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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.

Published in: Health & Medicine, Sports
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Youth Sports Injury Day: ACL Injury Prevention

  1. 1. Peter N Ove, MDSports Medicine, Arthroscopic Knee and Shoulder Surgery Orthopaedics and Sports Medicine
  2. 2.  ACL injury can be career ending Even if get back, risk for further surgery, re- injury, arthritis Focus on preventable ACL injuries
  3. 3.  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
  4. 4.  ACL tears 4-6x more common in girls than boys Why? Anatomy & Physiology Hormonal, ligament/house size, biomechanics Technique Environment, other factors’ contribution notwithstanding
  5. 5.  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!!)
  6. 6.  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
  7. 7.  Anatomical Differences Biomechanical Factors Hormonal Influences Neuromuscular Differences
  8. 8.  Women tend to have a more “knock-kneed” leg alignment The femoral notch, in women tends to be narrower
  9. 9.  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”
  10. 10.  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
  11. 11.  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
  12. 12. • Avoid vulnerable positions• Increase flexibility• Increase strength• Increase balance through agility training• Include sports specific exercises into the training program
  13. 13. 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
  14. 14. • 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
  15. 15.  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)
  16. 16.  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