The last post discussed injury treatment and what can be done after an ACL injury is sustained. However, Assistant Strength and Conditioning Coach at American University Alex Lee believes heavily in injury prevention. Prior into delving into preventative measures, I would like to take more time to talk about the causes of ACL injuries.
Causes of ACL Injuries
Although ACL injuries are thought mainly to be sustained by female athletes, research acknowledges that the male prevalence of ACL injury is not too far behind. According to Lee, many people say that women are at a higher risk of ACL injury then men due to an increase in their Q angle—a reference between the hip and the patella (knee cap). A greater Q angle is said to cause more stress on the knee. Generally, women have a greater Q angle than men because naturally, their hips are wider for childbirth. From Lee’s experience, he finds that innately most men are relatively stronger than women and athletes that are relatively strong and relatively mobile usually have fewer injuries, both in terms of occurrence and severity, regardless of their sex. Throughout Lee’s 9-year tenure working in collegiate strength and conditioning, he has worked with about 11 athletes for ACL recovery. He claims that there has been almost an equal divide between males and females. In his experience, there hasn’t been one specific sport that causes significantly more ACL tears than another. Most of the athletes with ACL tears he has worked with participated in basketball, soccer, or volleyball—all sports that involve frequent jumping and landing, change of direction, and physical contact. To Lee, ACL tears commonly occur when the athlete is lacking range of motion around certain joints or the athlete’s movement mechanics are poor due to fatigue or from previous knee injury.
Prevention Through the Eye’s of a Strength and Conditioning Coach
When asked how important ACL prevention is from the perspective of a strength coach, Lee answered that injury prevention in general is a huge part of strength and conditioning. Yet, it is also a byproduct of getting stronger, becoming more flexible, being in good cardio respiratory condition for your sport, and simply moving one’s body more efficiently. Particularly for leg strength and mobility, squatting through a full range of motion (with good technique and posture) is very important. As an athlete who works with Lee in the weight room at American University, I can attest to his claims that range of motion and mobility are proportional to strength. As my teammates and I have increased our range of motion using the techniques taught to us, we have been able to both increase our mobility and overall strength. Lee continued to explain that moving the body through a full range of motion while under a prescribed, progressively applied external load (weight), strengthens the muscles, tendons, and ligaments in and around any joint. Ligaments and tendons are connective tissue just like skeletal muscle, so they also adapt and become stronger when consistently exposed to resistance training. Lee also stated that it is important to develop single leg strength since there is a significant amount of time spent in athletics competition on one leg. Preventive exercises such as lunges, step-ups, and single leg squats can be done to help develop the strength and stability of each leg. In addition, Lee believes that strength and conditioning coaches should spend time with athletes on landing mechanics, running mechanics, and mobility exercises which all contribute to healthy ACL’s. Plyometric exercises where athletes can jump, according to Lee, help athletes develop and practice proper movement patterns so that subconsciously, these movements will carry over to practice and competitions.
“ACL Rupture.” Photograph. The Whitehouse Physiotherapy and Sports Injury Clinics, 2008. Web. 27 Nov. 2013.
“Correct v. Incorrect Landing Mechanics.” Photograph. DoTraining, 27 Nov. 2013. Web. 30 Nov. 2013.
Lee, Alex. Personal interview. 26 Nov. 2013.