Injury to the anterior cruciate ligament (ACL), the main
stabilizing ligament in the knee, remains a hot topic in sports
medicine. The incidence of ACL injury remains high,
especially in young female athletes aged 14-19 years, and is most
often a result of a non-contact event such as, planting and
pivoting, decelerating, or landing from a jump. Through a
16-year survey conducted by the NCAA, it was determined that the
percentage of ACL injury compared to the total injuries on a team
was highest in female sports-basketball, gymnastics, lacrosse, and
soccer!
Prevention
Numerous prevention programs have been introduced to reduce the
risk of non-contact ACL injury. These injury prevention
programs often include traditional static stretching, dynamic
stretching, strengthening, balance, agility/plyometrics, and
athlete education. Education is a crucial component because
it makes athletes' aware of high-risk positions that can lead to
injury. For example, studies have shown that women generally
land from a jump with more of a straight knee instead of a bend in
the knee which would cushion the landing. Because of this problem,
athletes are "re-educated" to focus on landing with "soft knees,"
letting the knees bend and absorb some of the shock of the
landing. Players are also taught to focus on "knee over toe
position" when cutting to avoid letting the knee cave in towards
the middle of the body.
Strength is very important and is directly correlated to knee
mechanics. In general, women are more "quadriceps dominant,"
meaning that the strength of the quadriceps muscles in the front of
the thigh is often unbalanced by the strength of the hamstring
muscles in the back of the thigh. The combination of the
stronger quadriceps and the straighter knee when landing can
produce more stress and strain on the ACL resulting in more
injuries. Studies have also shown that it is important to
increase hip strength, particularly the gluteus medius muscle, to
help prevent injury.
Studies have provided evidence that injury prevention training
programs can reduce the risk the incidence of ACL injury.
Sports Physical Therapy Institute offers instruction on the Prevent
injury, Enhance Performance (PEP) program that was developed by the
Santa Monica Sports Medicine Foundation. It is a 15-20 minute
warm-up program that replaces the traditional warm-up and consists
of stretching, strengthening, balance, plyometrics, and athlete
education-teaching the athlete how to avoid vulnerable
positions. Because the program is designed as a warm-up, it
is reasonable for coaches and athletes to remain compliant with it
without affecting their practice and game schedules. Sports
Physical Therapy physical therapists will join the coaches and
athletes during practice to teach the PEP program and to ensure
that all drills are being executed properly. Contact the office
closest to you for more information!
Sports Physical Therapy Princeton also offers a pre-season
conditioning program, helping athletes prepare and get in shape
before their season begins. The physical therapist will
assess the athlete in the areas of speed, flexibility, and
strength, and will perform an initial overall screening to
determine the individual's risk of injury. If you are
interested in either of these services, please do not hesitate to
contact us!