| s, both professional and amateur, are prone to | | | | close together and the knee should not go out to |
| numerous injuries during their careers. The body | | | | the side. Remain in an upright position and hold for 30 |
| takes a beating while engaging in sports. Many of the | | | | seconds before switching sides. This should be done |
| injuries athletes sustain can be prevented, allowing | | | | two times for each leg. |
| the individual to avoid uncomfortable procedures and | | | | Hamstring stretch — sitting on the ground, |
| medical devices as well as keeping them in the | | | | stretch the right leg out in a straight line with the left |
| game’. One of the most preventable injuries in | | | | leg bent and the left foot against the inside of the |
| sports today is an injury revolving around the ACL. | | | | right thigh. Keeping the back straight, lean forward to |
| What is the ACL? | | | | touch the chest to the knee. If able, reach towards |
| The ACL — anterior cruciate ligament — | | | | the toes and bring them back towards the head. Hold |
| is a major ligament that is found in the knee. It is | | | | for 30 seconds and then switch sides. This should be |
| responsible for keeping the knee from moving too | | | | done two times for each leg. |
| much, limiting the joint’s range of motion and | | | | Inner thigh stretch — while sitting, spread |
| stabilizing leg movement. The ACL is attached to the | | | | the legs apart and lower the upper body down while |
| front and top of the tibia and stretches diagonally up | | | | keeping the back straight. The muscles in the inner |
| to attach to the back and bottom of the femur. | | | | thigh will stretch. Sit up and reach over the right leg |
| People who complain of their knee giving | | | | with the right arm while extending the left arm |
| out’ or popping’ usually have some | | | | overhead to the right. Hold for 20 seconds and then |
| form of ACL injury. | | | | switch sides. This should be done three times for |
| How does an ACL injury occur? | | | | each leg. |
| ACL injuries can occur during sports related activities | | | | Strengthening |
| as well as during regular day to day activities. Most of | | | | In order to build up stability in the knees and legs, |
| them are due to sports but the ACL can tear during | | | | strengthening exercises should follow the warm up |
| a motor vehicle accident, a fall, a work related | | | | and stretching exercises. It is important that the |
| accident, rough play or during other activities that | | | | technique is followed closely and that the |
| causes the knee to move in a direction it is not | | | | performance of the exercises is adhered to in order |
| supposed to naturally go in. The majority of ACL | | | | to get the proper results. |
| injuries fall under the heading of | | | | Walking lunges — starting with the right |
| non-contact’ injuries. This means that the | | | | leg, lunge forward keeping the front knee over the |
| injury happens without another person being involved. | | | | ankle. Push off with the right leg and lunge forward |
| For example, an athlete can turn on their foot the | | | | with the left, dropping the right knee down. The |
| wrong way during a pivot or land improperly from a | | | | motion needs to be controlled with keep the knees |
| jump and tear the ACL. A good sign that the ACL is | | | | from caving inwards. The toes should be visible on |
| injured is the knee giving out from under the person | | | | the leading leg. If they are not, the exercise is not |
| when the ligament is torn. | | | | being performed properly and the stance needs to |
| A torn ACL that is due to non-contact usually occurs | | | | be adjusted. This exercise should be done in three |
| when there is a rapid deceleration of the body and | | | | sets of 10 reps. |
| the knee joint. If the body is not properly placed | | | | Russian hamstring — with a partner, kneel |
| during a sport or physical activity, the ACL can be | | | | on the ground with hands at the side while the |
| stressed and overloaded. When this happens, the | | | | partner holding the ankles. Lean forward from the |
| ACL will tear. The knee is not stable and the | | | | hips with knees, hips and shoulders in a straight line |
| pressure from the hips and ankles place it in a state | | | | and the back straight. Do not bend at the waist. The |
| of weakness. The muscles in the shins and thighs | | | | hamstrings in the thigh will be working. This exercise |
| attempt to control the deceleration of the body and | | | | should be done in three sets of 10 reps. |
| this causes the aforementioned stress and overload | | | | Single toe raise — standing with arms at |
| to the ACL. | | | | sides, bend the left knee upwards and balance on |
| How can you tell if you have an ACL tear? | | | | one foot. Stretch the arms to the sides to help |
| A person can have ACL problems without a tear | | | | maintain balance and rise up on the toes of the right |
| being present but if the ligament is not checked | | | | foot slowly. Hold and then lower. Repeat this exercise |
| prolonged injury could ultimately cause a tear. A good | | | | 30 times and then switch sides. |
| sign that a person has an ACL injury is the popping | | | | Plyometrics |
| of the knee or the knee simply giving out and | | | | Plyometric exercises are designed to help build up the |
| causing the person to fall. ACL tears usually come | | | | power, speed and strength of the body. The key to |
| with swelling and pain, but a minor injury may not be | | | | performing these exercises properly is to remember |
| painful. Going to the doctor and having the knee | | | | to land softly when jumping. Always land with the |
| tested for instability and other stressors are used to | | | | weight on the ball of the feet and then distributing it |
| diagnose the problem. Additionally, an MRI of the | | | | back to the heel with the knees bent and the hips |
| knee may be ordered to verify the injury and | | | | straight. It is important that the technique is followed |
| possibly any other injuries that could be associated | | | | closely and that the performance of the exercises is |
| with an ACL tear. | | | | adhered to in order to get the proper results. |
| What is done heal an ACL injury? | | | | Lateral hop over a cone — using a 6 inch |
| Depending on the severity of the ACL injury will | | | | high cone to the left of the body, hop sideways |
| determine what type of treatment may be used by | | | | over the cone landing on the balls of the feet with |
| the physician who diagnoses the tear in the ligament. | | | | the knees bent. Straighten the knee slowly. Hop back |
| People who suffer ACL tears that do not participate | | | | to the right to complete a rep. Do this exercise for |
| in sports or who are suffering from a partial ACL | | | | 20 reps. |
| tear may be required to wear a special knee brace | | | | Forward and backward hop over a cone |
| for a few weeks to allow the ligament to heal on its | | | | — using the same 6 inch high cone, hope over |
| own. If the tear is severe and the person is an | | | | the cone forwards landing on the balls of the feel |
| athlete who relies on the range of motion provided | | | | with the knees bent. Straighten the knee slowly. Hop |
| by the knee, reconstructive ACL surgery may be | | | | backwards over the cone to complete a rep. Do this |
| recommended. | | | | exercise for 20 reps. |
| It should be noted that many athletes who suffer | | | | Single leg hop over a cone — using the |
| from an ACL injury such as a tear may never regain | | | | same technique found in the forward and backward |
| total mobility in the ligament like they had prior to the | | | | hop over a cone, start with the right leg and |
| injury. Therefore, it is better to work towards | | | | complete a forward and backward hop for one rep. |
| preventing ACL injuries than dealing with them after | | | | Do this exercise for 20 reps, switch legs and repeat. |
| they occur. | | | | Single leg vertical jump with headers — |
| How do you prevent an ACL injury? | | | | stand straight with arms at side and knees slightly |
| It takes more than just strengthening the legs to | | | | bent. Push off with the right foot and jump straight |
| prevent an ACL injury. Everything from weak hips to | | | | up, landing on the ball of the foot with the knee |
| the internal rotation of the knee itself can add to an | | | | slightly bent. Do this exercise for 20 reps, switch legs |
| ACL injury. In order to prevent this injury, core body | | | | and repeat. |
| muscles, external hip rotators, the gluteus medius | | | | Scissors jump — using the same knee |
| muscle, lower abs and obliques all must be stretched | | | | over ankle technique in the walking lunge, lunge |
| and strengthened in order to help prevent an ACL | | | | forward with the right leg. Push off with the right |
| injury. Quadriceps and hamstrings should also be | | | | foot and bring the left leg forward into a lunge |
| strengthened in an even ratio to help in ACL tear | | | | position, maintain the knee and not allowing it to cave |
| prevention, especially in women who are not as | | | | in or out. Land on the balls of the feet. Do this |
| muscular as men. Finally, good calf and ankle muscles | | | | exercise for 20 reps. |
| are also required as they help control knee | | | | Agilities |
| deceleration and provide the body with stability. | | | | Agilities will help build up the range of motion in the |
| Athletes should engage in coordination drills and | | | | ankle, knee and hip combination, allowing the |
| training in order to learn how to properly move during | | | | participant to move more smoothly during exercise |
| sports activities. Cutting — the quick side to | | | | and physical activity. This will help stabilize the ACL |
| side movements seen in many sports — as | | | | and keep it flexible. |
| well as landing must be done so that the center of | | | | Shuttle run forward and backward — |
| gravity in the body is lowered and the knee flexes | | | | using as many cones as desired, sprint from the |
| more. The torso should remain upright at all times if | | | | starting line to the first cone and stop. Sprint to the |
| possible and where it is feasible, additional movement | | | | next cone and stop. Continue this to the end and |
| after the cut or land is encouraged as it helps with | | | | then reverse running backwards. |
| the deceleration process in the knee. | | | | Diagonal run — set the cones in a zigzag |
| Finally, the proper footwear for the activity is | | | | formation. Start at the line and run to the first cone |
| required. Shoes are important in that they provide | | | | to the left, pivot on the left foot, and run to the |
| stability for the body. They should have a good drip | | | | next cone on the right. Pivot off the right foot and |
| on the playing surface and prevent the person from | | | | run to the third cone. Continue to the end keeping |
| slipping. | | | | the knee slightly bent and over the ankle. Repeat 3 |
| Exercises to help prevent ACL injuries | | | | times. |
| About one month prior to any sports season starting, | | | | Bounding run — run from one line to the |
| athletes should add stability strengthening exercises | | | | other bringing the knees up high towards the chest. |
| to their routine. Cross training with a stair climber or | | | | Land on the balls of the feet with the knees slightly |
| elliptical should be included in the cardiovascular routine | | | | bent and the hips straight. |
| to help the muscles warm up and stretch. Here are | | | | Cool Down |
| some strengthening exercises that can be included in | | | | The cooling down phase of any exercise routine or |
| the workout to help prevent painful ACL injuries. | | | | physical activity is important and should never be |
| These exercises should be continued through and | | | | skipped. There should always be water at hand |
| after the sports season. | | | | through this phase and it should take about 10 |
| Warm up | | | | minutes. Jog slowly until the heart rate comes down |
| Because it is dangerous to stretch a cold muscle, | | | | and then stretch the hamstrings, calves, inner thighs, |
| warm ups should be done in order to prepare the | | | | quadriceps and lower back with the exercises listed |
| body for the exercise and physical activity to follow. | | | | above and the following exercises. |
| Warm ups should include: | | | | Alternate hip flex bridging — while lying on |
| Line to line jog — slowly jog from one line | | | | the ground, bend the knees and place the feet flat. |
| or cone to another while keeping the hips, knees and | | | | Raise the buttocks off of the ground and squeeze, |
| ankles in a straight line. Knees should not cave in and | | | | holding this as the right foot is lifted off the ground. |
| the feet should not whip out to the sides while | | | | Do not allow the hip to dip towards the ground. |
| jogging. | | | | Lower the right foot and repeat the motion with the |
| Side to side shuttle run — moving from | | | | left foot. Repeat 30 times for each side. |
| side to side, the hips, knees and ankles remain in a | | | | Abdominal crunches — while lying on the |
| straight line. The exercise should start in an athletic | | | | ground, bend the knees and place the feet flat. Lace |
| stance with the knees slightly bent. The participant | | | | the fingers behind the head with the elbows out. |
| pushes off with the back leg and sidesteps in one | | | | Breathe in and contract the abdominal muscles while |
| direction to a predetermined point and then reverses. | | | | exhaling. Do this 30 times. Drop the legs to the right |
| Backward run — this warm up helps to | | | | to the ground and repeat the crunching of the |
| prevent knee locking. The participant runs backwards | | | | muscles to work the obliques. Repeat 30 times and |
| from one line to another, landing on the toes lightly. | | | | then switch sides. |
| The knees should remain bent at all times. | | | | Knee to chest — while lying on the |
| Stretches | | | | ground, bend the knees and place the feet flat. Bring |
| Anyone who exercises should always stretch after | | | | the right knee into the chest while extending the left |
| warm up to limber up the muscles and ligaments in | | | | leg to the ground. Hug the right knee for 30 seconds, |
| the body. Stretches allow the range of motion to be | | | | feeling the muscles of the lower back and buttocks |
| maintained and helps reduce joint stiffness, soreness | | | | stretching. Switch sides and then bring both knees to |
| after activity and injury. Never bounce or jerk the | | | | the chest. Repeat all three motions as a rep and do |
| muscles during stretches. Instead, the stretch should | | | | two times. If there is any pain in the lower back, |
| be done to the point of tension in the muscle and | | | | discontinue the stretch. |
| held for 30 seconds. Breathing should be normal and | | | | Figure four piriformis stretch — while lying |
| the stretch should be muscle lengthening. | | | | on the ground, bend the knees and place the feet |
| Calf stretch — starting from a standing | | | | flat. Place the left ankle over the right knee. Holding |
| position, bend forward from the waist and lay the | | | | this position, take hold of the right thigh and pull the |
| palms on the ground. The right knee should be bent | | | | right knee into the chest. Hold for 30 seconds and |
| slightly while the left leg remains straight with the | | | | switch sides. This will stretch the gluteals and the |
| heel of the foot on the ground. Hold for 30 seconds | | | | sides of the thighs. Repeat the two motions as a rep |
| and then switch sides. This should be done two times | | | | and do two times. If there is any pain in the lower |
| for each leg. | | | | back, discontinue the stretch. |
| Quadricep stretch — this exercise is done | | | | Seated butterfly stretch — while sitting, |
| with a partner. Lay the left hand on the | | | | bring the feet into the body so that the soles are |
| partner’s left shoulder and then grab the front | | | | touching. Place the elbows on the knees and slowly |
| of the right ankle with the right hand from behind. | | | | push the knees down to the ground. This stretches |
| Bring the heel of the foot to the buttock with the | | | | the inner thigh. Hold for 30 seconds and repeat two |
| knee pointing to the ground. The legs should remain | | | | to three times. |