Youth Sports Injury Day: ACL Injury Prevention
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Youth Sports Injury Day: ACL Injury Prevention

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Dr. Peter Ove discusses anterior cruciate ligament (ACL) injuries and how to prevent them at Anne Arundel Medical Center's Preventing Injuries in Young Athletes program.

Dr. Peter Ove discusses anterior cruciate ligament (ACL) injuries and how to prevent them at Anne Arundel Medical Center's Preventing Injuries in Young Athletes program.

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Youth Sports Injury Day: ACL Injury Prevention Youth Sports Injury Day: ACL Injury Prevention Presentation Transcript

  • Peter N Ove, MDSports Medicine, Arthroscopic Knee and Shoulder Surgery Orthopaedics and Sports Medicine pove@osmc.net
  •  ACL injury can be career ending Even if get back, risk for further surgery, re- injury, arthritis Focus on preventable ACL injuries
  •  Bracing: no conclusive evidence Footwear: increased friction coefficient more risky Playing surface: lower friction (wooden vs artificial, turf vs. grass?, even vs uneven surface) better Environmental conditions: outdoor turf, grass cold better than hot weather
  •  ACL tears 4-6x more common in girls than boys Why? Anatomy & Physiology Hormonal, ligament/house size, biomechanics Technique Environment, other factors’ contribution notwithstanding
  •  38,000 estimated female ACL injuries each year  Estimated 2,200 at the collegiate level  May be 4 times as high at HS level (8000-9000!!)
  •  Increased Participation in sports (Title IX)  Female basketball players are 2x more likely to suffer an ACL tear than their male counterparts  Female soccer players are 4x more likely to suffer an ACL tear than their male counterparts
  •  Anatomical Differences Biomechanical Factors Hormonal Influences Neuromuscular Differences
  •  Women tend to have a more “knock-kneed” leg alignment The femoral notch, in women tends to be narrower
  •  Compared with men, women:  Have less muscle mass  Are slower at the rate of muscle force development (ms)  Have a stronger, quicker reacting quadriceps relative to hamstrings  Tend to be more upright when landing  Tend to be “quad dominant”
  •  Ligament Dominance  Knee ligaments rather than knee muscles absorb the landing forces during sports maneuvers Quadriceps Dominance  Quads react more quickly to forces than the hamstrings Leg Dominance  The non-dominant knee is at greater risk because it’s weaker
  •  ACL injury prevention programs have demonstrated a reduction in the rate of ACL injuries in 14-18 year old girls by 74-83%!!  Helping to change the position of the knee when landing or cutting and pivoting  Decreasing landing forces on the knee when landing from a jump
  • • Avoid vulnerable positions• Increase flexibility• Increase strength• Increase balance through agility training• Include sports specific exercises into the training program
  • Research-proven ACL injury prevention programs:-Preseason-In-season-Multi-yearRandomized Trials in high school, college, and professional athletes; female and maleExamples: Sportsmetrics, PEP, Frappier, BAPS
  • • Technique changes – Landing properly – Accelerated round turns, multi-step stop deceleration• Balance, proprioceptive training• Neuromuscular training – Correct imbalances (leg, muscle groups) – Improve strength, flexibility via plyometrics, weight training with proper alignment and technique
  •  Reduction in ACL injuries by 5X in many studies Usually most impressive statistics when you separate out non-contact injuries Improvement in performance (vertical jump)
  •  The research and development of training programs to prevent ACL injuries is evolving rapidly More attention needs to be placed on implementing these programs to younger athletes during their developmental years