ACL Injuries: What Are We Doing?

July 4, 2015

Unfortunately, NOT ENOUGH. None of us are. We must do better. Whether we are a coach, an athletic trainer, a parent, or an athlete. We all must do better. Too many of these injuries are occurring and too many of them can be prevented. But they aren’t. They are occurring daily. Female athletes suffer more ACL injuries than their male counterparts and the numbers are alarming. Even more alarming is the fact that those who tear their ACL are at a much higher risk of either re-tearing that same ACL or tearing the ACL in the opposite knee.

Gray Cook has said that a major factor for injury is previous injury. That goes to show how important injury prevention really is. We have to work to achieve this. And unfortunately, too many of us are not doing enough. Even our kids who do get into the weight room probably are not receiving the greatest benefits. If we are simply entering the weight room and lifting weights without appropriate movement screening and appropriate instruction, I have concerns. Are we preventing injuries or are we creating injuries in the weight room? If you don’t know the answer to that question, I believe you need to re-assess your program. Injury prevention needs to be the first priority when it comes to Athletic Performance and then we’ll allow the enhanced performance come. But you cannot perform at your best when you are injured.

The greatest concern, though, is that our athletes are not doing enough to prevent injuries. I have seen it regularly over my career, female athletes especially are too reactive rather than being proactive when it comes to injury prevention and athletic performance. Most female athletes never step foot into the weight room until after they suffer an injury. For this reason, they often suffer an ACL injury which sets them back several months out of their sport and it can be extremely depressing for the athlete.

So my question is how to we get our female athletes to buy-in? Unfortunately, I don’t know this answer. But one story I like to share is from my last year at Waterloo where I worked with our volleyball coach to integrate an “ACL Prevention Program” into their summer workouts and into their dynamic warm up on a daily basis. Near the end of the season, one of the girls came to see me on a Saturday morning after injuring her knee on Friday evening in practice. She had all of the signs and symptoms of a meniscus tear or ACL injury along with a mechanism of injury that would potentially cause such injury. Our team doctor and I both agreed that she seemed to have a meniscus tear so he ordered an MRI. Fortunately, he and I were both wrong and she was diagnosed with a Grade 1 ACL sprain. Our physical therapist told me after her first PT visit that she had never seen a girl with such strong hips. To me, I truly believe this girl would have torn her ACL without the prevention program in place at the beginning of the season. That would have caused her to not only miss the end of her junior year, but she likely would have missed her entire club season and most if not all of her senior year. Instead, she missed 6 weeks while she rehabbed and went on to return to volleyball in the spring.

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I see many girls who move incorrectly. People think that I am exaggerating when I show them a picture like the one above, but then I am more than happy to take a picture and/or video of them performing a squat or some sort of single leg movement like a single leg squat or a lunge. Then I ask them what they think. They no longer think I’m exaggerating so much. People also believe I’m exaggerating when I tell them, without manual testing, that their hips are weak. I truly believe I could take every single female athlete in my school and over 80% would have movement deficiencies and weaknesses attributed to their gluteus maximus and gluteus medius.

Whether you are a coach, an athletic trainer, a parent, or an athlete, I challenge you to find a way to prevent these injuries. ACL injuries may not be completely preventable, but there is so much we can do to lessen the severity of injury. And it might just make better athletes in the process…

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One Response to “ACL Injuries: What Are We Doing?”

  1. audricpr Says:

    i have a question regarding your article, more specifically the picture related to your article of the soccer player running. Wouldn’t the direction they are sprinting and the action of the opposite leg following deceleration affect the amount of pelvic tilt/rotation and femoral internal rotation ? I ask this because depending on the above that would affect the amount of activation of the abductor or adductor group. So wouldn’t a neutral pelvis limit contribution from the musculature that attaches to the pelvis especially those that cross both the hip and knee?


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