Ahh. 'Tis the season. And while the local departments stores already have their stockings hung by the cash registers with care, I'm referring to the fall/winter sports season. Yes, football and indoor volleyball are already upon us, while basketball and skiing are right around the corner. Unfortunately, with these sports come a huge increase in knee injuries.
Every year there are over 100,000 reconstructive ACL surgeries in the United States. That's an average of 2,000 repaired knees in each state. And about 1/3 of these involve high school-aged female athletes. If you didn't already know, females are 4-10 times more susceptible to knee ligament tears than men. We can get into a discussion on the reasons why this is, but who cares? What we need to do is twist the arms of physical education teachers, strength and conditioning coaches, and athletic directors to prioritize reducing the risks associated with these traumas.
Let's start with a little simple anatomy and physiology. The anterior cruciate ligament, or ACL and the medial collateral ligament (MCL) are both attached to the femur, or thigh bone, and to the tibia in your lower leg. They work together to keep the tibia from moving forward and inward. These two ligaments are the most prone to tears when discussing knee injuries. When torn, the knee joint loses stability, especially during rotational activities and when participating in almost every sport. Recovery from these tears are a fate worse than death--they are expensive, lengthy, and physically challenging. And once you suffer this type of damage, your chances of a future injury are significantly more likely. Just look at Kobe Bryant and Derrick Rose for recent examples.
These ligamentous injuries rarely occur when we're standing on both legs. Usually the damage is done when we are running and try to decelerate, stop, and or change directions too quickly. They are also caused by landing awkwardly after a jump, causing the knee to twist and/or hyperextend. Weak glutes and hamstrings, and a lack of ankle dorsiflexion also contribute to the likelihood of knee issues.
To stop tempting fate, athletes and exercisers need a thorough strength and conditioning program that begins with a complete warm-up. This warm-up must include exercises that take all joints through their full ranges of motion, as well as incorporating movements in all three planes of motion. The attention here is on stabilizing and mobilizing the proper joints.
There also has to be a strength component in your plan. This doesn't just mean lifting weights. It means learning how to control movement while under a load, known as eccentric strength. An example of this is being able to "stick the landing" when jumping or hopping. This is functional eccentric strength. Remember, these injuries almost never happen when on both feet, and they never occur when seated or laying down. Therefore, machines such as the leg press, leg extension, and leg curl should never be part of your arsenal for combating knee problems.
Add a progressive inventory of single leg movements such as squats, dead lifts, hops and bounds into your routine. These will enhance your body's ability to stabilize itself while you're playing your sport. Once your body can demonstrate the ability to reactively stabilize, you should insert some power exercises to your program. This means adding exercises that generate as much force as fast as possible, while controlling the movement. Power training is necessary to excel at all sports, as well as to keep from getting hurt in everyday life.
There you have it--a guide to keeping you from twisting in the wind because you weren't properly prepared for the unforeseen demands of your sport. Follow these recommendations and your Christmas list won't include a new knee brace, titanium crutches, or a gift certificate booklet to Physical Therapists R Us!
If you have questions on specific exercises that should be incorporated into your training program, give us a call at 775.432.1356.
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