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ACL Injury Prevention Programs

BOSU Ball used to train balance and help reduce ACL tears

BOSU Ball squats and balancing can help reduce ACL injuries by training joints and muscles to react appropriately.

A tear to the ACL (anterior cruciate ligament) in the knee can be one of the most detrimental injuries to an athlete. In order to decrease the chance of such an injury occurring, preventative programs should be performed by athletic populations. These programs can be done at home or during the beginning of a practice. ACL prevention programs can also be incorporated into a warm up, prior to exercise. The programs focus on plyometrics, balance, stretching, and strengthening exercises.

Plyometrics are described as rapid and powerful movements. These movements first cause a muscle to lengthen, then shorten. The combination of lengthening and shortening the muscle at a fast pace increases the power of a muscle. Plyometrics aid in the prevention of ACL injuries by training the muscles to react at a faster rate preventing the knee from shifting. Examples of plyometrics are single leg cone jumps, squat jumps, single leg bounding, and ladder drills. The goal when performing these drills is to jump immediately again after making contact with the ground. The exercises are generally performed for about 30 seconds, however when first starting the drills, a shorter time may be required to begin and then gradually increased with practice.

Balance and stretching are also key factors to preventing ACL injuries. It is important to thoroughly stretch the calf, quadriceps, and hamstring muscles. Stretching these muscles will ensure that the muscles are not too tight which could cause a muscular imbalance and increase your chance of injury. Balance or proprioception is also a goal in ACL prevention as it can allow muscles to work together to stabilize the body on various surfaces. If the body and knee cannot quickly react to surface changes, an ACL injury could occur. Balancing exercises can be performed on one leg, on uneven surfaces such as a BOSU Ball, and can incorporate throwing a ball while balancing to increase muscular stability and neurologic reaction time.

Strengthening is the final aspect of an ACL prevention program. It is essential to strengthen not only the hip and thigh musculature, but also the core. Strengthening the musculature of the legs allows for a more stable knee joint which decreases the risk of ACL injury. Core and leg strengthening can be done using the body’s weight through exercises such as walking lunges, squats, sit ups, and planks. Exercises such as walking lunges are also an adequate exercise to warm up and loosen the muscles before activity.

While performing ACL prevention programs, it is imperative to focus on technique more than the number of repetitions completed in the allotted time. When jumping during plyometrics, the proper landing technique is to bend at the knees and hips to absorb the force rather than keeping the knees and hips straight causing the force to compress the joints. The phrase ‘light as a feather’ is used to describe how to land, meaning land as softly and quietly as possible to absorb the shock. The toes are to remain pointing forward at all times, and the knees are to stay in line with the toes. This ensures that the muscles are functioning together providing the best stability for the ACL. Poor technique can lead to a muscle imbalance, decreasing the stability of the knee.

ACL prevention programs can be done in 15 minutes and research has found them to be beneficial to help prevent injury. These programs are recommended to be performed at least 2-3 times per week with at least 1-day rest between each session. A minimum of 6 weeks is needed to provide the best results. Although it appears to be a hassle, these programs only take a few minutes to perform and can be done using simply the body’s weight, while providing a decreased risk of a serious ACL knee injury.

Should I use Static or Dynamic Stretching in my Workouts?

     One of the most critical aspects of injury prevention is the maintenance of complete and non-restricted joint range of motion through stretching.  Stretching not only improves flexibility, but also can reduce the risk of injury.  The question of whether static or dynamic stretching is the most beneficial prior to exercise has been debated.  Recent evidence has determined that dynamic stretching is most effective prior to exercise, while static stretching is most beneficial following activity.  Dynamic stretches resemble the movements produced during activity, while static stretches allow a relaxation period for the muscles of the body to recover.  So what is static and dynamic stretching?

Static Stretching

            Static stretches are utilized to increase the flexibility of a joint or multiple joints while

the body is at rest.  During a static stretch, the muscle is placed at the maximal stretch, which is generally determined as the point at which a firm, yet bearable resistance is felt. 

Static Stretching

Perform static stretches after workouts.

The position is then held for 10 to

20 seconds and repeated from 3 to 5 times.  Static stretching can be as simple as the common hamstring stretch.  While sitting on the floor with legs extended straight out in front of you, slowly lean forward to touch your fingers to your toes and hold this position.  When performing the stretch do not bounce or rock, hold a controlled stretch the entire time.  This is an example of static stretching.  Resistance bands and stretch straps are two common pieces of equipment used by athletes to assist them in performing static stretches.      

Dynamic Stretching

           Dynamic stretching is a series of controlled movements with slight resistance which are intended to improve range of motion, or flexibility, as well as prepare the

Dynamic Stretch

Athlete warming up on the track performing dynamic lunge stretches.

muscles for a more intense activity.  A dynamic stretch is generally repeated about 10 times per stretch.  During the repetitions, the dynamic stretch is accelerated from small, slow movements to bigger and faster movements.  Unless physically fit, it is recommended that dynamic stretching is slowly incorporated into a fitness routine to prevent soreness or injury.  Walking lunges are an example of dynamic stretching in which a typical lunge is performed while walking forward for a designated distance.  Other examples include arm circles and half squats.  Dynamic stretches can also be performed using resistance bands and stretch straps.

 

            While both static and dynamic stretching have been proven effective in increasing the range of motion of a joint, dynamic stretching can also prepare and ‘warm-up’ the muscles for further activity by mimicking physical activity patterns.  Since sports and other activities are dynamic in nature, the best way to prepare for exercise is with dynamic stretching that incorporates full body stretching with your sports movement patterns.  Static stretching should be utilized following activity to allow muscles and joints to increase flexibility and aid in the prevention of soreness.  For those who are just beginning an exercise regimen, it is recommended that dynamic stretching is slowly incorporated into the warm up routine to prevent soreness or injury.

Tips to Avoid Joint and Hip Injuries

The body’s joints take quite a beating over the course of a person’s life, causing wear-and-tear damage that can lead to osteoarthritis and other chronic joint conditions. Weight-bearing joints, like hips and knees, are among the most vulnerable to this type of damage. While a certain amount of gradual wear on your joints is unavoidable, excessive wear can be prevented by taking good care of your body. Avoiding joint and hip injuries is an important step toward that goal and can help prevent disabling joint problems later in life, reducing your risk of needing surgery, such as a hip replacement.

 

Hip Joint

Painful Hip Joints Can Often Be Avoided

Exercise

Staying active is essential to maintaining joint health and flexibility. Exercise also helps maintain bone strength, which is very important in avoiding hip injury and deterioration that can lead to the necessity of hip replacement. The stress placed on the bones by exercise stimulates bone cell growth, slowing the pace of natural bone loss that occurs with aging.

Low-impact exercise is best, like walking, bicycling, swimming or aerobics, since exercise that pounds and jars the joints increases the risk of both immediate injury and the gradual damage that leads to overuse injuries and chronic joint problems. Resistance exercise, such as light weight-lifting, helps in the maintenance of joints and bones as well, and should be done at least twice weekly.

Be sure to warm up and stretch before exercise to reduce the chance of joint injuries, and avoid exercising on hard surfaces, such as asphalt, or rough, uneven terrain. Consulting a fitness instructor is the best way to devise an exercise plan that promotes optimal hip and joint health.

Weight Management

Being overweight is one of the biggest risk factors for joint and hip injury. Extra weight places undue stress on weight-bearing joints, increasing the risk of osteoarthritis and overuse injuries such as tendinitis and bursitis. Even losing a little weight can help, since each pound you lose takes about four pounds of pressure off of weight-bearing joints.

Nutrition

Eating well helps ensure that the body has a plentiful supply of vitamins, minerals and other essential nutrients to repair and maintain the joints. Among the nutrients essential to joint health are vitamins A and C, which aid in collagen production, and omega-3 fatty acids, which reduce inflammation. Getting plenty of minerals, especially calcium and phosphorus, is essential to maintaining bone strength, and balanced nutrition keeps muscles healthy and strong, providing vital support and protection to the joints.

Why Joint Health Matters

Joint injury and deterioration is a leading cause of disability in adults, particularly those older than age 65. While modern surgical procedures and prosthetic devices have provided relief to many, they are not without risk.

Defective hip replacement implants have caused high rates of complications in recent years. Among the most serious of these is metallosis, a condition that occurs when the components of metal-on-metal hip implants shed debris into surrounding tissues, causing severe pain and inflammation. Implant debris can also lead to osteolysis, which is bone loss around the implant that can cause it to loosen or fail. Revision surgeries have been necessary in many cases to repair the damage, and these issues have led to the recall of several products and thousands of hip replacement lawsuits.

Elizabeth Carrollton writes about defective medical devices and dangerous drugs for Drugwatch.com and is a guest article contributor to the Hat Trick Sports resource and sports performance pages.

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