FineSoccer Drills Newsletter - ACL Injuries

 

First, its important to understand that I am NOT writing this with any medical background and its just for general information purposes only. 

 

Among other knee injuries, the Anterior Cruciate Ligament (ACL) injury is one of the most common, particularly among athletes of high demand sports like soccer, football, basketball, gymnastics, skiing, hockey, wrestling, lacrosse and rugby.

 

The knee depends on four ligaments to keep it stable: Median Collateral Ligament - found along the inner part of the knee, preventing the knees from bending inward Lateral Collateral Ligament - found along the outer part of the knee, preventing the kneeds from bending outward Anterior Cruciate Ligament - located in the middle of the knees, preventing the tibia (shin bone) from sliding out in front of the femur (thigh bone). Posterior Cruciate Ligament - also in the middle of the knees, this ligament functions in tandem with the ACL in stabilizing the knees. The PCL prevents the shin bone from sliding backwards under the thigh bone.

 

The Anterior and Posterior Cruciate Ligaments forms a cross inside the knees, hence the name cruciate, which means 'cross-like.? They provide support to the knees, especially during movements that included angulation and rotation at the knee joints. The ACL is injured by twisting the knees or through an impact to the side of the knees. In an ACL injury, the knees becomes less stable, making sudden, pivoting movements difficult. It may also make the knee more prone to developing arthritis and cartilage tears. How do you know if you have injured your Anterior Cruciate Ligament? Four of the most common signs are: sudden giving away of the knee, hearing a 'pop' at the time of injury, sudden swelling of the knee joint, and pain in the knee when walking.

 

First aid treatment of an ACL injury is to apply RICE: Rest, Ice, Compression and Elevation. It is recommended to have the knee checked by a doctor to determine the extent of the injury. Surgery is generally recommended for an athlete, which will involve ligament reconstruction. Older and less active people may not need to undergo surgery.

 

Studies has shown that there are more women who injure their Anterior Cruciate Ligament than men. To this date, there has been no definite answers yet, but some theories are: Hormones - the ligaments are affected by the hormones level of the body. According to the studies, women in pre-ovulatory phase are more prone to ACL injuries. Women on oral contraceptives are thought to have lower risks. 

 

Difference in ACL shape - because females have smaller frames than males, they have slighty smaller ACL (on the average), and the place where the ACL passes through the knee joint (the intercondylar notch) is also smaller. This may account for greater ACL injury susceptibility. Upright position in sports - Studies has shown that ACL is usually injured when the athlete is in more of an upright position, like volleyball. Men are figured to participate more in sports wherein they are in a crouching position, like soccer or basketball.

 

Wider pelvis - the female body has a wider pelvis than men. This anatomic difference has been studied as a cause of gender discrepancies in injury rate. This increases the quadriceps angle (angle formed by the intersection of a line from the anterior superior iliac spine to the center of the patella and a line from the center of the patella to the tibial tubercle), which has long been linked to anterior knee pain. Muscle structure - the imbalance between hamstring and quadriceps muscle strength is another factor for increased ACL injuries among women. Men tend to have more developed thigh musculature than women. Stability of the knee is through to be more muscle-dominant in men, ligament-dominant in women. Female athletes' dominant muscle group are the quadriceps, which is an ACL antagonist. Male athletes, on the other hand, is hamstring dominant.

 

Exercises to strengthen the knees to help prevent ACL injuries Six-way lunge with arm drop The six-way lunge stretches and strengthens the hamstring muscles at the back of the thigh in all three planes of motion. Strong and flexible hamstring muscles assists the ACL in its job of controlling the knee joint and preventing the tibia from moving excessively during knee flexion.

 

Stand with your feet parallel and hip-width apart. Bend your arms at the elbows so that your hads are directly in front of your shoulders Take a long step forward with your right foot, as if you were doing a lunge. Lean your upper body forward, approximately 45 degrees at the waist as you do so. Drop your hands on either side of your right knee as your right foot makes contact with the ground. Quickly extend your right knee by straightening your right leg, and bring your body back to the starting position. Repeat with left leg. Again, from the starting position, step directly to your right with your right foot into a lateral-lunge position. Your upper body whould also face to the right, and it should lean forward over your right leg at approximately 45 degrees from the vertical position. Again, drop your hands on either side of your right knee as your right foot touches the ground. Your left foot must remain pointing straight ahead. Extend your right knee and return your body to the starting position. Repeat with the left leg moving to the left. Lastly, from the starting position, twist your body around at the hips and step diagonally and to the rear with your right foot in a backward-lateral-lunge position. Your upper body should face to the right-rear at about 'four o'clock.' It should also be inclined over your right leg at approximately 45 degrees from the vertical. Drop your 

hands on either side of your right knee as your right foot touches the ground. Your left foot must remain pointing straight ahead. Quickly extend your right knee and return your body to the starting position. Repeat the overall motion with your left leg, moving it to the left-rear (eigth o'clock) position. Repeat entire sequence three times for a total of 18 repetitions of stepping. Rest for 30 to 60 seconds, carry out 18 repetitions again. Rest for 30 to 60 seconds, and perform the last 18 repetitions for a total of 3 sets. Progressively toughen the exercise over a period of four to six weeks by increasing the resistance held in your hands (small dumbbells) and the speed of the exercise.

 

Zig-zag runs Zig-zag runs help develop the balance and body control required to move in multiple directions at various speeds. These runs require the knee joints to move through a number of different angles and directions, thus mimicking movements which can lead to an ACL injury in unprepared athletes.

 

Begin by running at half-speed straight ahead for about five meters. At the five-meter mark, cut quickly to your left for several strides by pushing off your right foot and moving in a left-forward (diagonal) direction. Then cut back toward the right for several strides by pushing off your left foot and moving in a right-forward direction. Repeat this sequence for a total of eight to ten cuts (four to five to the right, four to five to the left). Perform three to five sets of this exercise with a break of 30 to 45 seconds between each run. Gradually increase the intensity of your zig-zag runs over a period of four to six weeks by running faster and also by changing the number of strides between direction  

changes. Vary the number of numbers strides between one and five. You can also complete some of these sets in a backward direction.