Anterior Cruciate Ligament Injury Prevention
"A Skip and Hop" Program

Tears of the ACL have been estimated to occur in 1 out of 3,000 to 3,500 people in the Unites States each year. As a result, as many as 100,000 ACL reconstructions are performed annually. In the last 15 years knee ligament injuries have increased by 172 percent. It has been estimated that females are 4 to 8 times more likely to tear their ACL than their male counterparts. Re-injury of the ACL reconstruction graft is 12% to 15% in males and 25% to 30% in females.

The mechanism of ACL injuries is usually non-contact, and occurs most often in pivoting and cutting sports such as soccer and basketball. The reason why females are at greater risk has been the focus of much study recently.

A research conducted in 2000-2001 (USA) by Madelbaum et al, shows that neuromuscular training programs decreased the number of ACL ligament injuries in female soccer players by 88% and 74% in consecutive years.

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For the first time, we now have documented research that shows that specific stretching, strengthening, flexibility and balance exercises can significantly reduce injury rates.

The program will consist of one hour of training, twice a week for 6 consecutive weeks.

The curriculum will include:

* Warm-ups

* Upper and lower extremity functional strengthening exercises

* Plyometrics

* Education and training on jumping/landing strategies

* Stretching and anticipated as well as unanticipated agility drills

The consecutive nature of these drills provides an anaerobic and aerobic conditioning component as well.

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ACL Injury Risk Factors:

Anatomic risk factors include:

* Less total muscle mass per total body weight.

* Greater knee joint rotational laxity.

* Greater knee joint hyperextension.

* Increased femoral internal rotation, causing valgus stress at the knee.

* Increased valgus stress at the knee secondary to increased Q angle.

* Increased foot pronation.

* Narrow femoral notch width.

* Wider pelvis.

* Smaller skeletal size.

Neuromuscular Risk Factors:

* Increased electromechanical delay (elapsed time between neuro-activation of the muscle and actual force generated).

* Contraction of Quadriceps instead of Hamstring in response to anterior tibial translation.

* Tendency for females to land from a jump and perform cutting activities in a more upright position with increased trunk, knee and hip extension.

Physiologic Risk Factors:

* Hormonal influences (Estrogen & Progesterone).

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