ACL, The Training Nightmare!

If you're standing, please find a seat. No, it would help if you were seated to handle the information regarding anterior cruciate ligament injuries. It is staggering that this injury can happen anywhere to anyone, doing anything at any time! Contact or non-contact sports, males and females, mature versus immature athletes. Last year alone, over 200,000 cases were reported in the United States of America. Scary. Well, it gets better: two-thirds of all skiing-related knee injuries are ACL injuries. Depending on your source, it is widely accepted that ACL injuries are two to six times more common in women than in men, especially in basketball, downhill skiing, volleyball, and gymnastics. 

The anterior cruciate ligament (ACL) is one of the key ligaments that helps stabilize your knee joint. The ACL connects your thighbone (femur) to your shinbone (tibia). It's most commonly torn during sports that involve sudden stops and changes in direction & dash, such as basketball, soccer, tennis, and volleyball.

My first ACL experience occurred during my first year as strength and conditioning coach with the Michigan State University Women's Volleyball Team in 1994. All-Big Ten Setter Courtney DeBolt went down with a torn anterior cruciate ligament. I was somewhat perplexed at how this could happen to such a strong athlete. After all, the head coach at the time, Chuck Erbe, was a national championship-level coach and had won several titles at the University of Southern California (USC), so we were doing everything we could be doing. He said that these things happen at this level of competition. I didn't want to believe that; however, as I studied, researched, and attended more clinics, conferences, and workshops, I found that Chuck was right! Coaches, Athletic Trainers, and Physicians seemed to accept this injury as a part of sport, and NO amount of specialized training could prevent this injury. I understood, but I couldn't stop searching for alternative ways to begin developing athletes that were more resistant to this type of injury.  

Research suggests:

Three main movements are associated with non-contact ACL injuries. 

1- Planting and cutting

2- Straight knee stopping

3- One step landing with knee hyperextended

Back to Courtney...

She needed surgery, and MSU Women's Volleyball had planned an international trip to Japan for training, practice, and a few scrimmages. We began a vigorous sport-specific rehabilitation program when she obtained the surgeon's approval. That protocol, which I developed specifically for Courtney, addressed the following post-surgical ACL concerns:

1- ROM- Range of Motion at the joint

2- Reduce inflammation after every training session

3- Proprioceptive ground base unilateral movement

4- Neuromuscular coordination

5- Strength training- isometric, concentric, and eccentric

Four to five days per week, we worked off campus at a club I owned at the time called the Downtown Athletic Club. Preparing for what everyone thought was a lost cause, "red shirt," some suggested, is what all the other knee folks do. Goals had been set, and we had a schedule to keep; it was excruciating pushing her to get strong and endure the pain day in and day out! I reminded her that she was a Spartan and what that meant; in addition, she was a captain. Week after week, her strength increased, and her gait cycle (walking, running) improved. It was healing using a form of ballistic training called pliometrics (actual Russian spelling). Later, it became known as plyometrics. Yes, jumping up and down on a box enhances the stretch-shortening cycle within every muscle. In the research I had read until that point, rehabilitation exercises were done in "isolated environments" using machines; following these protocols didn't seem very logical. Prepare an athlete for a dynamic environment using non-dynamic exercises. I didn't believe this would work for us.  

The program she followed was progressive and provided her with muscular strength and neuromuscular coordination, which allowed her to practice longer with less post-workout inflammation; in other words, she was getting much better. For those of you who did not have the opportunity to witness the 1995-96 season, it was the best in MSU women's Volleyball History!! Courtney Debolt finished her senior season as a Big Ten Champion, Regional Champion, and Final Four participant. 

Those same exercises and very similar protocols have been developed today. They are used by physical therapists, trainers, and strength and conditioning coaches to speed recovery and help prevent or lessen ACL and knee injuries. 

Prevention Programs:

Research has shown that non-contact ACL injury can be reduced anywhere from 20% to 80% by engaging in regular neuromuscular training designed to enhance proprioception, balance, proper movement patterns, and muscle strength.

 ACL Checklist:

1. Train with multi-joint exercises – leg presses, one-leg squats, walking lunges.

2. Concentrate on Hip Flexion, Hip Abduction

3. Strength training the muscles of the calves and shin area.

4. Use Pliometrics- jump training has too many benefits to list. Start with a 6-12" box; please employ a professional trainer.

5. Do not forget the Hamstrings or the back of the thigh. There are multiple positions:

a- Supine or lying face down

b- Standing

c- Seated

d- Prone or lying face down

   6. Valgus and Vargas- Knocked knee –vs- bow legged

Are you recovering from an ACL injury? Do you want to do everything you can to prevent ACL injury in sport? Contact Steve and start your rehab or rehab program TODAY! Let's put an end to the ACL Nightmare.

email: pliometrics11@gmail.com

phone: 517-944-5100

 TRAIN HARD AND SMART!

Steven A. Morgan

Originally from Lansing, MI, Steve graduated from Lansing Everett High School and Michigan State University. While at MSU, Steve played for the Spartan baseball team as a pitcher. It was during this time that he became interested in athletic performance-based training.  He became a certified personal trainer 1991 through the National Academy of Sports Medicine (NASM). Strength and conditioning coach since 1993 for various teams and athletes. High School, College, and Professional, from basketball to hockey.

As a former educator for Life Fitness International (equipment manufacturer, including Hammer Strength products), Steve has conducted strength and conditioning certification workshops and seminars in over 36 countries worldwide. Steve has consulted with top-tier teams and athletes about safely implementing solid year-round plyometric programming. 

Steve has served as a Tactical Strength and Conditioning Coach, including field testing and training for the US Army. UAE Land Forces, and British SAS soldiers and airmen.

Steve is the Director of Maximum Athletic Performance (MAP) in Lansing, MI. He can be reached @ 517.944.5100 or by email: pliometrics11@gmail.com