ACL Tears! What's going on.

[TheRealTruth]

i have trained bodybuilders,kids and adults for over 20 yrs and one thing i have learned is "not to try and reinvent the wheel. In adapting my training programs especially for females i consulted Dr Laura Ramus, P.T. A.T.C. Head Athletic Trainer S&C Coach for the WNBA's Detroit Shock-Manager of Sports Medicine @ St. John Hospital & Medical Center. here are  excerpts from her website"girls can jump" under plyometric training & ACL prevention; Females have wider hips and a naturally more knock-kneed stance. They have looser ligaments because of monthly hormone fluctuations(81% of acl tears happen during this time) Their muscles are smaller and weaker than males particularly hamstrings, certain muscle reflexes are slower or fire differently. To compensate females tend to play sports in a more erect stance than males causing more force on the knee with every landing. Lower body strength is important but improper training is at fault also "for yrs, we have trained girls just like boys and although experts bicker over training details, they have known for a few yrs that a combination of plyometrics(jump training) and reflex training, foot and ankle strength trng, and functional weight trng(that is do things that mimic the movements you actually would use in a sport or activity), can cut the risk to female athletes. Not enough trainers know these things or know how to train with these techniques. We need to reach girls when they are 11, 12, and 13 because that's when they are developing those neural pathways.Girls are being subjected to heavy weight trng programs by trainers, who if you ask them why they use a particular exercise they usually can't give you a reason and this is at the high school & middle school level. The trick is getting out the word at these levels and changing decades of ingrained training techniques by these coaches and trainers who resist change.Anatomy and biology can't be changed, But Dr Ramus urges players and parents to demand specific trng geared to females, based on the latest research. She urges players to find out if they are at risk, by having their running, footwork and jumping evaluated by proper personnel. Maintain proper weight as each extra pound puts four pounds extra pressure on knees. I pass out this information at every opportunity that i have where parents are present, and to many of these parents dismay, they are told when they confront their high school coaches and AD's that if they want their daughters to play on their team they WILL follow the training program in place(end of conversation).  For me using these training techniques, has led to State titles in volleyball and basketball @ FCS  and many young athletes i have trained have avoided acl injuries even those who started playing competitively as early as 8yrs old and many who play sports year round. I urge you to go to her website.

Highlighted are very well described on points made earlier.

 

A few questions:

1. By trainers, are you saying personal trainers or athletic trainers?

2. FCS is what school?

 

A few thoughts:

Evaluating running mechanics, footwork and jumping is a task with 11,12,13 year olds for a single knowledgable person. As said, who typically working with this age group, much less high school ages, know enough? It may be easy to see a girl with valgus stress on landing a jump as most do, however, running mechanics takes a trained eye. I still believe using a Functional Movement Screen (FMS) is a great start as well as box jump test. I know more folks trained in FMS than folks that can truly break down running mechanics.

 

Single leg activities from hops forward, lateral, add a trampoline, and SL squats to SL KB deadlifts are helpful. Sumo squats, hack squats, add a bosu ball are helpful. Ladder drills single leg to double to single, add shuffles. SL or double squat to chest pass or push press or clean or frog jump with medicine ball are good. Maybe lunge forward, lateral, diagonal onto tramp or bosu to depth. Cross train with pool workouts preseason/summer. Shallow water with defensive slides to game speed to jumps with landing to deep squat. Squating and landing must be accomplished without valgus load and patella needs to line up with second toe. There are many exercise prescriptions that can work. The key is finding where the individual is and guiding her to perform A to B and down to Z. 

 

What all do you do within your exercise regiment?

Edited January 15, 2014 by TheRealTruth

[coachrlj]

Dr Ramus & I are not referring to Athletic Trainers-strength & conditioning coaches and personal trainers are the people that we need to get this trng info to, especially @ the high school and middle school levels. Most of our school workout rooms are equipped and setup for boys sports training, equipment needs for the trng that we do are multiple sizes of plyometric boxes, speed ladders, twelve lb medicine balls, benches, 5lb dumbbells, jump ropes, stairs or steps (calve raises), enough floor area to do core trng, and body vs gravity trng. Luckily for us( the incoming 2011 boys basketball coaching staff @ Friendship Christian School in lebanon which i was apart of ) we had two vertimax machines V-6 models that we brought there. Vertimax"s are widely used out west, Stanford womens volleyball team actually has enough that each player has their own. Many of your larger high schools, most major universities, wnba, nba and nfl teams also. Simply identifying kids that run flatfooted girls & guys would be a start toward evaluating footwork for the novice S & C coaches, I personally use boxes, ladders and vertimax to evaluate footwork & running form & weaknesses. Also want to say that i do like weight trng for both sexes during the off-season stressing proper form and range-of-motion especially for girls making sure to never do movements that require them to lock knees, building short fiber muscles-pre-season is when we lengthen the muscles w/before mentioned trng that Dr Ramus prescibes to build long fiber. Hip-flexor & IT Band stretches is another area overlooked that is included in my wkouts- i even have ankle exercises. You must be strong from the foundation up to play low(feet-ankles-calves-support muscles and ligaments surrounding the knee-inner thigh) i stress inner thigh & hamstring to balance the normally stronger outer muscles. Some of the exercises are sports related by design, (basketball-volleyball-football) mimic movements of sport to build muscle group in synergy. Every wkout starts with 20 mins of core. RealTruth seems like we are on the same page-glad to hear someone that speaks the language Now how do we get this info to high school strength coaches??

[MountainTroll]

Most schools don't even have strength and conditioning coaches, and the individual sports coaches have little to no understanding of these issues.  It would be nice if one of you guys in the business could work with the T$$AA to raise awareness, like they have done with concussions.  It is not ideal, but a video and some educational materials that could be distributed to the schools and coaches might help some.  It is certainly better than nothing.

 

We do our kids a disservice when we throw them into competitive sports without proper conditioning and training.  JMO

[coachrlj]

There is a well-known coach of WBB in the collegiate ranks whose team had just gone undefeated for the year won the national title also. Looking forward to the next season he faced a major problem- he had only 5 girls returning with experience and knew he would suffer anytime he went to his bench. He was approached about changing his trng regimen-he adamantly rejected this idea-reminding everyone that he was national champs and perfect season using his present weight training system-after much prompting he gave in and went to a trng regimen similar to the one that Dr Ramus uses-WELL its history now but his team went undefeated again and won the national title playing mainly 5 girls-when asked about his teams successful season he contributed-his trainer & new training method for their success-he said they were in the best condition stamina wise he had ever had a team and that with the preventive injury exercises they had no serious injuries or lost of playing time due to injuries-he admitted he was a skeptic-and stubborn but glad he had made the switch- it worked for Geno and UCONN

[MountainTroll]

The public schools either can't afford, or won't find the money for, a good strength and conditioning trainer/coach.  There is enough evidence-based research out now to support the value of these assessment and training programs for injury prevention.  We need an organization like the T$$AA to raise awareness and push for this, even in schools where money is tight.

[WarriorNation]

At the end of the day, in order to see the change that everyone seems to be talking about. It will require parent involvement, athletic trainers, and strength/conditioning professionals to reduce this issue. Those groups especially the parents can force the hands of the school boards and principles into action. Like teaching, Strength/conditioning is not a one size fits all approach and children can get left behind under the wrong circumstances.