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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.

Types of Knee Braces: A Guide to Finding the Right Knee Brace

knee-brace

Knee Bracing can be used for prevention, post-injury, or rehabilitation.

Knee pain is a very common ailment affecting a wide range of people.  A variety of knee braces from many well-known manufacturers such as DonJoy, Breg, New Options, McDavid, and Cho-Pat are available to help alleviate the pain associated with different knee injuries.  Patellar, or kneecap pain associated with poor tracking, subluxation, dislocation, or tendonitis can be treated with sleeve type braces or Cho-Pat Straps, while ligamentous knee injuries to the ACL, PCL, MCL, LCL or cartilaginous injuries to the meniscus can be treated with a variety of hinged braces.  With the help of a medical professional, finding the right brace for a specific injury can be easy.

Knee sleeves and knee straps are the most commonly used types of knee braces used for athletes and the physically active person.  Neoprene knee sleeves are used to give the knee and patella additional support and stability. They are elastic, easy to apply, and provide compression and heat to the knee.  They are great for athletes or patients with arthritis, patellofemoral pain, or chronic inflammation or swelling.  Sleeves with a supportive doughnut around the patella, such as the DonJoy Deluxe Elastic Knee Sleeve or the DonJoy Lateral J Support Knee Sleeve are used to help with patellofemoral pain, patella subluxation, or lateral patella tracking.  Knee straps, such as the Cho-Pat Knee Strap are used for athletes, running, or patients suffering from patellar tendonitis or runner’s knee.

Hinged knee braces are most commonly used for athletes or patients who are suffering from injuries to the ligaments of the knee.  Whether the injury to the ligaments is mild or requires surgical intervention, a hinged knee brace will provide support and stability to the knee during the rehabilitation process and eventual progression back into activity. There are a wide variety of hinged braces specifically designed for the different ligament injuries that can occur in the knee, and provide a varying degree of support to correspond with the severity of the injury.  Design of the braces also varies for patient comfort and use, with the DonJoy Playmaker Hinged Knee Brace in the knee sleeve style or the DonJoy Playmaker Wraparound Hinged Knee Brace in a style that Velcro’s around the knee instead of having to pull the brace on, while still providing similar knee support.  Custom braces are also available to fit specific injury needs. When choosing a knee brace it is important that all aspects of the injury are properly supported, and sometimes a custom brace is necessary.  Custom bracing is usually expensive and made to fit your specific leg.  For proper sizing of a custom brace, measurements are taken by a doctor or trained professional, and the brace is then made to your specific body specifications.

It is important to talk to a medical professional before deciding on a brace.  They can help guide you to the right type of brace for a specific injury and also help with the correct sizing.  If the sizing is incorrect, the brace may not be effective or support the knee and its structures properly.  Always make sure to wear the knee brace during the times and activities it is prescribed by the medical professional.  When they are used safely and correctly, knee braces are very effective tools at reducing knee pain and adding additional support.  For more information on the different types of knee braces, please visit http://www.hat-trick-sports.com/shop/category/knee-brace-support.

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