By Nate Henry, Orthopedic and Sports Enhancement Center
ACL injuries are on the rise. In fact, according to a recent study, there are 250,000-300,000 new cases each year nationwide among athletes. The Anterior Cruciate Ligament (ACL) is the smallest of the four major ligaments in the knee, but it acts as its primary stabilizer, especially of rotational movements. This is why the incidence of ACL tears occurs primarily in athletes, especially those who play sports that require many changes in direction, multi-directional movements, and landings from a jump (soccer, basketball, football, volleyball, etc.). There has been a major movement in recent years for a training program that will prevent these injuries before they happen. Which begs the following question: Is ACL injury prevention simply good training? This is a common question among many experts and professionals in the world of strength and conditioning. Many programs use the same training program for all of their athletes, regardless of the risk of ACL injury. The feeling is that we should be practicing great injury prevention/reduction concepts with all our athletes, regardless of their sport.
I would disagree slightly with this line of thinking, although I do agree we should be practicing these concepts to a certain degree with all of our athletes. Awareness is key for an athlete who may be at risk of an ACL tear; similar to an athlete who does a lot of overhead throwing being aware of potential shoulder problems, which is why most baseball and softball players will address this in their training. Athletes competing in sports with numerous changes of direction, landing from jumps and any contact sport should be aware that the sport they participate in puts them at risk of a devastating knee injury. In addition to athletes competing in change of direction sports, female athletes are said to be 4-6 times more likely to tear their ACL than a male playing the same sport. There are many reasons hypothesized for this fact, with the greatest being that women tend to have a strength imbalance between their quadriceps muscles and their hamstrings muscles. For this reason, we spend a great deal of time with our female athletes on ACL tear prevention strategies.
The main areas we address in a good knee/ACL injury reduction program are a good dynamic warm-up, activation of the proper muscles, developing strength and power, and teaching the components and concepts in change of direction and landing drills. A proper dynamic warm-up is where we always start. A dynamic warm-up primes the body for the activity that is to follow, so activation and blood flow to the muscles is the goal.
Activating the muscles of the posterior chain, specifically the glutes, hamstrings, and lower back, is often overlooked. Many athletes are quad dominant, and this can lead to valgus tendencies and potential acute and chronic injuries. Training athletes to activate the posterior chain in both the weight room and the field of play is vital for preventing injury and performing optimally.
Developing strength and power in the weight room and on the field or court is a vital component as well. Many of our favorite exercises are single-leg in nature to avoid a dominant side handling the majority of the workload.
Developing power on the field of play is also extremely important. We do this through a series of plyometric (jumping and hopping) movements. We teach these movements and emphasize both the concentric portion (the jump) and the eccentric portion (the land) to ensure proper execution is displayed during both. This training translates to the athlete’s sport and field of play because they are familiar with executing these movements properly through training in the off-season.
Agility drills are very similar to the plyometric movements, in that the eccentric portion is of the utmost importance. Teaching the athlete to decelerate, activate the proper muscles, and powerfully contract is the goal of our agility drills. Many of them are very basic in nature, but athletes can learn fundamentals on how to decelerate, accelerate, and translate that to their sport or sports.
Appropriate training by someone who is experienced and educated in the mechanics of sports can go a long way in reducing the incidence of ACL injury. A proper warm-up, developing strength and power, and learning to decelerate and land are all hallmarks to a sound ACL tear reduction program.
Nate Henry is the director of sports performance at the Orthopedic & Sports Enhancement Center. For more information on the programs available you may call 309-663-9300 or visit them online at www.sportsenhancement.net. They are located at 2406 East Empire in Bloomington. Personal training for all ages is offered in addition to the sports acceleration programs for athletes of all levels.
Photos courtesy of Sports Enhancement Center