
Written by The A-Team: Dr. Davis & Dr. Shields
I’ve worked with a lot of patients over the last 20 years and one of the things they often struggle with (needlessly) is understanding how their body works BEFORE they get hurt. It is only after an injury takes place that the learning begins. Parents and athletes who have experienced this catastrophic injury begin reading, researching and asking questions.
After hearing from so many of our patients about the practice schedules, lack of downtime, and constant 51-week training schedules, I decided that something has to give. Our athletes are training longer and working harder than ever before. They are not given rest time and recovery methods. They are not taught how to take care of themselves both physically and mentally. This is something that needs to be built into every practice session and post-game ritual. It begins with education.
Don’t get me wrong... I love sports. I love to compete and push it to the next level. Above all else, I love to WIN! Preventative care has been proven to drive down the incidence of ACL injury. It has proven to assist athletes in gaining momentum in their sport, as well as elongating their athletic careers.
Research says… ACL injuries are at epidemic levels. The athletes suffering from this injury are younger than ever. Females have a greater risk of non-contact ACL rupture than males. This is mostly due to their hormone
levels and anatomical makeup. Following puberty, female athletes have wider hips which places greater stress on the knee. Some athletes are only a hard plant and pivot away from tearing an ACL.
How do we fix it and keep our athletes safe? Let’s get into it.
Know Your Sport. Each sport has a set of skills that are required for an athlete to learn and develop. This begins when they are young and changes as they get older. The key to safe training is to know what is needed for your particular sport. Does it require endurance? Do you need to run fast for short periods? Do you need to be able to jump? On one foot or on two? Does it matter what your dominance is (right vs. left)? Each sport can be broken down into categories of skill and then muscle activation/requirements to meet and develop that skill.
Most coaches are excellent in knowledge of what skill is needed for the sport. Soccer - ball skills, running, passing, shooting. Football - tackle execution, play development, passing, catching. Softball - throwing accuracy, base running, hitting, catching. What is typically lacking is the knowledge of how the body needs to move to accomplish each task. And even deeper than that, what muscles are required to fire, relax, stretch, contract in order to excel at that skill.
This is where athletes get in trouble with over training, and potentially reinforcing bad or less than awesome body mechanics. If our body is constantly repeating inefficient movements and does not have enough strength to support the skill that is being taught, it is only a matter of time before injury occurs.
Know your sport. Seek out advice on the things that are important to your body and development as a player. This is not knowledge that every coach or even every personal trainer will have. It is something that requires a sports science background that is based on research and experience with athletes. Knowledge is power. Protect yourself.
Cross Train
We talk about this all the time. No athlete should be participating in the exact same sport ALL YEAR ROUND. It is called accommodation and it happens to your muscles if things aren’t changed up. Your body is just like your mind - it gets bored if it’s stuck doing the same thing over and over. If you are participating in the same sport, same drills, same everything 50 - 51 weeks out of the year, your body will not know how to handle it if something different comes along and challenges it. This will increase your risk of injury.
You have got to change it up. If you are doing a predominantly lower extremity sport, you need to make time to develop your upper body and core muscles as well. Multi-sport athletes are less likely to get injured than those that play the same sport all year round. If you are a runner, you need to get in the pool and swim. If you are a pitcher, you need to make time to bike or do the elliptical. Everything works together. Take care of yourself.
Get Stronger - Everywhere As long as you are participating in sports, you will be training. The sooner you learn how to plan your training/competition schedule out, the better off you will be. There are things you should be doing during the season and there are things you should be doing in the off-season. In-season training is more about maintenance and small supplemental programs to keep your body performing at its best. Off-season training is another animal. This is when you go hard. This is when you should be pushing to gain strength, stability, core engagement, power.
Good body mechanics are the key component to any training program. When we talk about injury prevention, that is what we need - an athlete to demonstrate a good solid understanding of how their body moves. We call it Player Maturity. A mature player takes the time to learn how to move their body correctly. A mature player will work on good mechanics and dedicate time to strengthen EVERYTHING.
Finesse Is Best Attention to detail and the little things in training is what matters most. You can lift 1000 lbs in the gym? Awesome. Can you stand on one leg with your eyes closed? Probably not. Our body needs stability in order to develop strength. Stability at the hips will allow for improvements in thigh strength. The smaller muscles that surround the hip structures require just as much attention as the big thigh muscles. They are the ones that are going to protect you when you try to come to a complete stop. Those hip rotators are key components to protecting your ACL - don’t ignore them!
Soccer players don’t need arm strength? So not true. The rotator cuff acts as the stabilizer for the upper body. What happens when you are challenged for a ball? If you have a good base of arm strength and core, you will most likely stay on your feet. If not? Hello ground and potentially a contact injury.
The small muscles in your shoulders, hips and ankles work hard to keep you stable in unstable situations. Don’t ignore them. Smaller, less sexy exercises will help develop these stabilizers and again, help lower your risk for injury.
Rest
This is the most underrated and ignored aspect of injury prevention and training. Your body needs rest. Your mind needs rest. IF... we are resigned to playing 6 days a week. IF... we are going to play all year round within the same sport 50 weeks a year - then we need to make time to rest and recover.
There are lots of ways to participate in active recovery - foam roller, NormaTec, CryoChamber, deep tissue massage. We are not talking about active recovery. We are talking about plain old- sit on your butt and do nothing - REST! This has to be in the plans. If we aren’t resting then our muscles are in constant use. This means they will eventually break down. Weakness and fatigue are key components of ACL rupture. Reduce your risk of injury and hang out with your friends, watch Netflix, read a book, do Tik Tok videos - but for goodness sake - REST!
Learn how to jump...and land It sounds so simple. Jump. Land. What could possibly be wrong with how I jump? When I tell you I spend most of my time in the office reviewing mechanics of jumping with athletes, I am not kidding. I probably spend at least 10-15 hours a week on jumping/landing mechanics alone.
The need for proper jumping and landing is key to keeping your knees safe. Knee collapse (called Valgus) is a common occurrence in most girls 12 and over. The presence of knee valgus in athletes participating in sports drastically increases their risk for ACL injury. Knee valgus greater than 5-10 degrees places an athlete at high risk for injury.
Teaching someone how to jump and land requires strong knowledge and coaching skills. Proper squat mechanics drive this conversation. Good squat, good knee position, strong legs and soft landing are all components of a good jump cycle. This is so very important for all athletes. The sooner you learn how to squat, jump and land - the lower your risk level of injury becomes.
Get tested with updated technology.
I have treated and trained athletes for over 20 years. Nothing frustrates me more than when I evaluate an athlete that has just undergone ACL reconstruction - especially if it was a non-contact injury. Why? It is preventable. I have spent the past 5 years reading and researching the latest technology available in sport science.
We use wireless sensors that are placed on an athlete’s legs and back. The sensors give us hard numbers on how the body is moving. It allows us to see how much varus / valgus is present. It allows us to see how well the core is activating. It allows us to see if there is a marked difference between right and left leg stability.
The data is backed by research and this system is used in professional training rooms all across the country. We have been using it for 4 years and could not be happier with the results. The testing takes 25 minutes and gives you a data print out and summary of your movements. We have a scoring system, backed by research, that lets us know if you are ready to return to sport or if you need some more work.
I take great pride in knowing that when we put an athlete back out on the field following an injury, they are good to go. We discharge patients with confidence. We also give non-injured athletes the confidence to drive their training and take their skills to the next level. It is no coincidence that I have met with and consulted for professional and Olympic athletes using this same system.
It works.
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