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The Non Contact Truth about ACL Injuries

December 9, 2014 1:30p | CORE PT & MC | by CORE Movement Specialists

You probably know someone who’s suffered an ACL tear.  The ACL (anterior cruciate ligament) is 1 of 4 major knee ligaments.  It prevents the lower leg (tibia) from sliding out in front of the thigh (femur) and provides rotational stability in the knee.  Athletes who suffer an ACL tear lose time from sport due to surgery and rehabilitation.  They’re likely to suffer joint arthritis later in life and this risk is compounded if other structures like knee cartilage (meniscus) are simultaneously injured.  The American Orthopaedic Society of Sports Medicine (AOSSM) reports ACL tear rates exceed 150,000 annually and cost more than a half-billion dollars a year.

ACL injuries occur in all sports but most frequently in basketball, soccer, football, and skiing as they involve jumping, pivoting, and quick changes in direction.  ACL tears can occur with a direct blow to the knee as is common in football; however the majority of ACL tears are non-contact, occurring when the athlete fails to control body alignment during landing or pivoting maneuvers.  The good news is specific training can improve mechanics and decrease risk during these activities.  ACL tears occur in both male and female athletes; however female athletes are at greater risk for non-contact ACL injuries.  AOSSM reports female athletes participating in basketball and soccer have 8 times greater risk for ACL injury than their male peers.  Preventative screening and training can successfully reduce the risk of ACL tears and other similar non-contact injuries.   

Stop Sports Injuries, an injury prevention initiative, recognizes the importance of preseason screening programs to monitor important risk factors and identify “high risk” athletes who require targeted neuromuscular training.  It’s important to realize that ACL injury risk is not just a knee problem.  Rather, poor control at the hip, trunk, and lower leg are the primary causative factors for non-contact ACL injuries.  Dynamic stability of the knee depends on accurate sensory input and appropriate neuromuscular responses throughout the body to adapt to rapid changes in body position during landing and cutting.  Neuromuscular training is more than strengthening muscles; it involves creating new movement patterns in the brain.  Quality prevention programs decrease one’s risk of non-contact ACL tears and re-tears. 

ACL injury prevention programs are found in schools, healthcare facilities, and sports performance organizations.  Many programs target females due to their increased risk for ACL injury.  However, any athlete participating in a high risk activity such as basketball, soccer, or football should consider advanced training.  Premium ACL prevention programs assess the whole person, identify the site and direction of uncontrolled movement(s), and develop an exercise program specific to the individual athlete.  These programs emphasize cognitive retraining to change how the brain coordinates movement, improve body control, and then progress to traditional strength training.  Educating athletes about their body is crucial in reducing the risk of many sports injuries.  At CORE we screen our clients with The Performance Matrix.  It provides the level of detail and specificity needed to reduce the risk of all non-contact injuries while also maximizing performance.       

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