It is currently estimated that there are over a quarter-million anterior cruciate ligament (ACL) injuries per year in the United States. A number that continues to grow, despite evidence of the effectiveness of ACL injury prevention programs.
Greater than 50% of these injuries occur in athletes 15-20 years of age. This is of critical importance in athletes of this age group due to the non-physical effects that an ACL injury can lead to. Studies have indicated that GPA declines, and several of my own personal clients have lost or have had their scholarship reduced.
With ACL injuries becoming so commonplace, it is essential to develop a more defined strategy to reduce their number. Merely having programs that address ACL injury prevention is not enough. We have to take these programs to the masses. Going directly to teams, leagues, school districts that these athletes play and screen them. Athletes who are predisposed to ACL injury must be identified and have access to the tools that will help them avoid these injuries.
What is the research indicating is the cause of these knee issues? Poor Movement Strategies and Hip/Pelvis Imbalances.
The ACL is most vulnerable when the knee is positioned in valgus (knock-kneed), and the femur is internally rotated on a fixed tibia. In order to protect the joint and ligaments, strength training and neuromuscular coordination re-training must occur. Typical muscle imbalances found are weaknesses in the lateral stability systems, lower abdominals, and posterior chain. Tightness tends to develop in the adductors, hip flexors and gastroc/soleus (calf muscles). Correction of the imbalance must occur before movement retraining starts, otherwise you will continue to reinforce the compensatory movement strategies that exist.
Every athlete must first have their movement strategies individually analyzed before they begin training.
Physical therapists are the ideal professionals to examine these strategies due to their extensive education in the foundations of movement.
Currently, there is an overall lack of adequate movement and strength analysis before starting many training programs. Many are “one size fits all” and don’t account for the uniqueness of each athlete. Poor movement patterns and strength deficits must be “diagnosed” prior to “prescribing” the correct training program.
In order to establish a successful prevention program we must proactively educate society in the benefits of true prevention. Our current actions are to only seek medical guidance when we are already injured.
If dentists can screen for gum disease, perform regular checkups, and are successful in getting patients to perform daily prevention tasks such as brushing and flossing, Physical Therapists can perform movement screenings and testing for weak muscles at an early age as well. Once vulnerable athletes are identified, they must then begin systematic injury prevention training. We have the ability to protect up to 88% of athletes from the harmful effects of an ACL injury. The research has been done, and the protocols have been written, now it is the PT’s job to implement them.
Schedule your ACL Injury Prevention Screening HERE.