It seems every time I turn on ESPN I hear about another athlete who has suffered a season ending or possibly career ending ACL injury. Statistics show there are between 250,000 and 300,000 ACL Injuries per year and they occur almost exclusively in athletes. The chance of a non-athlete suffering an ACL injury is 1,000 to 1.
What Is The ACL?
ACL stands for Anterior Cruciate Ligament. Most medical types will talk of the ACL as one ligament; however it is actually composed of an anterior band and a posterior band. Depending if the knee is in flexion or extension will dictate which fiber is under tension. The ACL is a stabilizer of the knee and it stabilizes rotation and the lower leg bone (tibia) gliding on the upper leg bone (femur).
How Is The ACL Torn?
The ACL can be torn in many different ways. However, the most common mechanisms of injury tend to be:
- Coming to a quick stop and the lower leg bone (tibia) continues to shift forward.
- Hyperextension of the knee joint.
- Non-contact Injury – Planting and twisting while the foot gets stuck.
- Contact injury – for example when AJ Peterson from the Vikings was hit on the back of the knee just as he planted his foot.
- Jumping and landing on someone’s foot as happens in basketball and football going up for the ball.
Treatment For ACL Tears
Unfortunately most ACL tears end up being surgically repaired. There are several surgical approaches that are used such as patella tendon graft, allografts (cadaver graft,) hamstring tendon graft, quadriceps tendon graft and synthetic grafts. The type of graft chosen seems to be surgeon dependent. Once the surgery has been performed, most athletes undergo rigorous rehabilitation and are sidelined for 1 year and some never return to form.
Preventing ACL Injuries
Most athletes have severe muscle imbalances with the quadriceps much stronger than the hamstrings. This sets up a shear force that quickly tears the ACL during deceleration or twisting motions. Also nutrition and lifestyle is a factor. Paul Chek calls this P.P.P. which stands for Piss Poor Protoplasm. Since most athletes use their mouths as garbage cans, there is little wonder why their ligaments are often frail and of poor tissue quality. Older orthopedic surgeons will be the first to tell you that the overall tissue quality of humans is not the same as it was 30 years ago.
Proprioception And Awareness..
Ligaments Can Be Smart. I feel this is the most important part of the blog and a lot of the the non-contact ACL tears can actually be prevented. Very few rehabilitation and fitness professionals actually know that ligaments can be trained. Most “experts” think that once a ligament is damaged it is damaged for life. This is not true! There are proprioception and awareness exercises for all the ligaments in the body and they work amazingly in the knee joint. Did you know that France’s Pierre Vaultier actually won the Olympic Gold Medal in Sochi after tearing his ACL? Doesn’t this make you wonder what types of exercises he was doing?
Visit The H3 Learning Center
If you are an athlete and suffered an ACL injury or would like to prevent one, contact the H3 Learning Center today for your free consultation at 954.566.0585. Rehabilitation, fitness experts and coaches are also welcome to learn these very powerful proprioception and awareness exercises.
Better Body. Better Life.
Dan Hellman, MSPT, C.H.E.K Faculty