The Dreaded "POP"

What do Tom Brady, Tiger Woods, and Carson Palmer all have in common?

They are all fairly attractive athletes. YES, but not the answer I'm looking for. They are just a few of the nearly 80,000 people who tear their ACL each year.

Chances are anyone reading this can name a handful of people in their own life who have suffered from a torn ACL.  The fact of the matter is that this injury is RIDICULOUSLY common. I don't want to bore you with all the medical details of the injury but trust me it is a LONG REHAB where you and your PHYSICAL THERAPIST will see each other way too often!

The good news is there are research PROVEN methods of preventing an ACL injury! Pay careful attention WOMEN because we are THREE TIMES more likely to have an ACL injury than are men. Not fair right?

MOST ACL injuries occur during sport when pivoting, cutting, jumping, or with high impact. So how can we possibly prevent cutting in football, jumping in basketball, and pivoting in soccer? Of course you can't, that's the nature of the game... BUT you can train in a manor that will give your knee better control such that it is STABLE during these high intensity moments.

ACL INJURY PREVENTION TRAINING PROGRAM:
This 15 minute program was developed by the Santa Monica Orthopaedic and Sports Medicine Foundation and has been shown to decrease the risk of ACL injury. I encourage you to try this protocol or at least incorporate some of these activities into your workout regime. Remember that for this to be successful FORM is key!

The goal of the prevention training is to increase balance, flexibility, strength, agility and promote proper technique during vulnerable movements for the knee. This exact protocol is being used by high school and college athletic programs around the country with excellent results in injury prevention.

I CHALLENGE YOU TO TRY THIS PROGRAM.... and believe me it is CHALLENGING!

Warm Up:

1. 30 sec Jog straight
2. 1 min Shuttle run (side to side): Do not let your knees cave in, knees should be directly in line with 2nd toe when you look down.
3. 1min Run backwards: Land on the toes without letting your knees snap backwards.

Stretching:

1. 30 sec Calf Stretch: Stand in lunge position, bend down placing hands on the floor and keeping heel of back leg flat on the floor. Repeat 30 sec on opposite leg.
2. 30 sec Quad Stretch: Stand holding support and pull one ankle up to the butt making sure knee is pointing straight and not twisting at all. Repeat 30 sec on opposite leg.
3. 30 sec Hamstring Stretch: Sit with one leg straight out and other leg bent. Keep back flat as you lower down towards straight leg. Repeat 30 sec on opposite leg.
4. 20 sec Inner Thigh Stretch: Sit with legs out in a V. With a flat back reach forwards down the center. Repeat reaching to the right for 20 sec and to the left for 20 sec.
5. 30 sec Hip Flexor Stretch: Lunge forwards, drop to your knee of the back leg. Take heel of the back leg and pull up to butt. Make sure to keep knee straight and hips facing straight ahead. Repeat 30 sec on opposite leg.

Strengthening:

1. 3 sets of 10 Walking Lunges: Lunge step forwards, push off with front leg and lunge forward with the opposite leg and so on. Make sure your knee does not go past your toes but that your knee is in line with your foot, not caving in!
2. 3 sets of 10 Hamstrings: Kneel on the ground with a partner holding your ankles firmly to the ground. Lower your body down towards the ground in a straight line without bending at the waist. Raise back up without bending at the waist and continue. *This is very difficult, and you may only be able to lower and raise a portion of the way to the ground- that is fine, only go as far as you can without collapsing.
3. 30 reps Single Leg Calf Raise: Balance on one leg without holding support. Raise up onto your toes and slowly lower back down while maintaining your balance. Perform 30 reps trying to stay on one leg the entire time. Repeat 30 reps on opposite leg.

Plyometrics:

(Drew Kelly/Getty Images)

1. 20 reps Lateral Hops over Cone: Jump side to side over 6inch cone landing softly on balls of the feet with a bend in the knees to absorb the landing.
2. 20 reps Forwards/Backwards Hops over Cone: Jump forwards over the cone and immediately after landing jump backwards over cone, continue. Again land on balls of feet with a bend in the knees.
3. 20 reps Single Leg Hops over Cone: Perform the above exercise (Forward/Backwards Hops over Cone) but this time on one leg. Maintain balance for 20 reps without touching other leg down. Do not let knee snap back, keep a slight bend entire time. Repeat 20 reps on opposite leg.
4. 20 reps Vertical Jumps: Use your arms and jump straight up off of both feet. The goal is to work on the form of your landing accepting weight on the ball of the foot with knees bent and facing straight forwards (no caving in of the knees).
5. 20 reps Scissor Jumps: Stand in a lunge, jump straight up scissoring legs to land in a lunge with opposite leg forwards. Continue for 20 jumps keeping knees stable and directly over the ankle.

Agility:

1. 1 min Shuttle Run: Make a square out of 4 cones, Sprint forwards from cone 1 to 2, backwards from cone 2 to 3, forwards from cone 3 to 4 and backwards from cone 4 to 1. Continue until 1 minute has elapsed.
2. 1 min Diagonal Run: Set up 4 cones in a W shape. Run at a diagonal from cone 1-2, pivot on inside leg and run at a diagonal from cone 2-3, pivot on inside leg and run at a diagonal from cone 3-4. Continue until 1 min has elapsed.
3. 1 min Bounding Run: Run bringing knees to chest each step

Cool Down: (YEAH! YOU'RE ALMOST THERE!)

1. 30 reps Bridging with Hip Flexion: Raise up into a bridge position with knees over ankles and not caving in. Lift one leg off the ground raising up without letting your hip dip down. Repeat on opposite leg. Continue to alternate leg lifts until you have reached 30 reps on each leg.
2. 30 reps Abdominal Crunches: Lay on back with knees bent and hands behind head with elbows out wide. Tighten abdominals and crunch until shoulder blades are raised off the ground, slowly lower back down. Repeat 30 times straight up and then drop knees to one side for 30 reps and knees to other side for 30 reps.
3. 30 sec Knee to Chest Stretch: Lay on back and raise one knee up to chest, hold 30 sec, repeat on opposite leg. Now bring both knees up to chest and hold an additional 30 sec.
4. 30 sec Piriformis Stretch: Lay on your back, cross right ankle over left knee and then pull left thigh towards chest to feel a stretch in the right glut area. Repeat 30 sec on left leg.
5. 2 x 30sec Butterfly Stretch: Sit with soles of feet flat together and use elbows to press knees down towards the ground. Hold 30 sec and repeat.

CONGRATULATIONS YOU MADE IT! You are on your way to a healthier happier KNEE and better athletic performance! The goal is to repeat this program at least 2-3 times per week for 4-6 weeks.

References:

• http://pt.usc.edu/aclprojectprevent/pep_tr.htm
• http://sportsmedicine.about.com/od/kneepainandinjuries/a/022202b.htm
• http://orthopedics.about.com/od/aclinjury/tp/acl.htm
• http://www.financeprofessor.com/funlinks/running/aclsurgery.html
• http://en.wikipedia.org/wiki/Anterior_cruciate_ligament_injury