By Fiona Jacobs, Physiotherapist
HOW TO PREVENT KNEE INJURY IN TEAM SPORTS
The incidence of serious knee injuries in sport has been shown to occur substantially more frequently in women than in their male counterparts. Research suggests female athletes are at x 2-5 greater risk of Anterior Cruciate Ligament (ACL) injury than males, and in the first 2 seasons of AFLW this rate was higher again.
HOW DOES ACL INJURY OCCUR?
The majority of ACL injuries are noncontact in nature.
Most of these injuries occur because of the way the knee is loaded with manoeuvres in sports, such as:
- decelerating,
- change of direction,
- jumping and
- landing.
Uncontrolled and excessive knee valgus, whereby the knee collapses and rotates inwards, is the most common associated mechanism. Adequate neuromuscular strength and control is required to prevent this excessive movement occurring, and particularly so when the athlete is fatigued, or under pressure to make highly skilled reactive manoeuvres during the demands of sport.
Understandably then, sports such as Aussie Rules Football (AFL) which showcase and demand this sort of athleticism are at higher risk.
This movement control is a skill and habit that can be taught and optimised.
WHY DO WOMEN GET MORE ACL INJURIES THAN MEN?
There have been several theories as to why there is such a large difference in injury rates between genders. The risk factors identified include anatomical differences, hormonal changes, and neuromuscular deficiencies.
Because anatomical, genetic and hormonal factors are not easily modifiable, a successful injury prevention program therefore focuses on improving the modifiable neuromuscular factors, therefore optimising:
- Movement patterns
- Training loads
- Muscle function
Other considerations such as footwear, the surface, and the overall health of the athlete also should be considered modifiable.
Ok, so now I know WHY these injuries happen. How do I “Optimise Neuromuscular Control?”
HOW CAN I PREVENT ACL INJURY?
Fortunately, a lot of good quality research has been undertaken on how to best prepare athletes for their sporting demands, to maximise their performance, and minimise injury risk. Several programs have been created and tested with very encouraging results.
The AFL in conjunction with La Trobe University and industry experts have created the PREP TO PLAY resource specifically for females playing Australian Rules Football. As a team head AFLW Physiotherapist, I was fortunate to be asked to contribute to this resource.
Like other injury prevention programs such as the FIFA 11+ for soccer, and the NETBALL KNEE program, following a program such as PREP TO PLAY x 2-3 per week for a minimum of 6 weeks, not only reduces injury risk by up to 50%, it also enhances performance.
The common elements of these programs include the following components:
- Individual preparation
- Movement skills
- Sport specific drills
- Strength and Conditioning
- Education
1. Individual preparation refers to ensuring adequate recovery, addressing mental and nutritional preparation for sport, mobility and activation exercises, an appropriate warm up, and any individualised activities that may have been prescribed by the medical team to address key areas or deficits to work on.
Pre Season Screening and frequent player monitoring identifies an individual’s unique requirements that can be addressed to maximise their performance, wellbeing and injury risk mitigation.
At MSP we are excited to offer our clients SCREENING which involves a mix of clinical assessment, thorough history taking, and objective measures, including the use of muscle force testing with advanced technology such as dynamometry and force plates.
2. Movement Skills refers to the frequent quality training of, and breakdown of, the skills required for sport.
Jumping and landing, deceleration and change of direction are skills that should be practiced from a young age with good coaching and feedback, and should continue to be incorporated into every training session with feedback.
This can be easily feasibly done in a team warm up.
Movement control is a skill and habit that can be taught and optimised.
Once the basics are established, these skills should also be taught under various chaotic conditions depending on the nature of the sport and skill level of the player. This may include:
-
with contact,
-
catching/marking a ball,
-
reactively moving around another player, and
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under fatigue.
Coaches, trainers, medical staff, strength and conditioning staff or even the players themselves can be taught how to identify and teach good technique, so that frequent feedback can be provided to players in real time, so that skill improvements can be realistically achieved.
3. Sport Specific Skills refer to practicing the specific skills required for a particular sport. This may include learning safe tackling technique, safe contact skills, or learning to fall safely, or pick up a ground ball in footy.
Each sport has it’s unique skill set, and coaches are well placed to deliver high quality skills practice.
4. Strength and Conditioning refers to the specific strength, power and endurance exercises that target all the key muscle groups to provide the individual the capacity to sustain the demands of the skills of their chosen sport.
In particular, these strength exercises must include focusing on:
- Trunk control
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Strong hamstrings and quads
-
Strong hips
-
lyometrics
Optimal conditioning helps prevent fatigue and overload related training errors that are well known to increase risk of injuries.
Training consistently is KEY!
Ideally, these exercises will be appropriately individualised to the athlete’s ability and needs, as indicated by their SCREENING, which provides information about past injury history, any imbalances or deficiencies, and athletic age and experience.
Injury programs such as the NETBALL KNEE and PREP TO PLAY offer different levels of exercise prescription depending on the experience of the player, from youth, to amateur, to elite. Working with an accredited Strength and Conditioning coach or experienced Sports and Exercise Physiotherapist will best help optimise your training program.
5. Education is a key injury prevention element often overlooked, but knowledge is power!
Teaching individuals how to best look after their own mental and physical health, and when to seek help is POWERFUL!
Learning to identify how to move well, recover well, eat well and train smart has a significant impact on injury risk minimisation.
Understanding the healthy menstrual cycle is also critically important for female athletes, as is learning about the signs to look out for when training is not optimal such as missing periods, or excessive pain or sluggishness, and also how to use various phases of the cycle to advantage.
BOOK ONLINE FOR YOUR SCREENING TODAY!
We are passionate here at MSP on educating athletes to minimise injury risk and maximise sporting performance.
We have experienced and Titled Sports and Exercise Physiotherapists who offer SCREENING in order to provide you with training and recovery advice and recommendations.
We work with teams and coaches to help deliver efficient, effective, and affordable injury prevention programs, and can help your team have the best season on the field yet! Let us come on your journey with you and book today!
What is “SCREENING”? Should I have one?
Pre season SCREENING and frequent player monitoring identifies an individual’s unique requirements that can be addressed to maximise their performance, wellbeing and injury risk mitigation.
At MSP we are excited to offer our clients SCREENING which involves a mix of clinical assessment, thorough history taking, and objective measures, including the use of muscle force testing with advanced technology such as dynamometry and force plates like they use in the elite sporting team environment.
After the impact Covid-19 has had on 2020 team fitness, establishing a clear plan to resume your sport safely is now more important than ever!
BOOK ONLINE FOR YOUR SCREENING TODAY!
How can we help you at Melbourne Sports Physiotherapy?
At Melbourne Sports Physiotherapy our goal is to get you moving pain free as soon as possible.
But, we also want you to actually move better and live a healthier, more active and fulfilling life!
If your sports, fitness training or work has been wearing your body down, book in with one of our expert massage therapists so we can help you reduce your pain or stiffness.
If you are showing some signs of this condition or simply want help prevent this from happening in the future then book in with one of our highly experienced Remedial Massage Therapists today!
You can make an appointment by calling or booking online.
BOOK ONLINE NOW TO FIX YOUR PAIN