Tuesday, September 18, 2012

Can You Prevent ACL Injuries? [Guest Post]

I have been slacking off on the blog lately and I totally know it. Between caring for my twin newborn daughters, running a business and keeping up with my own training, things get pretty hectic in my life. The good news is my friend Jerry Shreck is coming in to help me out. Jerry is a the Head Strength Coach at Bucknell University and he wrote a nice article about preventing ACL injuries. ACL injuries are seen in many high speed, stop & go type of sports, but they can also occur to the weekend warrior while skiing, trail running, and soccer.

Jerry wrote a nice article on this topic and he wanted to post it to my blog. He created a product that really coincides with the article and deceleration. By learning how to activate the glutes and strengthening the posterior chain, the ACL has a better chance of staying protected during high-impact acceleration movements. The posterior chain along with the glutes comprise the "braking system" of the body and can do alot in preventing ACL tears.

Here is Jerry Shreck's article, Can We Prevent ACL Injuries?

“He is sprinting down the field, cuts left, POP! Oh no, his right knee just buckled out from under him. He really is in some obvious pain. Medical staff is on the field. He is being carried off the field. This does not look good, hopefully he will not miss the rest of the season.”

Why does this happen? Why is the number of ACL tears increasing each year? Why with the advancements in training does this continue to happen? Why? Why? Why!!!

As I sit here and write up this article, I am not going to profess to have all the answers, I am not going to proclaim that I am the world’s leading expert in injury prevention, and I am not going to dazzle you with physiological terms that you will need to look up to understand everything. What I am going to do is give you some of my thoughts and opinions as to why these injuries happen more and more each year and what just might be the biggest factor in preventing this major knee injury.

First, let’s briefly explain what the role of the ACL (Anterior Cruciate Ligament) is. The ACL attaches the femur (upper leg bone) to the tibia (lower Leg bone) and prevents the tibia (shin) from moving forward, thus helping to stabilize the knee. Understand that there are more structures and ligaments that support the knee, but we are going to focus on this main one.

When an ACL tears, athletes will typically explain a “popping” sensation in the knee at the time of injury. There are predominately two ways it tears-contact and non-contact. A contact tear is described as being in a collision or contact with something violently. An example of this might be when a football lineman is involved in a pile-up and another lineman falls into his knee. A non-contact tear would be when there was no apparent contact with anyone and the knee buckles under him/her. Many times this will occur when an athlete is sprinting and goes to cut in on an angle and the knee buckles, as described in the first paragraph.

As a D-I Strength Coach, I train hundreds of athletes with weights each week trying to strengthen the supporting muscular integrity of the body with the main goal to prevent injuries. Although we can get our athletes stronger, contact tears are almost impossible to prevent. So why then are non-contact tears on the rise in athletics?

Well I think the obvious one is that we have much better medical advances today for diagnosis. There are Athletic trainers at sporting events, Doctors specializing on knees, better advancements in MRIs and surgical procedures, and more sports reporting with stats than ever before. So it would make logical sense that we would hear more about these injuries.

Now ask someone in their forties, fifties, or sixties that played sports about how many ACL tears they saw or knew of when they played. Most of them will probably say it was not much of an issue back then or they never knew of anyone tearing an ACL. So why in the last 20-30 years has it become much more prevalent, particularly in the last 10 years?

Could it be that women’s sports are gaining in popularity now days and there are more women competing competitively than ever before? There are many studies, which support that women are at a much higher percentage chance to tear an ACL than male athletes for multiple studied reasons. Which I do want to point out that I do agree with the majority of those studies, particularly the ones covering the different hip to knee angles for childbearing purposes and hormone differences. This will certainly increase the statistics.

I personally believe we need to take a much closer look at our youth today. How many 3-4 sport athletes are we seeing today? Some but more and more I am seeing athletes specializing in just one sport at increasingly younger ages. Most soccer kids now play school soccer in the fall, then into an indoor league over the winter, then straight into an AYSO spring season, and right onto a traveling club team in the summer. No exposure to anything else.

I recently went to a clinic and listened to a Physical Therapist talk about this very subject and how specialization for youth is a negative, which I totally agree. He went on to talk about little time off and exposure to the same types of repetitive sports movements, which can make the neurological proprioceptors in the ligaments kind of “numb” when they need to have tensile strength when stressed. This can result in a ligament that is slightly relaxed. I had never heard it explained like that before but man did it make sense.

OK, at this point in this article, I have given you a couple of possible reasons why the stats on ACLs continue to increase each year. Now I would like to discuss what I think is the biggest contributing factor to this puzzling problem. When I was a kid growing up, seems like that was a long time ago, I would go home eat something quick and then head out to practice (whatever sport I was doing at that time) and when I came home from practice I usually would run around and get involved in a game of kickball or capture the flag until my mother would call me in (not from a phone) for dinner. Many times I would go right back out and play until called in to shower up and go to bed. My point here is that we were very active growing up.

This is the trend I am seeing today. Kids go to practice and practice hard, but at the end of practice coaches are telling their players to go home and recover, stretch, and take it easy to rest up for the upcoming game. Now I know this does not sound like a bad thing to say but I think it is being said to often. In reality, most young athletes are going to go home and do very little physical activity outside of their practices or games anyways. This is the biggest problem of today’s youth!

Our youth today sit all day at school, and then when not at practice sit on their butt watching TV, texting, at the computer, or playing video games in all their free time. It is my belief that the increased levels of inactivity our young athletes are doing in seated positions is shortening and tightening their hip flexors and in return they are experiencing a greater lack of stimulation from the glute muscles.

Ten years ago, my freshmen athletes were having strength deficiencies in the hamstrings in relationship to their quads. I am not seeing that as much now days with incoming freshmen. I am seeing a complete lack of glute firing when trying to teach any triple extension movement, knees buckling in when squatting, and the inability to straighten their legs and touch the floor without pain and discomfort.

In plain English, kids just don’t know how to use their butt! I am convinced that there is a direct relationship between shortened hip flexors and the inability to get the glute muscles to actively respond to athletic movements. It is this thought process that has lead me to develop a plan of attack to re-educate the body to make the glute musculature an emphasis component for all athletic positions. Seeing that the glutes should be the strongest and most powerful muscles in the body-it just makes sense to come up with a way to neurologically get these muscles active in sport.

Let’s take a look again at the example given at the beginning of this article to discuss what happens with most non-contact ACL tears. An athlete is sprinting forward and decides to cut to the left. The athlete will plant the right foot and turn the body to the left and should push off the right foot and extend the ankle, knee, and hip (triple extension) to complete the cut and change of direction. If the athlete is not getting good glute activation then there will be no deceleration to acceleration properties going on. This will put the focus on the athlete’s quads. The quads are made up of 4 muscles that basically attach to the kneecap and run down over it and attach to the front of the tibia (shin bone). If the quads dominate, there will be forward pulling placed in the tibia and with the momentum of the forward sprint, you can easily see how this additional tension is placed on the ACL to keep the tibia pulling forward. If it is too much and as the athlete starts to rotate, it can stretch the ACL to its breaking point. Game Over! 

 If the glutes are the dominant muscle group going into the change of direction, there will be less forward tension placed on the tibia and the knee will be kept in a position behind the toes. By the way, this will result in the athlete being able to cut more smoothly and with much more power.

This is the basis that I focused the Deceleration Training To Prevent ACL Tears Systematic Progression. This has been in place for the past 8 years. Hundreds of athletes have successfully gone through this simple but effective training progression. The results have been extremely positive with a huge decrease in ACL tears at my University.

I told a good buddy of mine, Jedd Johnson from DeiselCrew.com, about my system and the tremendous results that we have gotten. When I told him that I think all coaches should review and learn this system; and I would like to make it available to them, his response was: “Let’s Do It!!” So we teamed up and now it is finally available. I personally believe that every coach should digest this information and implement the principles of this proven system. I know this will help many coaches and athletes. [END]

I personally checked out Jerry's product. He sent me the links to the videos (which are immediately downloaded after payment) and the manual. I thought they were fantastic and right on point with where I stand with strengthening the lowerbody to prevent such serious injuries like an ACL tear. Check out the product to begin implementing these deceleration drills into your programming. 

1 comment:

  1. There are many types of injuries which can create many problems and in sports game, people generally get injuries. In any kind of injuries, they can contact to personal injury lawyer to get help.

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