ACL Injuries

Of course ACL Injury would be an early topic of conversation on the Blog.  After watching several friends tear their ACL and rehab for months on end to get back to the basketball court, I applied to PT School with the intent of learning how to contribute to ACL injury prevention.  There's tons of research saying how common ACL injury is, particularly in women's sports, and there are also numerous programs available working to prevent it.

But there are also countless sports teams and sporting organizations that don't implement any of these practices.  It's a little bit shocking to me since an injury prevention program could equally be called a performance enhancement program.  Some of these programs have published research showing they decrease risk in injury - but they could easily be assessed differently.  For example - complete the program for 6 weeks and compare maximal strength in a squat and it would be expected that these athletes would improve.  They'll have increased motor control and core stability from the program translating into functional testing.  I guess there's a study to be had there. The way to teach your body to move to avoid injury is the same way to move to be an all around better athlete.

As a component of my graduate school research, I surveyed 35 athletic trainers and strength/conditioning coaches working with women's basketball teams at the Division I and WNBA levels.  In my unpublished data, I asked these individuals if they implemented any injury prevention techniques with their athletes: Twenty three out of the thirty five said yes. That's 66%. Two thirds.  So... what exactly are they doing if not focused on improving performance.. and at this elite level?!  No look at a younger population, such as middle school, where overall the coaches don't have specific training on how to improve human body movement.  How can this group possibly implement programs when they aren't trained in how to use them properly?

Even more startling than the providers who answered that they were not incorporating these routines into their athlete's programs the results of the next question.  When asked what sort of measures were implemented to specifically prevent ACL injury, every single answer was different and not one of them utilized an organized injury prevention program.  So everyone is trying to do it their own way, based on whatever they've learned in the past.

Last night the Seattle Pediatric Sports Medicine ACL Injury Prevention Task Force met to plan implementation stages of their new program.  It was inspiring to see physicians, physical therapists, and athletic trainers brainstorming ways to prevent injury in the kids of our region.  Their intentions are great.  The program is comprehensive.  I'm concerned for the potential obstacles the group will face as far as resources to implement the program and coaching buy-in.  I'm also optimistic that they can sell the program as a combination of injury prevention AND performance enhancer.

The program, once it has been well learned, is 4 components that takes about 15 minutes to complete.  It is intended to be the daily warm-up for practices and games - but could be split into parts if needed.  Videos of each component are available on the website, and each activity has proper mechanics that need to be adhered to and properly trained.  Untrained coaches simply printing the program and trying to teach it to teams won't provide the proper mechanics.  Basically - we need to teach sports team coaches how their players should be moving, so they can help guide them through this process.

Preliminary implementation of the program has had athlete feedback that they feel stronger and move better.  The detractor from coaches is that it takes 15 minutes of their valuable practice time - but in comparison - is a warm-up of arbitrary jogging and sprints without proper body control really making these players better at their sport?

As I see it, there are two primary goals here: 1) Get these athletes moving in a purposeful manner on a routine basis because kids need to learn how to move properly and 2) Educate coaches and parents so that they can help improve the way their athletes are moving to prevent injury.

Here's the outline of the program. Ultimately it gets the blood flowing so the team is ready to participate in practice when they're done.  Interestingly, it similarly mirrors several components of a post-op ACL Injury Rehabilitation Program in many ways.

1) Dynamic Mobility: 
Open/Close Gate, Forward Jog, Side Lunges, Backwards Jog, Cradle Walk, High Skips, Quad Stretch with Reach, Carioca, Butt Kickers, Lateral Shuffle with High Knees, Lunge with Rotation, Inch Worms

2) Strength:
Rotating Side Planks to Prone Planks, T's, Double Leg Squat, Single Leg Kick Stand Squat, Double Leg Squat Jumps

3)Motor Control:
Single Leg Deceleration, L Hops, Diagonal Hops

4) Agility
Partner Jump Bump, Diagonal Backwards Shuffle, Cone Weaving, Bounding

Check out the program if you're interested and reach out if you have a group that would benefit from being trained to participate and I'll help get it set up.

Abby