By: Mind to Muscle Sports Conditioning Centre
Knee injuries are common among athletes. The type of injury depends on several factors: nature of the sport (contact or non), impact on the knee joint, predisposition to injury. This article will outline injury prevention and care for a specific ligament in the knee, the ACL (anterior cruciate ligament).
The ACL is one of the four main stabilizing ligaments of the knee joint. Ligaments are found in and around joints acting as stabilizers connecting bone to bone. The ACL connects the femur (thigh bone) and the tibia (shin bone). The role of this ligament is to prevent forward movement of the tibia on the femur.
ACL injuries commonly occur in soccer. Common mechanisms of injury include: planting on one foot and cutting, straight leg landing, one step stop landing, knee hyperextension, pivots and sudden deceleration. Damage might also be caused from blows to the front of the knee forcing the joint into hyperextension or from lateral blows forcing the knee to give in medially.
Common signs and symptoms of ACL injury include; one of the above listed mechanisms, the sensation of a pop, giving out at the knee, immediate swelling and the inability to fully weight bear. If any of these signs are experienced in combination with a common mechanism of injury the athlete should seek assistance from an Athletic Therapist and Sports Physician who will clinically assess the injury, begin treatment and refer the athlete to the proper specialist if necessary.
Both males and females are susceptible to ACL injury however, females have are seven to ten times more likely to sustain injury to this ligament then males. Women are at higher risk then men because typically they have wider hips creating a greater angle (Q angle) at the knee. This larger angle contributes to higher stresses in the knee joint predisposing it to injury.
The best way to prevent injury to the ACL is to properly stabilize the knee through exercise training. One of the most important muscle groups to develop is the hamstrings (back of the thigh). In regards to the ACL the most important function of the hamstrings is to flex the knee by pulling the tibia (shin bone) backwards on the femur (thigh born) acting as a dynamic restraint to ACL injury. The best way to develop this muscle is to focus on the fast twitch muscle training (fast and quick movements). Another important muscle group to train is the quadriceps (front of the thigh). In most athletes the quads are over developed in comparison to the hamstrings creating an imbalance. It is important to establish and maintain a strength ratio of 2:1 quad to hamstring to properly stabilize the joint and prevent injury. The hip flexors, groin and gluteals (bum) are other muscle groups important to strengthen in order to prevent injury to the knee. Along with strength training, it is also important that athletes incorporate proper functional flexibility and balance training as part of their prevention program. This training will help to prevent imbalances as well as dynamically stabilize the knee joint in preparation for the season.
Damage to a ligament is clinically referred to as a sprain. There are three degrees of injury which may occur with any ligament. A first degree sprain results in mild lengthening of ligaments and has the fastest recovery time typically requiring rehabilitation only. A second degree sprain generally involves some tearing of the ligament. A third degree sprain causes discontinuity or tearing of the ligament and instability of the joint. In most cases, if an athlete has suffers a third degree sprain and wishes to continue to participate in their sport, surgical reconstruction is usually recommended.
There are three main surgical techniques, each requiring a different graft designed to reconstruct the ACL. Orthopaedic Surgeons will use either the patellar tendon, hamstring tendon or donor graft tissue for repair. The patellar tendon repair is presently the most common type of ACL repair. Athletes who require surgery are recommended to begin a pre-operative strengthening program one month prior to their surgical date in order to increase muscle mass and develop muscle memory. This will accelerate recovery after surgery and assist to increase initial comfort and confidence.
For more information, contact Mind to Muscle at 705-737-5097. www.mindtomuscle.ca