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ACL Injury Prevention and Performance Enhancement Programs

  • Anterior cruciate ligament (ACL) injuries are one of the most common knee joint injuries in athletes, with 250,000 occurring annually in the U.S.

    They occur in females much more frequently than in males who are playing the same landing and cutting sports. The gender difference for ACL injury risk may be due to many variables, including anatomical, neuromuscular, biomechanical and hormonal factors, as well as other external variables.

    Injury prevention programs

    Proper training can help to reduce the number of ACL injuries. Prevention has become an important focus for athletic and medical organizations, with the development of programs that emphasize neuromuscular training.

    Such programs can reduce the risk of ACL injury from approximately 25 to 80 percent in female athletes in sports such as soccer, basketball and volleyball.

    One formal program is the Santa Monica Prevent Injury and Enhance Performance (PEP) program, which has been widely used in athletics since 2008.

    As research has progressed, so have new trends in ACL injury prevention, which have shifted from static stretching to more sport-specific dynamic flexibility and gluteal strength and "core" strength and stability. These play a vital role in protecting the ACL before injury or after surgery.

    Sports and Orthopaedic Specialists (SAOS), in partnership with Courage Kenny Rehabilitation Institute, has developed an ACL Injury Prevention/Performance Enhancement Program that incorporates existing scientific-based knowledge about ACL injury prevention, combined with newer information on the importance of dynamic flexibility and hip/trunk strength and stability for prevention and performance.

    In-season sports warm-up

    The following exercises help the athlete run, decelerate, jump and cut with ideal form to prevent future injury. They should be done for approximately 10 to 15 minutes prior to every sports practice.

    • squat
    • hip hike
    • single leg squat
    • double leg forward jump
    • single leg forward jump
    • side/side single leg jump
    • deceleration/ back pedal
    • run-cut.

    Off-season training/in-season conditioning

    The off-season is the optimal time to condition the body and focus on proper mechanics and form. During pre-season, the athlete should continue with the exercises listed below, transitioning into the in-season program when the sports season is in session.

    These exercises should be completed three (3) times per week for 25-30 minutes and should be performed over half the width of a soccer field or the length of a basketball court.

    • jog
    • heel kicks
    • side/side shuffle
    • carioca right and left
    • diagonal change of direction (W pattern)
    • diagonal single leg bounding
    • deceleration - back pedal
    • walking lunge with trunk lean forward
    • inchworm
    • figure 4 sit-walk
    • single leg squats
    • side lying and prone plank
    • bridge glute/ham raise
    • clamshell with band
    • squat hold with band
    • squat jump in place with band
    • squat jump forward with band
    • forward/backward single leg jump
    • side/side single leg jump.

    In all exercises - both in-season and off-season - make certain that:

    • knees are aligned
    • pelvis is level
    • trunk is vertical
    • landings are quiet
    • hips are down and back.

    Email ACLinjuryprevention@allina.com for more information or to schedule an instruction session.