletes healthy and in competition is our primary goal, above all else.

 

If you are looking for a performance institution to help you or your athlete(s) prevent this particular injury from occurring, ensure that the programming makes certain that the following items are inclusive:

·         The musculature of the body is strengthened, balanced, and progressively overloaded

·         High-risk movements, positions, & postures are identified and addressed

·         Proper deceleration techniques are instructed

·         Suitable planting, cutting, & pivoting techniques are instructed

·         Appropriate landing & bodily control from jumps is addressed

·         Sport-specific balance is enhanced through practice

·         The musculature is conditioned in a sport-specific manner through movement (agility) training to improve the reaction time of the hamstrings & calves to prevent anterior translation of the tibia

 

For additional information or questions regarding athletic performance, feel free to contact Pinnacle Sports/Edge Sports Performance: