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Friday, February 1, 2008
ACL Injury Prevention
Greater Reading, PA
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By: Cody Keeney, Spring Valley Athletic Club
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Imagine it is the first game of your senior year of high school. You have high hopes for playoffs and envision finishing your career with a great last season. A few minutes into the game you jump to challenge for a ball in the air. As you land, your knee buckles….you hear a “pop” and collapse to the ground. You have just torn your ACL. Your senior season is over. What will follow is surgery and months of tedious and painful rehabilitation.
There are an estimated 56,000 ACL injuries that occur during sports annually in the United States. Many of these injuries occur in non-contact situations. The Anterior Cruciate Ligament (ACL) is vital to athletes. This ligament controls rotational forces in the knee. If the ligament is torn, sudden changes in direction are nearly impossible. ACL injury prevention should be a priority in every athlete’s training and conditioning program.
Control of the knee during sports is maintained by a balanced interaction between the quadriceps and hamstring muscles. This includes the muscles and the nerves which tell the muscles when to contract. Non-contact ACL injuries are usually the result of a biomechanical breakdown in muscle recruitment which fails to reduce stress on the ligament and instead increases stress. The quadriceps muscle places stress upon the ACL when contracting, while the hamstring muscle reduces stress on the ligament when contracting. If an athlete’s hamstring muscles are weak or inflexible, they may not be able to protect the ACL during an intense quadriceps contraction.
An off-season conditioning program focusing on ACL injury prevention should contain exercises that increase both strength and flexibility in the hamstring muscle. It should also focus on proper technique for landing and decelerating. These are keys to injury prevention. Too many coaches, players, and parents become obsessed with increasing speed and strength. It is important that athletes first learn how to slow down correctly so that they can properly handle increases in strength and speed without sustaining injuries.
For landing technique, it is very important that the athlete learn to land on the balls of their feet, knees flexed, and chest over the knees. This engages the hamstring muscles which will reduce stress on the ACL. The athlete should also learn to avoid any excessive rocking or inward movement of the knees upon landing. During technique training the coach should use verbal cues such as “light as a feather” or “stick the landing”. Emphasis should always be on form and mechanics. Efforts to increase speed and strength should only occur once proper technique has been established. Strengthening exercises should focus on improving hamstring strength and flexibility as well as coordination with the quadriceps muscle. Some useful exercises are: weighted 45° back extensions, squats, deadlifts, and hang cleans.
ACL injuries during sports are increasing every year in the United States. Once an injury is sustained, it takes months of grueling therapy to return to playing; usually with reduced performance levels and a greater risk of re-injury. Following a well-designed periodized strength and conditioning program with particular emphasis on technique and hamstring development will greatly reduce the risk of ACL injury. As we continue to make our athletes faster and stronger it is important to protect them from injury to ensure a healthy season and future.
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