Who's At Risk?: ACL Prevention

Neuromuscular differences are common place in the field of strength and conditioning.  Each athlete has different musculoskeletal differences- either excellent or poor.  Neuromuscular limitations should be addressed in order to prevent the incidence of injury in your athletes.  If you're a football fan, I'm sure you know who Tom Brady and Willis McGahee are.  What do these two athletes have in common?  They both tore their ACL's.  Annually, 100,000 athletes are left to deal with the pain and disappointment caused from this PREVENTABLE injury. A recent study found that over 70 percent of ACL injuries were non-contact.  What does this percentage mean?  ACL injuries can be prevented by corrective exercise, plyometrics and agility training.

Who is at risk?  When Male and Female athletes are compared, research states that females are more susceptible for an ACL tear during their athletic careers.   Females have specific anatomical and hormonal attributes which are typically not found in males.  To avoid a large amount of anatomy and physiology terminology, the picture and chart (Malinzak AAOS 1999) below show these differences well.  As for the hormonal differences, elevated levels of estrogen and progesterone during menstruation may decrease the amount of ACL collagen. 

Anatomical Attributes

Male

Female

Knee Flexion

29.8 degrees

24.6 degrees

Hip Flexion

39.0 degrees

30.9 degrees

Knee Valgus

1.9 degrees

11.1degrees

Quad Activation

135 percent

146 percent

leg[1] Eye opening... You don't need to be a doctor to see that the Q- Angle of the female athlete puts a large amount of stress on the knee.  A number of biomechanical properties can be observed during a SL squat which can determine the likeihood for an ACL tear in the future. 

Male- Hip directly over the knee and ankle.  Places the knee in a neutral/safe position.  Connective tissues are not stressed or jeopardized. 

Female- Hip abducted and internally rotated, knee valgus is noticeable, tibia externally rotated and the foot is pronated.  Connective tissues of the knee are under a constant amount of stressed in order to avoid anterior tibial translation and medial/lateral deviations. 

 Injury prevention exercise or kinematic correction is needed if your athletes (Male or Female) perform the SL squat with:

-  Poor Hip and knee Flexion (Athlete is in an upright position)       

-  Athletes back is straight not concave (Athlete is displaying a poor posterior pelvic tilt)

-  Excessive knee Valgus (Kiss Knee Syndrome or Knee Knocking)

 The Prevention Equation:

Diagnosis + Treatment = Optimal Performance

 

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