ACL Tear prevention in female athletes
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Transcript of ACL Tear prevention in female athletes
ACL TEAR PREVENTION IN FEMALE ATHLETES
Nicole PecoraroOctober 21, 2012
THE ANTERIOR CRUCIATE LIGAMENT Two bands
Anteromedial band is tight in flexion Posterolateral band is tight in extension
Courses from femur to tibia Prevents anterior translation of the tibia on the
femur Provides passive stability to the tibiofemoral joint
STABILIZERS AROUND THE ACL
Muscles Quadriceps Hamstrings Popliteus Gastrocnemius Pes Anserine group
Gracilis Semitendinosus Sartorius
Other Ligaments PCL MCL LCL
Joint Capsules Anterior capsule Posterior capsule
HOW IS THE ACL TORN?
Large valgus or varus force while the foot remains planted in the ground
Hyperextension of the knee Patient will typically hear popping sound and feel
and tearing sensation
WHY ARE FEMALES AT A HIGHER RISK OF TEARS?
ACL tears occur 4-8 times more frequently in females Four primary factors
Neuromuscular differences How muscles contract and react Less force and torques can be generated in the hamstrings and
quadriceps muscles in females Anatomical differences
Females have wider hips resulting in a larger Q angle Women rely on the use of their quadriceps muscles heavily, adding a lot
of stress on the knee, whereas men rely more on their hamstrings. Hormonal differences
Ligaments tend to be more lax in females due to hormones Bio-mechanical differences
Increased knee abduction and valgus torques in females Females have a higher lateral trunk motion
Majority of the body’s weight is shifted onto one leg Foot remains planted in surface and is displaced from the center of mass
HOW CAN YOU REDUCE THE RISK OF INJURY?
Strengthen muscles Particularly hamstrings, gluteal, and core
muscles Correct any abnormal movement
patterns in their gait These could be adding stress to the joint
Exercise programs that include stretching, strengthening, coordination and plyometrics
PREVENT INJURY & ENHANCE PERFORMANCE(PEP)
The PEP Program has shown to reduce injury up to 41% in female athletes Study done by the NCAA including 1,435 Division 1 female athletes Designed by physical therapists at the Santa Monica Orthopedic and
Sports Medicine Group
Addresses potential deficits in neuromuscular coordination and strength in the stabilizing muscles around the knee joint
5 parts Warm-up Strengthening Plyometrics Agilities Stretching
Approximately 15-20 minutes
WARM-UP 1½ minutes Promotes blood
circulation to the muscle tissues Reduces risk of injury
Example: Jog from line to line(cone to cone) Make sure the
athlete’s hips/knees/ankles are in straight alignment
STRENGTHENING
3 minutes Strengthening the
muscles surrounding the knee will make the joint more stable
Example: Walking Lunges Strengthens the
quadriceps muscles
PLYOMETRICS
2½ minutes Improve power, strength, and speed
through explosive exercises Proper, soft landings are crucial
“softly accept your weight on the balls of your feet slowly rolling back to the heel with a bent knee and a bent hip”
Example: Scissors Jump Increases strength and power of vertical jump
AGILITIES
3 minutes Each of the 3 activities has a different
purpose Example: Lateral Diagonal Runs
Purpose: Increases dynamic stability in the ankles, knees, and hips.
Prevents a “knock knee” position from occurring which puts the ACL in a vulnerable place
STRETCHING
5 minutes Improves or
maintains mobility and range of motion
Reduces stiffness in joints and post-exercise soreness
Example: Figure-4 hamstring stretch
ADDITIONAL INFORMATION
Video by the NCAA on the PEP program Demonstrates some of the exercises http://www.youtube.com/watch?v=t_yz7yW
Lo5o
The entire PEP Program http://smsmf.org/files/PEP_Program_04122
011.pdf
REFERENCES
APTA. (2008). PTs: Appropriate exercise can help prevent ACL injuries in females. Retrieved 10/12, 2012, from <http://www.apta.org/Media/
Releases/Consumer/2008/9/25/> Hewett, T. E., Myer, G. D., Ford, K. R., Paterno, M. V., & Quatman, C. E.
(2012). The 2012 ABJS nicolas andry award: The sequence of prevention: A systematic approach to prevent anterior cruciate ligament injury. Clinical Orthopaedics and Related Research, 470(10), 2930-2940.
Neumann, D. A. (2012). Kinesiology of the musculoskeletal system (second ed.). St. Louis, Missouri: Mosby, Inc.
Noyes, F. R., & Barber Westin, S.,D. (2012). Anterior cruciate ligament injury prevention training in female athletes: A systematic review of injury reduction and results of athletic performance tests. Sports Health, 4(1), 36-46.
The Santa Monica Sports Medicine Research Foundation.The PEP program: Prevent injury and enhance performance. Retrieved 10/12, 2012,
from <http://smsmf.org/files/PEP_Program_04122011.pdf>