Physio: Prevent injuries with pre-season, pre-game training

Proper pre-season and pre-game training is a crucial component of sports.

As the weather warms up, many athletes are returning to their spring and summer sports; and with no snow on the fields we are all eager to play our first game.

Proper pre-season and pre-game training, however, is a crucial component of the sport that all athletes and coaches should take advantage of, in order to prevent injuries during the season.

Most of us are aware of the risk of spraining our ankles when we engage in sports, but not all of us are familiar with knee sprains. One of the most common knee sprains, and a potentially very serious injury, is an anterior cruciate ligament, or ACL sprain.

Normally, athletes participating in contact sports need to be more careful of ligament injuries. ACL injuries, however, occur just as often in non-contact situations, therefore all athletes should be aware of this injury and the ways to prevent it.

The ACL is a ligament that lies deep within the knee and helps to stabilize the knee so the shin bone does not move improperly on the thigh bone. Most people injure this ligament when they plant their foot on the ground and then pivot on the planted foot in order to change directions. If the foot digs into the ground and does not move with the thigh bone when the player pivots, the ACL can be stretched and potentially torn. This ligament can also be torn when the knee is hyper-extended, meaning it is straightened beyond the normal range of movement. This can occur when a player jumps up and lands with the knee fully straightened, instead of landing with the knee bent. In a contact situation, the ligament can be torn on impact if the player is hit on the side or the front of the knee, causing the knee to buckle inwards or to hyper-extend.

There are many factors that place players at a greater risk of injury. Research shows that women are more prone to sustain this type of injury if it is in a non-contact situation (Kisner 2007). Leg alignment and muscular imbalances can also place a person at a greater risk of injury, as they can change the muscular forces on the knee and the stress placed on the ACL.

If you are playing a sport this spring that involves jumping, pivoting or stopping quickly, you may want to take part in a training program to decrease the risk of tearing your ACL.

The Santa Monica Orthopaedic and Sports Medicine Research Foundation has used the latest research to create a training protocol that addresses muscle strength and length, and balance deficiencies that can contribute to the injury. The basic principles behind the protocol are to strengthen the muscles around the knee joint, which will prevent excessive movement of the thigh bone on the shin bone, and to train athletes to run, pivot, jump, and stop with the proper body mechanics needed to prevent an injury. The protocol includes exercises to strengthen the hamstring, which works with the ACL to hold the shin bone in place, and to improve timing of contraction of the hamstring and quadriceps so the quadriceps does not pull the shin bone forward and stress the ACL. Luckily, our muscles have a “memory” and if you train your body to perform an action properly, you are more likely to use that proper movement pattern when you are in a game situation, even if you are not consciously thinking about it. Check out http://smsmf.org/smsf-programs/pep-program to access the protocol and begin training your muscle” memory” to avoid ACL injuries.

Quick tips to remember when playing and practicing are: 1. After jumping, land softly on the balls of your feet, keeping the knees bent so they do not hyper-extend. 2. Avoid running over large holes or dips in the field or stepping on another player’s feet. 3. Try using a quick rounded turn off a bent knee when changing directions, instead of pivoting and cutting with a planted foot.

If you or your young athlete can head to the field 15 minutes before a game or practice, or incorporate these drills into the warm-up already performed by the team, you can help to decrease the risk of an ACL injury. The key to a prevention program, however, is to be consistent. Try to fit the program into your schedule 3-4 times per week and keep up with it before and during the season.

If you do suspect an ACL injury has occurred, you can always visit your family doctor or physiotherapist who can help determine if a referral to an orthopeadic surgeon is necessary.

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