Prevention of cruciate ligament tears.

Anterior cruciate ligament rupture requires surgery. It is a major reconstruction involving extensive rehabilitation over 5 months.

This injury sometimes will end a player’s career so can we do anything to prevent them? YES!!!!!

As 60 to 80% of ACL injuries happen in a non contact situation it is worth working on prevention.

In soccer two common mechanisms cause tears

1. Cutting manoeuvre i.e. side stepping with rotation stress. Typically with the knee turned out and slightly bent and the player takes off with the foot fixed and the knee turns in with the aim of changing direction.

2. Landing on one leg close to full extension stresses the ACL

Clinical Features of ACL tear

A patient often describes an audible pop or something going out and then going back.

Most are extremely painful.

Knee is usually very swollen very quickly.

Why does the ACL tear in situations that the player has performed many times in the past?

There is usually an external factor that makes the player more susceptible.e.g. Being pushed, having an unusually wide foot position, trying to avoid a collision, fatigue and loss of concentration.

Ladies are between 2 and 8 times more at risk due to hormones, anatomical differences, shoe surface interface and neuromuscular differences.

ACL Prevention exercise program

1 Floor exercises

a) Running backward and planting

b) Jumping exercise i.e. right leg, right leg over to left leg, left leg and finishing with two foot landing hips and knees bent

c) 2 players together. Two leg jump forwards, backwards then 180 turn and the same mvt backwards. Partner tries to push the player out of control.

2 Mat exercises

a) Two players standing on one leg on the mat throwing to each other.

b) Jump from a box with a two foot landing with flexion in hip and knee.

c) Two players trying to push partner off balance first on two legs and then on one.

d) Jumping on a mat, kick ball and then take a 180 turn on the mat.