How to Prevent Knee ACL Injuries

A knee anterior cruciate ligament (ACL) injury is the most common injury affecting the knee joint. About 70% of all serious knee injuries involve damage to the knee ACL. And, about 80% of these injuries occur without any contact from another player.

There are some training techniques you can use to lessen the risk of this injury. The knee ACL is located within the capsule of the knee and connects the thigh bone (femur) to the shin bone (tibia).

Most knee ACL injuries occur when you decelerate, come to a sudden stop or land with improper technique while placing too much stress on the knees. Athletes should dominate the hamstrings, hips and glutes during movement. The hips are often under-used during sports competition.

Lateral lunges and lateral bounding teaches you how to move correctly while dominating movement with the hips.

You should also learn proper landing techniques using exercises such as vertical jumps, broad jumps and depth jumps.

Another common mechanical breakdown is when the knees protrude far in front of the feet when decelerating, landing or squatting. This puts undue stress on the knees and often causes injury. Also, when the quadriceps are much stronger than the hamstrings, this can cause an ACL injury. Research has shown that the hamstrings play an important role in stabilizing the knee and protecting the ACL during deceleration.

Females injure their ACLs at six times the rate of males. Females demonstrate a lower hamstring to quadricep ratio. This means they typically have weaker hamstrings compared to males. They also demonstrate different muscle activation patterns compared to males.

Females are typically quadricep dominant athletes which means they use their strong quadriceps muscles and do not use their weak hamstrings enough.Strength training for females should be adjusted to adequately strengthen the hamstrings.

There are few injuries as bothersome and harder to recover from than hamstring injuries. Prevention of hamstring injuries is the best solution.

The hamstring muscle group acts to protect the ACL and the opposing quadricep muscle group places stress on the ACL.

The best prevention for hamstring injuries and hamstring-related injuries are adequate flexibility and strength.

You are also at risk of a hamstring injury when the gluteus maximus doesn't fire properly. When the hip flexors are tight, they cause weakness in the gluteus maximus.

This often leads to the hamstrings doing the work that the gluteus maximus should be doing. And, since the hamstrings are not equipped to handle this type of workload, injury to the hamstrings is the result. Therefore, it is critical to have flexible hip flexors.

Try these flexibility and strength exercises for your hamstrings:

Hamstring Flexibility - walking lunges, resistance band eccentric stretch and static stretch (static stretch should be done after workout or game).

Hamstring Strength - lying or standing hamstring machine curl, deadlift, good morning exercise (with or without weights) and glute/ham raises.

Surgery will be necessary for a tear of the ACL. Usually, the tear is repaired by using a part of another healthy ligament to replace the damaged ACL. Rehabiliation for a torn ACL takes about 3-4 months and it takes 8 months or more before you can return to competition.

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Mark Dilworth, BA, PES
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