ACL Prevention

ACL Injuries and Prevention - Part 3

Here is video #3 in our series on box jumps to decrease the risk of ACL injuries and also to improve jumping performance. 

If you have not watched the previous two videos, you can do so below:

Part 1

Part 2

Remember these exercises alone are generally not the complete solution. This is just one piece of the puzzle and their are other aspects of training that should be addressed as well if you are looking complete recovery or do all you can to prevent an injury.

If you want more information on the topic, be sure click the image below to get your free tips report!

Sports Specialist Physical Therapy Clinic| Ann Arbor, Mi | FREE Discovery Session|

About the Author: Dr. Greg Schaible is a physical therapist/strength coach specializing in athletic performance. He attended The University of Findlay, graduating in 2013 with his Doctorate of Physical Therapy (DPT). As a Track and Field athlete, he was as a 5x Division II All-American and 6x Division II Academic All-American. Greg is the owner of On Track PT and Performance in Ann Arbor, Mi. You can stay up to date with helpful information and news on Facebook.

ACL Injuries and Prevention - Part 2

Last week I talked about some of the main causes of ACL injuries and why they occur at a rate of 3-4x more often in female athletes.  You can find that article along with our first jump training video HERE:

This week I’m posting the second video in a series of three showing how we begin jump training to a box.  This type of training can be used for ACL injury prevention and to enhance sports performance.  It’s also what we do post-surgically to get the athlete used to jumping again and landing safely.

The great thing about box jumps is that the forces on the knee are quite low because you are not coming all the way back down to the floor.  It’s also much easier because of this for the athlete to work on proper landing technique.

Before I get to the video though I thought I’d post a picture of what you don’t want your athletes knees to look like.

Looks fairly simple but let me assure you it can be quite challenging for many athletes – boys included.  Learning to jump and land correctly has been proven to help prevent ACL injuries and it must also be a huge focus of any post-surgical ACL rehabilitation program.

If you would like to learn more about how to recover from an ACL injury or just better prevent one from occurring, click on the free guide below!

Sports Specialist Physical Therapy Clinic| Ann Arbor, Mi | FREE Discovery Session|

About the Author: Dr. Greg Schaible is a physical therapist/strength coach specializing in athletic performance. He attended The University of Findlay, graduating in 2013 with his Doctorate of Physical Therapy (DPT). As a Track and Field athlete, he was as a 5x Division II All-American and 6x Division II Academic All-American. Greg is the owner of On Track PT and Performance in Ann Arbor, Mi. You can stay up to date with helpful information and news on Facebook.

ACL Injuries and Prevention

ACL injuries (anterior cruciate ligament) have been an epidemic in sports but even more so in women’s athletics.  Females are 3-4x more likely to tear their ACL than men.  There are several proposed theories on why this is so but for the purposes of this article and what we address here at On Track PT and Performance we will discuss the following:

  • Poor movement quality
  • Strength deficits
  • Landing mechanics

There certainly are other factors, but for brevity sake on this article these are what we tend to see most commonly. I’ll go more in depth in subsequent articles but for now here are the basics:

Poor movement quality

There are just certain joints in our bodies that need to be very mobile in order to get us through our daily activities and especially sporting activities like running, jumping, and cutting.  Don’t get me wrong – all of our joints need to move through their full range of motion for us to be efficient movers.  Some just need to be emphasized a bit more because of their tendency to become stiff while other areas of our body need a bit more stability/motor control.  Check out the picture below to get an idea of how this works – it’s called the Joint – by – Joint theory.

It’s a very simplified way of looking at things but it does often work out this way.  The knee joint needs to have a great deal of stability in all directions to prevent injury.  If the ankle and hip joints above and below are moving well then the knee joint will more likely stay within it’s accepted range of motion during athletic movements.  If the ankle and/or hip are stiff then the knee may just have to go outside of it’s normal boundaries to land from a jump or decelerate while cutting.  This is where things can go south in a hurry!

Strength deficits

There is plenty of research out there in the medical and physical therapy journals showing that strength deficits can lead to knee injuries, and in particular ACL tears. Years ago the main concern was the ration of strength between the quadriceps and hamstrings, which if it was below a certain level it could inhibit an athlete's ability to decelerate correctly leading to injury.

Lately the focus has been more on the hips and muscles of the ‘core’ and how weakness or lack of control in those areas can contribute to injury.  I’ll get more into the ‘how’ and ‘why’ in another article but it is a reality that needs to be addressed.

At On Track PT and Performance, we know that a comprehensive strength program must be implemented to assist in the prevention of ACL injuries.  Quality movement is critical for effective strength training as well.  Being able to combine these qualities is what we do best, and definitely one of my favorite things to talk about so more to come for sure!

Landing mechanics

It is also well documented that female athletes land and cut differently than the male athletes.  Women tend to land stiffer and higher than the men who typically land in deeper hip and knee flexion angles.  Stiffer and higher landings are more dangerous as far as the knee joint is concerned.

Strength and movement quality again play a large role in this.  Some athletes can’t even get into a good position to perform complex athletic movements.  Big problem!

Many don’t have the strength to get into the proper positions.  Another big problem.

As the athletic activities get faster, more complex, impose higher forces, etc it becomes more and more challenging to perform them using good technique.  Fortunately all of these qualities can be addressed through physical therapy and proper training techniques.

Check out the video below filmed by a good friend of mine Joe Heiler. We both use these methods to start teaching athletes to jump correctly using box jumps.  The nice thing about landing on a box is that you don’t really have to come all the way back down.  Much less strain on the knees and an easy way to work on jumping and landing technique.

If you would like to learn more about how to recover from an ACL injury or just better prevent one from occurring, click on the free guide below!

Sports Specialist Physical Therapy Clinic| Ann Arbor, Mi | FREE Discovery Session|

About the Author: Dr. Greg Schaible is a physical therapist/strength coach specializing in athletic performance. He attended The University of Findlay, graduating in 2013 with his Doctorate of Physical Therapy (DPT). As a Track and Field athlete, he was as a 5x Division II All-American and 6x Division II Academic All-American. Greg is the owner of On Track PT and Performance in Ann Arbor, Mi. You can stay up to date with helpful information and news on Facebook.

ACL Prevention Test

One of the keys to preventing ACL injuries is to display control of the hip, knee, and ankle during dynamic movements. In particular we want to pay attention to this in the deceleration phases. During this test you will be watching or video taping the client from the front. What you are looking for is an inward collapse of the knee upon landing on the ground. You should notice minimal to no inward collapse of the knee. If the knee frequently caves inward or does so excessively, that would be considered a failed test. 

The second part of this test is repeatability. You should be able to jump up and bring the heel to the back of the thigh x10 reps in a row without having to reset, loose your balance, or loose explosiveness. This portion of the test forces the client to demonstrate control of the knee while maintaining explosiveness and resisting fatigue.

This test could be used as a component of return to play testing or just general screening for your clients to see what exactly needs to be worked on during your workouts.

ACL Prevention. The Importance of Youth Coaches

For top notch ACL rehabilitation in Ann Arbor, Mi contact On Track PT and Performance.

Calling all you coaches, athletes, therapists and trainers out there, it's time for us all to face facts; we've failed as an industry in protecting our clients from ACL injuries.

Even with all the BS "ACL Injury Prevention" programs specializing in reducing the incidence of non-contact injuries, the most recent statistics show an INCREASE in ACL injuries in active populations.

Time to stop patting ourselves on our backs (coaches and researchers) and realize that what we've been doing over the last two decades to combat this monumental problem is just not working.

You know what will work and has been a proven track record for hundreds of years? Old school, traditional strength and conditioning. Maybe try and master that, ingrain some sound movement patterns in your athletes and just maybe then they can stay on the field long enough to make a dent in their athletic potential.

Full article available  via DrJohnRusin.com by Dr. Greg Schaible.

Exercises for Athletes #2 - Goblet Squat

The Goblet Squat is a great lift to teach proper technique to a youth athlete or beginning lifter while still eliciting a training effect.  Due to the anterior load of the weight, it allows the lifter to better obtain a squat position as the weight will act as a counter balance. For this reason, a Goblet Squat will actually start to improve squat mobility by gaining control over deeper ranges of motion in the squat position while still maintaining a neutral spine. Once optimal squat depth is obtained with a neutral spine you can then start to focus on increasing load and time under tension. The amount of load you can perform with this lift is limited. However as youth athlete or beginning lifter, ultimately your main goal is time under tension.  In other words, performing set/rep ranges of 3-5 sets x 8-12 reps will give you a baseline level of strength needed to then progress to a lift that will allow for greater loads such as a box squat. As the athlete progresses in his strength and lifting technique, the Goblet Squat will remain a great tool for warm ups or accessory lifts. 

Exercises For Athletes #1 - Drop Jump Landing

The Drop Jump Landing is a entry level exercise to shock plyometric training. It teaches an athlete how to decelerate and absorb forces. The best athletes all have the ability to quickly absorb and transmit a high amount of force over a short period of time. This exercise can also be used for injury prevention. It is commonly included in ACL prevention programs because research has shown that a possible cause for non-contact injury is the lack of ability to absorb a large amount of force in a short period of time. This exercise should be programmed into a youth athlete's training routine in addition to some sort of squat variation. An athletes' training superset may look something like this: A) Box Squat 4 x 5  B) Drop Jump Landing 4 x 2.