Let's Talk About ACLs

Posted by Tim Nash on Dec 28, 2017 11:00:00 AM

You’re standing over an injured player and she says, “I heard a pop.” You immediately think: ACL.

Let’s talk about ways to avoid that.

Knee injuries are certainly not new to sports, especially ACL injuries. But a study published in the Journal of the American Medical Association (JAMA) says they are more frequent than ever.

“Among teenage athletes, the rate of ACL tears is rising, with the sharpest increase seen in females aged 13-17 who, over the last 13 years, have experienced a 59 percent increase in the number of required reconstruction procedures,” the study says.

So, the question is this: If we know ACL injuries are likely, even more likely than before, why aren’t we doing anything about it?

"There are proven injury prevention resources available, but the continued high rate of injuries suggests that they are not being implemented across the board," said lead study author Mackenzie Herzog, doctoral candidate in the department of epidemiology at the University of North Carolina Gillings School of Global Public Health.

Part of the problem, it seems, is there’s an attitude among coaches and parents that the injury is inevitable, some piece of bad luck that is going to happen to someone at some point during the season. Instead of taking a pro-active approach to prevention, we tend to use the “hope and pray” method.

"These injuries are seen by parents as just part of the game, but we have prevention programs that have been shown to reduce injuries," said Dr. Jeffrey Spang, associate professor of orthopedics at the UNC School of Medicine. "My hope is that when parents see this information and begin to connect the dots they will be empowered to push youth sports leagues and school teams to adopt an evidence-based injury prevention program."

With that in mind, let’s look at some of the steps we, as coaches, can take to lessen the likelihood that our players hear “a pop.”

Monitoring Your Players

4568542798_3aa5589c12_z-603307-edited.jpgThe most frustrating part of ACL injuries is they aren’t logical. They are usually non-contact injuries that happen when no one is expecting it. It’s helpful to understand when ACL tears occur most frequently.

  • Suddenly slowing down, cutting or changing direction.
  • Pivoting with your foot firmly planted.
  • Landing from a jump incorrectly.
  • Stopping suddenly.
  • Receiving a direct blow to the knee or collision.

Simply monitoring and tracking your athletes’ well-being can play an enormous role in preventing ACL and other injuries. By monitoring how your athletes perform in the ACL specific exercises listed below can help prevent ACL injuries.

  • Exercises that strengthen leg muscles, particularly hamstring exercises, to ensure an overall balance in leg muscle strength
  • Exercises to strengthen the core: hips, pelvis and lower abdomen.
  • Training and exercise for proper techniques and knee position in jumping and landing.
  • Training to improve techniques for pivoting and cutting.

Dr. Spang said there is a lack of understanding among youth coaches and league officials “who think injury prevention programs require specialized training or equipment to be effective. In fact, most youth coaches can facilitate these programs during team warm-ups.”

Spang notes one of the most popular and well-studied injury prevention programs is the FIFA 11-Plus program, a 20-minute warmup routine. If you take a look at the elements of 11-Plus warmup (videos are split into several parts), you can identify the muscles and movements it targets – hamstrings, quads, balance, jumping and landing, planting and cutting, etc. You then concentrate on training and developing those outside the warmup.

Simply having your players perform specific exercises is not enough, though. In fact, the 11-plus warmup is ineffective if the exercises are done incorrectly. Coaches still need to monitor their players to stay on top of a variety of aspects of their fitness and well-being.

Coaches without sports science or medical staffs obviously need help keeping up with their players’ fitness. DRVIN has a simple and affordable way for coaches to understand when an environment is right for injuries to occur. Players complete a daily questionnaire pertaining to aspects of their general fitness, and coaches can see red flags that could indicate a problem coming.

DRIVN trackers measure and record things like fatigue and muscle soreness which can indicate an athlete needs a rest. Or, tracking activities that involve core or hamstring strength can identify athletes who might be prime candidates for ACL tears.

By doing just a little bit more for your athletes and paying closer attention to some key elements of injury prevention, coaches can avoid those conversation about hearing a pop.

Topics: Strength Training, Athletic Performance, Coaching, Recovery, Injury Prevention