ACL Prevention Guide

It’s the pop no athlete wants to hear. In a split second the knee buckles, the athlete goes to ground and that’s the season. 

The Anterior Cruciate Ligament (ACL) is a critical ligament in the knee which gives it stability and controls the position of our tibia (shin bone) in relation to the femur (thigh bone).

Whilst the rupture of the ACL often involves a surgical repair and 12 months of rehabilitation to recover, this guide is focused on preventing (or at least reducing the risk) of ACL injuries. Recent studies into the effects of exercise programs on reducing the incidence of non-contact ACL injuries have shown up to 50% decrease across a range of sports. 

Adding in some specific ACL injury prevention work in your weekly training sessions is an essential play for the modern athlete, which not only reduces the injury risk but also boosts performance. 

How do ACL injuries happen?

ACL ruptures typically occur without contact from another player. This can happen via two common mechanisms:

Excessive rotation of the knee when sidestepping or landing from a jump

Hyper-extension of the knee when decelerating

The good news here? Both movements can be trained to significantly reduce the chances of injury. Here’s how…

ACL Prevention Program Design

Prepare Your Body

Taking the time to prepare your body for battle in a progressive and specific manner will reduce the risk of ACL ruptures. This preparation needs to be specific to the individual and the sport, but should include:

Investing time on fundamental movements like jumping, landing, accelerating, decelerating and cutting, if required. A simple concept that many athletes skip, but spending some time on developing your chops in the simple stuff will bolster up your performance and prevent time on the sidelines

Developing strength in your lower limbs to facilitate better control of your body during sporting movements. Use exercises that require you to support your own body weight, control a movement pattern and develop adequate range.

A good amount of single leg exercises into your training – the vast majority of ACL injuries occur as a single leg strikes the ground and loses control, thus being stronger on one leg is essential.

Drills and exercises to mimic or develop sport specific situations such as speed, agility, surfaces, fatigue and opponents. For example, unstable surfaces like Bosu balls have been popularised but unless your sport requires you to land on surfaces like this, it’s not the best use of time.

Don’t Plan Everything

Sport is unpredictable. Movements happen in split seconds and we don’t have time to stop and think about our body position. Instead we need to develop adequate mobility, stability and  strength to cope with the positions we can end up in.

Unplanned practice is the real litmus test of our strength and control – where change in direction and deceleration can be practiced. It’s the unplanned situations that provide a real test of movement quality, responsiveness and control and it’s the body’s ability to respond in these situations that reduces our risk factors.

Fortify Your Ligaments

As we add progressive amounts of stress to ligaments they are capable of bolstering their own resilience and building strength in much the same way our muscles get stronger with applied stress, suitable nutrition and adequate recovery time.

Add generous and progressive amounts of agility, deceleration and unplanned practice to your training on a regular basis to expose the body to positions it will encounter in games and the adaptive processes of the body will work its magic for you.

The Bioathletic On-Field ACL Prevention Program

Perform the following types of exercises twice per week for optimal results:

  • Hopping Drills
  • Y Drills (Agility & Deceleration)
  • Unplanned & Rotational Landing

For some examples, head to our instagram post that accompanied this guide…

Written by

Tim O’Grady

Tim is a Physiotherapist who specialises in football/Rugby and golfing injuries. Tim doesn’t believe that rest will make you a better athlete and he focuses on performance-based rehab methods. Tim is also qualified in golf biomechanics and injuries.

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