07/16/2018
ACL Injury Prevention - Why It's Not Working for Young Athletes. Fatigue is one powerful reason. The American Orthopaedic Society for Sports Medicine published a recent study showing that ACL prevention programs are not resulting in reduced numbers of ACL tears in athletes. Female athletes and those over the age of 15 years old are especially at risk.
ACL injury prevention focuses on strengthening and aligning the core, hip, knee and ankle. ACL prevention programs consist of a specific drill of exercises that are generally performed prior to play with the thought being the body will learn and remember the correct alignment throughout play.
Fatigue overwhelms an athlete's ability to maintain their best alignment of the knee. During action filled play – most often in sports that include cutting, jumping, pivoting and contact with a blow to the side of the body, the knee becomes at risk of being forced to a position where the ACL is vulnerable to a tear injury.
What can you do about it?
1. Train for endurance and fatigue resistance. Be certain that endurance for the sport is up to par and incorporates correct hip, knee and ankle alignment technique. Training should include doing the ACL exercise protocol to fatigue after play as well as before.
2. The most significant building blocks for fighting against athletic fatigue is taking consistent sleep habits, proper nutrition and hydration seriously.
3. Do the ACL exercise protocol to a level of muscle fatigue. This means several repetitions of the exercises and multiple sets to fatigue. Don't simply go through the motions with 15 repetitions of each exercise. It should be a workout in itself so the muscles that drive correct alignment and stabilize that alignment have to adapt to the demand.
4. Exercises alone will not correct alignment of the hip, knee and ankle during play. The correct movement pattern with the hip, knee and ankle alignment is learned with focused exercise, but the real prevention comes by incorporating that awareness into play and all the movements - pivoting, cutting, jumping, landing, that are a part of any given sport. An exercise program alone will not prevent an ACL injury.
5. Not all athletes are the same and some athletes need much more work on endurance, strength and alignment for ACL injury prevention. This should be a priority on the part of the coach and athlete. The idea that a universal "team" participation with an ACL prevention exercise drill will effectively address everyone's needs is grossly deficient. Some athletes are much more challenged to maintain correct alignment than others. These athletes must be identified and must spend more time performing movement training to address their alignment and movement correction.
6. Visible alignment and technique changes mean an athlete is fatigued and has already played into the danger zone! Truthfully, if an athlete can no longer maintain correct alignment and proper form for the sport, that athlete is past the vulnerable stage for ACL injury. The best protection from ACL injury is limiting time of play and allowing that athlete to rest BEFORE form suffers. Shorter segments of play time with rest on the sidelines and getting back in the game multiple times are better than playing to the point where fatigue is obvious. If an athlete cannot maintain correct hip, knee and ankle alignment that athlete's play time is over. Most often this decision needs to be made by an outside party because athletes are self-driven to continue to play – coaches and parents need to be aware of how to identify correct alignment, how to identify changes in alignment and knowing individual-athlete alignment challenges.
ACL injuries are one of the most common sports injuries affecting adolescent athletes, leading to lost playing time and high healthcare costs. Research shows athletes who experience fatigue -- tested on a standardized assessment -- demonstrated increased risk of ACL injury. The study is the first to...
