Mar 27, 2018Preventing ACL Injuries
An athlete’s worst nightmare is to tear his or her anterior cruciate ligament (ACL), and with biology to blame, females are up to eight times more prone than males. Naturally wider hips, differently angled knees, and even hormonal changes during menstrual cycles are all contributing factors of ACL injuries for women.
Miho Tanaka, MD, Director of the Women’s Sports Medicine Program at Johns Hopkins Hospital, explained in an article for HopkinsMedicine.org that reducing the risk is possible.
“70 percent of ACL injuries occur without collisions, meaning there are things women and girls can do to help prevent this type of injury from occurring,” said Tanaka. “Data show that doing the right exercises can actually help prevent certain knee ligament injuries – like ACL tears – by strengthening the right muscles.”
The New Jersey State Interscholastic Athletic Association (NJSIAA) has begun hosting workshops to educate their schools’ athletic trainers on incorporating proper ACL-injury prevention techniques to their training regimens, according to the Asbury Park Press. In the Shore Conference of girls’ basketball, Middle South High School alone has three players coming back from serious knee injuries, and the same article encourages athletes to “change how they play” by learning “how to land properly and make a cut in the optimum way” to reduce likelihood of an ACL tear.
One of the highest regarded programs for preventing ACL injuries is a product of Boston Children’s Hospital and their Sports Medicine Division, where specialists are teaching proper techniques for landing and squatting, “two motions that frequently cause ACL tears when performed incorrectly.” According to the Micheli Center for Sports Injury Prevention, which the hospital opened in 2013, warming up properly and strengthening the knees, surrounding muscles, and core can decrease the risk. Bodyweight squats, forward lunges, donkey kicks, lateral shuffles, and two-foot hops are all recommended by the center with instructions and video tutorials available for download, along with their guide to dynamic stretching.
Rick Scarpulla, contributing expert for Stack.com, makes other suggestions for females, who are naturally “quad dominant,” to keep in mind while training:
- Parallel Box Squat: Scarpulla uses this exercise to aid in “developing the backside of the body” since it places emphasis on the hamstrings and glutes. To perform the squat correctly, keep your back straight, lean forward at a slight angle, and drive the knees outward. “Disengage your hips before your knees, which will keep your knees behind your toes and minimize quad engagement,” he writes. “We have our athletes do it two times per week, always varying loads and rep schemes.”
- Physioball Squeeze – By placing a physioball between an athlete’s thighs and having them pull it up into the groin region, “this develops groin strength and improves hip stability, which is critical for keeping the knee stable,” according to Scarpulla. To perform this exercise properly, the upper body should be slightly leaning forward, and the athlete should be standing over the physioball. “This exercise is meant to compliment the box squat and should not be one of your primary lifts,” warns Scarpulla. “Stick to four sets of 15 reps, twice per week.”
- Bench (or Box) Jumps – Most experts agree that learning how to properly jump and land is vital in preventing serious knee injuries. “Jumping with perfect form teaches your muscles how to fire to maintain stability while also strengthening glutes and hamstrings,” notes Scarpulla, who also works as a strength and conditioning coach for professional athletes. To start, jump on a bench (or box) and land softly. Feet should be shoulder-width apart before driving the knees outward to take off and land. Eventually, athletes can work in hopping down from the bench and then immediately back up. “Again, this is meant to complement your other work. We generally do three to four sets of 10 to 15 reps, depending on the athlete’s training level,” writes Scarpulla.
Tanaka also urges athletes to take stretching seriously.
“Even 15 percent side-to-side differences in flexibility and strength can increase a female athlete’s risk for injury, so it is important to pay attention to any imbalances while stretching. This imbalance can cause the body’s center of gravity to shift while landing from a jump and places girls at risk,” said Tanaka. “Sometimes athletes think that stretching is boring and don’t pay attention, but subtle things, such as stretching the right side less than the left, can add up.”
