Best Practices for ACL Injury Prevention Programs

ACL injury prevention

Contributed Article – By: Chris Cowper-Smith and Kristen Fortune at Spring Loaded Technology

Spring Loaded Technology

It’s well-known that our knees are the most commonly injured part of the body. However, while effective prevention strategies for these potentially life-changing injuries are now established, they are not widely communicated or used by athletes. What’s more, 80% of anterior cruciate ligament (ACL) tears are caused by non-contact injuries, suggesting that in most cases the injury could have been avoided altogether.
Research shows that with proper preventative training, risk of injury (or re-injury) can be greatly reduced. However, if you’ve been injured in the past, it’s important to consult your doctor and regain your muscle strength to perform these exercises pain-free.
Understanding the risk factors
In order to minimize the risk of ACL injury you must first understand the risk factors themselves. Some risk factors cannot be altered or prevented, such as a person’s age and gender. For instance, female athletes under the age of 25 are about four times more likely to experience an ACL injury than their male counterparts. However, this pattern reverses after the age of 25 when males become more likely to experience ACL injury.
Other environmental factors can occasionally be avoided, but are often out of our control. For example, playing on artificial turf increases an athlete’s risk of injury compared to playing on natural grass. Similarly, dry weather conditions can increase your chance of ACL injury as well.
When it comes to preventing injury it’s important to be aware of the risk factors we can’t control, but it’s even more important to consider the factors that we can control. As a result, ACL injury prevention programs developed by scientists focus on making ‘controllable’ biomechanical and neuromuscular changes in the athlete. Biomechanical changes typically focus on your patterns of movement, while neuromuscular changes focus on altering the communication between your brain and muscles.
Together, these changes are intended to improve your control and coordination of movements. In short, the goal is that with proper training and practice, new habits can be formed to reduce the risk of injury for athletes.

What makes an effective ACL injury prevention program?
Many studies have reviewed the effectiveness of existing ACL injury prevention programs. While these programs vary, evidence suggests that there are four major components to successfully preventing injury.
Component #1: Key Exercises
Well-rounded injury prevention programs understand that it’s not sufficient to focus on one type of exercise – rather, successful programs use a combination of exercises to reduce the risk of injury. A truly well-rounded prevention program should include exercises in each of the following areas: plyometric exercises, dynamic stabilization exercises and body-weight strength training exercises.
Also known as ‘jump training,’ plyometric exercises are specialized, high intensity training techniques used to develop athletic strength and speed. Dynamic stabilization exercises balance strength and flexibility to optimize knee function. Body-weight strength training swaps out standard weight training exercises for bodyweight equivalents without sacrificing strength or muscle growth.
Education and feedback on correct technique are also imperative to injury prevention. Doing the right exercises is only half the battle. Doing the exercises correctly, and training your brain to remember the correct technique, is just as important. As you complete your injury prevention program, be sure a trained professional is watching closely and providing you with plenty of feedback along the way.
Component #2: Frequency of Exercise
Studies show that the duration and frequency of preventative training is extremely important for success. On average, effective injury prevention sessions last only 20 minutes. While this may sound like a short amount of time, longer sessions can cause fatigue, resulting in the practicing of incorrect – and possibly dangerous – techniques. When it comes to injury prevention, quality is always more important than quantity.
Additionally, the most successful programs start at least six weeks before the athlete’s sporting season begins. This timeframe allows the muscles to get used to any new techniques that minimize the risk of injury, and trains an athlete’s brain to communicate those new techniques to the muscles quickly in any game time situation.
Pre-season sessions should occur multiple times per week to allow the body time to adjust its techniques. When an athlete’s season begins, frequency can be reduced to one or two sessions per week. One great way to do this is to simply integrate preventative programming into your existing in-season training routine.
Component #3: Tailored Programming
Since different activities require slightly different preventative training measures, there are many existing injury prevention guides for popular sports such as soccer, hockey and racquet sports. While all training programs should include the key exercises and frequency mentioned above, be sure to incorporate some sport-specific exercises as well.
Tailoring your routine is especially important for agility-based sports like soccer, basketball and squash. Agility training exercises should focus on improving form (e.g. increasing knee flexion)  throughout the high-risk positions for ACL injury that occur in the sport (e.g. pivoting, cutting and jumping maneuvers).
Some exercises that you may want to incorporate into your training program are drills like the shuttle run, bounding run and zigzag run. Remember to always accompany drills with constant feedback on technique from a trained professional to make the most of your tailored injury prevention training.
Component #4: Bracing Technology
Studies have shown that knee bracing technology can also be incorporated into your injury prevention training. Presumed to hinder athletic performance, today’s knee bracing technology can actually be used to support and stabilize the knee joint without inhibiting performance.
Among the most common knee bracing technology is the knee sleeve, which is designed to protect the knee from future injury or risk of damage. With the combination of compression and increased blood flow, knee sleeves can also lead to better recovery for athletes with existing injuries. However, knee sleeves cannot be used to fix or stabilize an already unstable knee – this is where knee braces come in.
Traditional rigid-shell knee braces are designed to protect the knee and provide ligament support for recovering athletes. With the advancement of technology, companies like Spring Loaded Technology have taken this function a step further by incorporating revolutionary technology like liquid springs to go beyond stabilization, offering augmented strength and reduced pain during rehabilitation exercises. This enables athletes to follow rehabilitation protocols that will get you back to normal sooner.
As the age-old saying goes, “It’s all fun and games until someone gets hurt.” Always work with a trained professional such as a trainer or therapist to design an ACL injury prevention program that is right for you. By regularly practicing short, well-rounded and tailored prevention programming, and utilizing the proper bracing technology when necessary, you can effectively reduce your risk of injury – ensuring that the fun and games can last a lifetime.

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