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What can I do to prevent an ACL injury?

Dr. Sean McMillan, DO
Orthopedic Surgeon

To prevent anterior cruciate ligament (ACL) injuries, perform training drills that incorporate balance, power and agility. These include:

  • focusing on jumping and landing with the feet, knees and shoulders vertically in line
  • training core muscles (abdomen, pelvis, buttocks) to be strong
  • proper stretching pre- and post-sports participation
  • wearing proper footwear, including appropriate orthotics

Working with your trainer or coach on an appropriate regimen can help you prevent injury and keep you on the field having fun.

Trinity Health is a Catholic health care organization that acts in accordance with the Catholic tradition and does not condone or support all practices covered in this site. In case of emergency call 911. This site is educational and not a substitute for professional medical advice, always seek the advice of a qualified healthcare provider.

To prevent an anterior cruciate ligament (ACL) injury, you should follow a prevention program that concentrates on four main principles: balance, strength, proprioception or the body’s ability to land where it is supposed to and plyometric training, which is jumping and explosive movement.

Large physical therapy or sports conditioning places offer specific ACL prevention programs. It's important to get in with a physical therapist or athletic trainer who knows these prevention programs and can guide you with these exercises. A huge portion of this is learning how to land correctly. You can’t do that by looking at yourself critically if you don’t know what you’re looking for.

Trinity Health is a Catholic health care organization that acts in accordance with the Catholic tradition and does not condone or support all practices covered in this site. In case of emergency call 911. This site is educational and not a substitute for professional medical advice, always seek the advice of a qualified health care provider.

There are many things that can be done to prevent ACL injury. Make sure your strength, flexibility and endurance are appropriate for the type of sport you will be playing. Strengthening activities should incorporate the entire kinetic chain including the hips and core. Particular emphasis should be placed on correct form and muscle endurance to ensure that proper mechanics are maintained even when fatigued. Incorporating activities into your training routine that challenge your balance may also help prevent an ACL injury. Balance activities generally start on stable ground (i.e. single leg stance), progressing to an unstable surface (i.e. foam) or stable surface with upper/lower extremity movement, and finally to more dynamic activities that involve unstable surfaces and upper/lower extremity movements. If you will be participating in a dynamic contact sport such as soccer, football or basketball, incorporate plyometric workouts into your regular routine. Emphasis should be placed on establishing proper landing mechanics, postural alignment and reactive body efficiency. For example, with box jumps, practice landing softly by bending the knees and landing in a correct squat position. Make sure your knees do not move too far forward during the movement (you should be able to see your feet at all times), and make sure your knees do not cave in (your knees should stay in line with your toes the whole time). If you are unsure of your technique, consult a personal trainer, athletic trainer or physical therapist to evaluate your biomechanics.

Brian Yee
Physical Medicine & Rehabilitation Specialist

An ACL injury is usually due to the knee going into excessive valgus (knee turning inwards) and/or some type of rotary/pivot force. Many people focus on training the musculature around the knee such as the quad and hamstrings. This does help, but one must also consider the stability of the joints above and below—which would be the hips and ankle/foot complex.The knee can be viewed as a junction between two different stilts. If the hip is not stable or has excessive mobility, or the foot/ankle is not supportive, such as excessive flat feet or stiff ankles from an old ankle sprain—it can place excessive valgus force at the knee—possibly leading to increased stress to the ACL.

Training thus should consist of hip and thigh training that does not promote internal rotation/valgus to the knee—such as gluteus medius/lateral hip stabilization, as well as improving ankle mobility/foot stability exercises. Once proper movement patterns are established, progression to higher level plyometrics, as well as sports specific training should be introduced.
 
 
 

Dr. Jaspal R. Singh, MD
Physical Medicine & Rehabilitation Specialist

ACL injuries have been associated with improper landing technique. Many athletes tend to jump and land with their knees in a “knocked knee” position. You can reduce your risk of ACL injuries with proper training and specific knee strengthening exercises. There is no way to completely prevent an ACL injury.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.