Ortho NC: Training Tips To Help Avoid ACL-Related Injuries

In the May issue of VYPE, we began a discussion on ACL injuries and how they more frequently occur in female athletes than they do in their male counterparts. In that issue, I suggested that the cause of this higher frequency was based on differing lower body alignment and mechanics as a probable cause. This month, we'll take a look at several training methods and exercise programs that will hopefully make these proper alignment positions instinctive in all your athletic activities. Proper alignment is a combination of strength and flexibility of the core, thigh and leg muscles. The following are some recommended exercises, with a description of how they should be completed, that should provide you with greater strength and flexibility in these areas and reduce the risk of an ACL-related injury. These exercises should be supervised and it is not recommended that they be performed without a certified trainer or qualified therapist. The online version of this article has photos showing how four out of the six exercises should be performed. The print version shows the remaining two exercises, which can be accessed by downloading July's digital magazine.

Leg exercises: Quadriceps: Squats and lunges. As always, proper form is paramount. It is better to avoid these exercises than to perform them incorrectly. The athlete should keep the knee over the toe-both pointed forward, chest and chin up, as well as allowing both the ankles and hips to flex slightly (see photos in print version).

Calf: A very simple exercise, such as a calf raise can be of immeasurable benefit to strengthen the lower leg.

Hamstring: The ACL and the Hamstring work together to prevent the shin bone (tibia) from moving forward on the thigh bone (femur). Training the hamstrings using a physioball also incorporates core stability and balance. To perform this exercise, the athlete lifts the hips up, while pulling and pushing the ball away from the body.

Hip Abductors: A collection of muscles in the gluteal region are responsible for stabilizing our hips as we run and walk, providing a foundation upon which our entire leg works and is balanced. When these muscles are weak or uncoordinated, all joints of the lower limb are in danger of injury. Two very simple exercises are sufficient to train these muscles. It is important to stand tall and not "drop" the hip on the weight-bearing leg to achieve the motion.

Plyometrics: Plyometrics is another technique used to train proper mechanics of the leg. The box jump is one of the easiest exercises to perform. The athlete stands on a plyobox in a squat, jumps up and lands first on the balls of the feet (if done correctly, landing will be nearly silent), with ankles, knees and hips bent, chest and chin should be up.

Running Form: See figures in print version to view the appropriate lower extremity alignment when running. Hips, knees and ankles should be in alignment with body weight centered.

Please note that these training techniques are advanced and should be performed only under the guidance, supervision and instruction of a qualified therapist or athletic trainer. With diligence and guidance the athlete will be able to improve overall athletic performance. While no prevention program is 100% effective, maintenance of proper technique is helpful for optimum performance and health of our athletes.

Dr. Galland is a Board Certified Orthopaedic Surgeon specializing in Sports Medicine practicing in Wake Forest and North Raleigh. He currently serves as: Team Physician and Orthopaedic Consultant to the Carolina Mudcats, AA Affiliate of the Cincinnati Reds of Major League Baseball; Medical Director and Orthopaedic Consultant to the Louisburg College Athletic Program and Team Physician and Orthopaedic Consultant to several area high schools. Dr. Galland has authored book chapters and papers in Sports Medicine. His advice and consultation is routinely sought by World Class Athletes of Track and Field and Major League Baseball. His passion for resolving musculoskeletal ailments and injuries in the most conservative manner possible puts all his patients in the most capable and caring of hands. He is available for consultation and you may schedule an appointment at www.orthonc.com or by phone 562-9410.