Anterior Cruciate Ligament Injury Prevention
The anterior cruciate ligament (ACL) is one of the most important ligaments in the knee and, sadly, one of the most commonly injured ligaments in the knee. ACL injuries account for a large health care cost estimated to be over half-billion dollars each year, with about 150,000 ACL injuries occur in the United States each year.1 Female athletes who participate in basketball and soccer are two to eight times more likely to suffer an ACL injury compared to their male counterparts. Athletes who have suffered an ACL injury are at increased risk of developing arthritis later on in life, even if they have surgery for the injury.1
Why do ACL injuries occur?
External Factors. External factors include any play where the injured athlete’s movement is disrupted just before landing or slowing down. Examples of a disruption include being bumped by another player, landing on an unstable or uneven surface, or a ball deflection. Other external factors which have been studied include the effects of wearing a brace, how shoes react to the playing surface, and the playing surface itself.1
Internal Factors. Internal factors include differences in the anatomy of men and women, increased hamstring flexibility, flat footed, hormonal effects, and variations in the nerves and muscles which control the position of the knee. The pelvis is wider on women, which causes them to be “knock-kneed”, predisposing them to a greater chance of ACL injury.1
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How do ACL injuries occur?
Studies of athletes show that tearing an ACL occurs approximately 70% of the time during noncontact and 30% occur during contact. The noncontact injuries usually occur during landing or sharp deceleration. In these cases, the knee at the time of injury is almost straight and may be associated with valgus (inward) collapse.1 Contact injuries occur with the knee is actually forced into the inward collapse. ACL injuries can also are paired with other injuries to the medial collateral ligament (MCL) and meniscus.
How to prevent ACL injuries?
Several prevention programs have been developed in an attempt to decrease the incidence of noncontact ACL injuries. The focus of current prevention programs is on proper nerve/muscle control of the knee. These programs focus on stretching, plyometrics, balance, and strengthening/stability exercises.1,2 Research suggests that using an ACL prevention program can reduce the risk of injury by almost 50%.2 ACL prevention programs can also help improve measures of performance: vertical jump, sprint speed, hop distance and speed, and overall aerobic capacity.2
Here is a list of free preventative training programs that have been supported by research.2
Sources:
1 Boden, B., Anterior Cruciate Ligament Injury Prevention. (2008) Retreived from AOSSM: http://www.sportsmed.org/uploadedfiles/content/patient/sports_tips/st%20acl%20injury%2008.pdf
2 Preventing ACL Injuries and Improving Performance. Retreived from NATA: http://www.nata.org/sites/default/files/prevent_acl.pdf
With today's technology this injury has went from life changing to very manageable. A few years ago the recovery time for this injury was 9 months to a year, now the recovery time is 6-9 months. Some athletes are even coming back ready to perform at 4 and 5 months and being very successful. People are starting to be a lot more educated about this injury because it does seem to occur more often. Hopefully more teams will start to use a prevention program so we can see soem of these numbers drop.
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