ACL Injury Prevention

ACL Tear
Summer is in full swing and with wonderful weather comes increased activity for people of all ages. Unfortunately, more activity can lead to increased injuries, the most dreaded being an ACL tear.

The ACL is one of four ligaments in the knee that attaches the thigh bone (femur) to the shin bone (tibia). The ACL is vital for allowing direction changes, deceleration, pivoting, hopping and jumping. A tear of the ACL can lead to major surgery and a recovery time of 9-12 months. Some risk factors that can lead to an ACL tear are beyond the athlete’s control, such as playing surface, body anatomy, and hormone changes. Fortunately, biomechanical risk factors CAN be controlled with proper mobility, strength, balance, and dynamic control exercises. As 70% of ACL tears occur from noncontact injuries, athletes have the ability to prevent ACL tears by participating in proper training of the entire lower kinetic chain which must include the hip, knee and ankle joints.

One important concept to understand in regard to injury prevention is the hip/knee/foot alignment. When the knee collapses inwards, in what is called a knee valgus position, the forces applied to the knee can cause an ACL tear. While training, it is vital for the athlete to be aware and control the hip/knee/foot alignment during all tasks. Ideally, hips should be level (do not allow one hip to drop below the other), the middle of the kneecap (patella) shoulder be aligned with 3rd or 4th toe, and feet should be pointed forward, not outwards.

hip/knee/foot alignment during all tasks

Exercises for ACL Injury Prevention

Exercises performed incorrectly can do more harm than good. If the athlete is unsure if exercises are performed correctly, an evaluation by a 1st Choice Physical Therapist is essential.

Following is a list of suggested exercises to perform to prevent an ACL injury after a 5-10 minute warm up:

  • Mobility: stretch gastrocs, soleus, hamstrings, quads, hip flexors, glutes, hip internal rotators
  • Strength: 2 leg to 1 leg bridge, side plank, 2 leg to 1 leg heel raises with knee straight and bent, 2 leg to 1 leg deadlift, squats, lunges, step downs
  • Balance: single leg stance with arm reaches/leg reaches/hip rotation/eyes closed/compliant surface, single leg squat with arm/leg reaches
  • Plyometrics: double leg hops forward/back/lateral/rotational with progression to one leg, bounding, speed skaters, compass hops, landing from elevate surface
  • Agility: box drill clockwise and counterclockwise, T drill, shuttle run, backward pedal, lateral diagonal runs

The above list is a sample of important tasks for an athlete to work on for ACL injury prevention, but must be performed with correct form and progression. If unfamiliar with the above activities or if you or a friend/family member would benefit from an individualized ACL prevention program, please contact 1st Choice Physical Therapy for an evaluation.

The Benefits of Exercise: Back to Basics

Posted by Said Lissone on Thursday, 14 August 2014 in Physical Therapy

Participating in regular exercise is the only way to achieve and maintain the health of our precious body, mind, and spirit. Regardless of this, we are often misguided by the supplement and beauty industry into believing that physical exercise is merely an adjunct to the products they are selling to us and profiting from. As a passionate health professional, I want to remind you of the reasons why exercise is beneficial to our overall health. Exercise causes long-term physiological adaptation including improvements in heart function, muscle strength, muscle endurance and body composition. These adaptations allow you to better perform the activities of daily life and help to maintain your functional independence as you age.

A common axiom is resistance training strengthens and sculpts our muscles. What is less widely discussed is that the tendons, ligaments and other supporting structures in our body also get stronger when engaging in this type of exercise. Additionally, the density of our capillaries increases to compensate for the increased oxygen demand of our muscles. Changes in our nervous system also occur with resistance training. These include increased neural drive resulting in more forceful muscle contractions and improved communication between our brain, muscles and peripheral sensory systems. This type of neural adaptation is the reason why exercise is so effective in improving the symptoms of central nervous system diseases such as Parkinson’s and others.

Physical Therapy Fitness

Cardiovascular exercise also induces specific physiological adaptations. The most apparent adaptation is the increased efficiency of the little engine of life, our heart. On average, the resting heart rate decreases by 10 – 15 beats per minute. Blood pressure decreases in untrained individuals who engage in regular cardiovascular exercise. The reason our heart function improves is that our heart literally increases in volume, what we call healthy cardiac hypertrophy. Invariably our heart also gets stronger. A stronger and bigger heart means that the heart can pump more blood with less effort. In essence, cardiovascular exercise is a drug-free approach to reducing blood pressure and can prevent many dangerous diseases of the cardiovascular system over time.

It is well known that cardiovascular exercise and resistance training is beneficial for people with diabetes. It improves glucose tolerance and insulin sensitivity through a combination of physiological adaptations and changes in body composition. Guidelines on exercise jointly released by the American Diabetes Association and the American College of Sports Medicine say regular exercise can tame Type 2 Diabetes. These guidelines recommend at least 150 minutes of moderate-to-vigorous exercise per week spread out at least three days with no more than two days between each exercise session. Considering individual limitations, diabetes should not be an excuse to avoid physical activity.

Exercise is the magic elixir, the fountain of youth, and the panacea. Now that I have reinforced what you already knew, Saïd says, “Exercise, be healthy, and love your life!” Physical Sarasota Main Street offers PT-directed fitness training along with a modern fitness center, complete with a full line of strength and cardio equipment.

Always consult with your physician before starting any exercise program.