With the AFLW season in full swing, Anterior Cruciate Ligament (ACL) ruptures are back in the news, with 3 more athletes rupturing their ACL on the weekend. This brings the total number of players to tear their ACL during the season to 15. This is significant considering the number of games the women play compared to the men. 

However, ACL rupture is not just limited to Elite sport, with an alarming number of recreational (local sport) athletes also succumbing to the injury, especially in youth athletes. A study in the Medical Journal of Australia found that 197 557 ACL reconstructions were performed between 2000 and 2015, with the number of non-operated on ACL injuries unknown. The incidence of ACL reconstructive surgery is among the highest in the world and is emerging to be an internationally recognized public health problem.

During exercise, especially team sports, our bodies are required to produce a large force in order to propel our body in the different directions needed to perform that sport effectively, generally speaking, this means up, forward and side to side. In order to stop this large force effectively, the body must produce a larger force or learn to absorb the force, otherwise, we create massive amounts of load through the joints. Massive amounts of load through the joints causes our ligaments and tendons to take the pressure rather than the muscles, too much force equals a rupture of the ligament. Therefore, if we teach athletes to absorb the force in the correct way, we can reduce the pressure on the ligaments and reduce the likelihood of an ACL rupture.

Luckily, with the correct training and education, anywhere from 50-80% of these ACL injuries can potentially be avoided.11

WHAT IS THE TRAINING?

In order to help prevent ACL ruptures, athletes should undertake neuromuscular jump/land and change of direction training. We need to teach athletes how to position their bodies to allow for effective force absorption when landing, thus reducing the load on the joints and ligaments. A few key things to remember when teaching this position are:

  • Soft knees
  • Try to land as quiet as possible
  • When landing on one leg, make sure knee doesn’t collapse inwards
  • When changing direction, ensure our centre of gravity stays over one limb, not inside it

This type of training should be done as early as possible in the athlete’s career, as the earlier you start an intervention, the better success it has.  Youth coaches should be seeking out Strength and Conditioning coaches and exercise Physiologists to assist them with this training as it will benefit the team as a whole. The more robust you can make junior athletes, the more time they spend training for their sport and the greater chance they have of having a long and successful career. It is important that you see a Strength and Conditioning Coach or Exercise Physiologist who can show you how to complete the exercises properly as the training is only successful if done correctly. 

References

Mandelbaum, B. R., Silvers, H. J., Watanabe, D. S., Knarr, J. F., Thomas, S. D., Griffin, L. Y., . . . Garrett, W. (2005). Effectiveness of a Neuromuscular and Proprioceptive Training Program in Preventing Anterior Cruciate Ligament Injuries in Female Athletes. The American Journal of Sports Medicine, 33(7), 1003-1010. doi:10.1177/0363546504272261

Zbrojkiewicz, D., Vertullo, C., & Grayson, J. E. (2018). Increasing rates of anterior cruciate ligament reconstruction in young Australians, 2000–2015. Medical Journal of Australia,208(8), 354-358. doi:10.5694/mja17.00974

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