How to Prevent Your ACL From Tearing Again
An anterior cruciate ligament (ACL) tear is one of the most devastating injuries an athlete can go through. It is season-ending and often keeps the athlete out of a chunk of the following year as well. It is common at the professional, collegiate, high school, and an alarmingly rising number of middle school levels.
Sadly, ACL injuries have skyrocketed in recent years, particularly in women’s sports at the high school and collegiate levels. No other population has a higher frequency of ACL injuries than female athletes, particularly in field and court sports such as soccer, basketball, and volleyball. This is outside the scope of this article’s topic, but know that it mainly revolves around athletes playing too much of the sport. With the rise of year-round sports, this has undoubtedly given rise to injury rates. Additionally, they often don’t have sufficient strength or proper biomechanics to support the demand placed on the knee.
The ACL
This short but excellent video explains the ACL and how it works.
For athletics, the ACL often gets torn when an athlete tries to stop or change direction really fast. Sometimes the force of the shin flying forward is too great, and the ACL tears. It’s nasty stuff.
The Supporting Cast
Stabilizing the knee joint isn’t just the ACL’s job. That’s why we have muscles. We need muscles that are strong enough to support the knee joint structure. That’s why strength and conditioning are so important.
We basically have two groups of muscles around the knee. The quadriceps, or quads in the front, and the hamstrings in the back. ACL tears most commonly tear from weakness and imbalances of these two muscle groups.
So to keep the ACL from injury, we need strong quads and equally hamstrings. And for those already recovering from an ACL repair, you guessed it; we still need to develop strong quads and hamstrings.
We will not talk about the recovery of an ACL injury, as that is the job of the physical therapist, athletic trainer, and doctor. However, we can and should talk about preventing it from happening again after you’ve fully recovered. Much of the literature out there recommends that an athlete not return to sport until the quads are within 10% as strong as the healthy knee. Getting the muscles back to full or near full strength is more difficult than you may think.
Quads
To develop strength and stability from the quads, nothing beats the squat pattern. Back squats, front squats, goblet squats, and body weight squats they’re all great for knee strength and stability. What matters is technique and consistency with progressive overload, AKA getting stronger with consistency.
Lunges are essentially a single-leg squat. Forward, reverse, and lateral lunges should be in every athlete’s program. I recommend doing reverse lunges more than the others, strengthening the hips more. More on that later.
Hamstrings
Hip hinge patterns. Deadlifts, RDLs, single leg RDLs, Swiss ball hamstring curls, and kettlebell swings are among my favorite hamstring exercises.
Here is a single-leg RDL, my personal favorite.
Jumping and Landing
Developing strength and stability is crucial to preventing any kind of injury. But strength won’t matter much if you jump and land poorly. Stopping and landing can put up to 7 times your bodyweight’s worth of force into the landing leg. The ACL is only built to withstand about 500 lbs. of force. You do the math.
If you take your sport seriously, preventing ACL re-injury should be your top priority. This video lays out a great outline of progressions you can follow to prepare for an upcoming season. Learning to run, jump, land, squat, and lunge are critical to maintaining knee health.
Developing balanced knee and hamstring strength and integrating proper jumping and landing biomechanics are the absolute keys to preventing another ACL tear. Research shows the rate of retear is especially high for athletes under the age of 20, so this is especially important for high schoolers.
On a very specific and sensitive note, female athletes should also pay attention to their menstrual cycle. When that time of the month is approaching, the body produces a hormone called relaxin. This causes all ligaments in the body to loosen and relax. This is an especially vulnerable time for the female athlete. Of course, this is a sensitive topic, but particular caution should be used in this time frame.
Utilizing these techniques can drastically reduce the risk of re-injury and can help prevent future knee problems for the athlete as well. The most important thing is to restore as much strength as possible in the knee and maintain it throughout your athletic career.
https://journals.sagepub.com/doi/full/10.1177/2325967120982281
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How to Prevent Your ACL From Tearing Again
An anterior cruciate ligament (ACL) tear is one of the most devastating injuries an athlete can go through. It is season-ending and often keeps the athlete out of a chunk of the following year as well. It is common at the professional, collegiate, high school, and an alarmingly rising number of middle school levels.
Sadly, ACL injuries have skyrocketed in recent years, particularly in women’s sports at the high school and collegiate levels. No other population has a higher frequency of ACL injuries than female athletes, particularly in field and court sports such as soccer, basketball, and volleyball. This is outside the scope of this article’s topic, but know that it mainly revolves around athletes playing too much of the sport. With the rise of year-round sports, this has undoubtedly given rise to injury rates. Additionally, they often don’t have sufficient strength or proper biomechanics to support the demand placed on the knee.
The ACL
This short but excellent video explains the ACL and how it works.
For athletics, the ACL often gets torn when an athlete tries to stop or change direction really fast. Sometimes the force of the shin flying forward is too great, and the ACL tears. It’s nasty stuff.
The Supporting Cast
Stabilizing the knee joint isn’t just the ACL’s job. That’s why we have muscles. We need muscles that are strong enough to support the knee joint structure. That’s why strength and conditioning are so important.
We basically have two groups of muscles around the knee. The quadriceps, or quads in the front, and the hamstrings in the back. ACL tears most commonly tear from weakness and imbalances of these two muscle groups.
So to keep the ACL from injury, we need strong quads and equally hamstrings. And for those already recovering from an ACL repair, you guessed it; we still need to develop strong quads and hamstrings.
We will not talk about the recovery of an ACL injury, as that is the job of the physical therapist, athletic trainer, and doctor. However, we can and should talk about preventing it from happening again after you’ve fully recovered. Much of the literature out there recommends that an athlete not return to sport until the quads are within 10% as strong as the healthy knee. Getting the muscles back to full or near full strength is more difficult than you may think.
Quads
To develop strength and stability from the quads, nothing beats the squat pattern. Back squats, front squats, goblet squats, and body weight squats they’re all great for knee strength and stability. What matters is technique and consistency with progressive overload, AKA getting stronger with consistency.
Lunges are essentially a single-leg squat. Forward, reverse, and lateral lunges should be in every athlete’s program. I recommend doing reverse lunges more than the others, strengthening the hips more. More on that later.
Hamstrings
Hip hinge patterns. Deadlifts, RDLs, single leg RDLs, Swiss ball hamstring curls, and kettlebell swings are among my favorite hamstring exercises.
Here is a single-leg RDL, my personal favorite.
Jumping and Landing
Developing strength and stability is crucial to preventing any kind of injury. But strength won’t matter much if you jump and land poorly. Stopping and landing can put up to 7 times your bodyweight’s worth of force into the landing leg. The ACL is only built to withstand about 500 lbs. of force. You do the math.
If you take your sport seriously, preventing ACL re-injury should be your top priority. This video lays out a great outline of progressions you can follow to prepare for an upcoming season. Learning to run, jump, land, squat, and lunge are critical to maintaining knee health.
Developing balanced knee and hamstring strength and integrating proper jumping and landing biomechanics are the absolute keys to preventing another ACL tear. Research shows the rate of retear is especially high for athletes under the age of 20, so this is especially important for high schoolers.
On a very specific and sensitive note, female athletes should also pay attention to their menstrual cycle. When that time of the month is approaching, the body produces a hormone called relaxin. This causes all ligaments in the body to loosen and relax. This is an especially vulnerable time for the female athlete. Of course, this is a sensitive topic, but particular caution should be used in this time frame.
Utilizing these techniques can drastically reduce the risk of re-injury and can help prevent future knee problems for the athlete as well. The most important thing is to restore as much strength as possible in the knee and maintain it throughout your athletic career.
https://journals.sagepub.com/doi/full/10.1177/2325967120982281