scholarly journals Implementing ACL Injury Prevention in Daily Sports Practice—It’s Not Just the Program: Let’s Build Together, Involve the Context, and Improve the Content

2021 ◽  
Author(s):  
Anne Benjaminse ◽  
Evert Verhagen
Keyword(s):  
Injury Prevention ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Health Impact ◽  
Acl Injuries ◽  
Differential Learning ◽  
Implicit Motor Learning ◽  
Prevention Programmes ◽  
The Individual ◽  
Acl Injury Prevention

AbstractAlthough the benefits of current anterior cruciate ligament (ACL) injury prevention programmes have been demonstrated in efficacy studies, they, unfortunately, have had limited public health impact to date. For example, the incidence of ACL injuries continues to rise in adolescent athletes. Raising awareness and educating coaches and athletes is not enough to facilitate the widespread, sustained use of these programmes in the real-world setting. Considering the profound burden of ACL injuries, it is necessary to continue to improve the current ACL injury prevention programmes through co-creation. First, the uptake of the programmes should be optimized by a better appreciation and understanding of the individual, socio-cultural and environmental context (i.e., community). Second, the content of the programmes should be optimized to better reflect the demands of the sport by creating more ownership and increasing motivation (incorporating challenging, sport-specific and fun elements) with the end-users. In addition, implicit motor learning, random practice and differential learning are concepts that should be integrated when practising to obtain the most optimal results when learning or finetuning skills.

Effect of Fatigue Protocols on Lower Limb Neuromuscular Function and Implications for Anterior Cruciate Ligament Injury Prevention Training: A Systematic Review

2017 ◽  
Vol 45 (14) ◽  
pp. 3388-3396 ◽  
Author(s):  
Sue D. Barber-Westin ◽  
Frank R. Noyes
Keyword(s):  
Systematic Review ◽  
Injury Prevention ◽  
Lower Limb ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Inclusion Criteria ◽  
Acl Injuries ◽  
Prevention Training ◽  
Anterior Cruciate ◽  
Acl Injury Prevention

Background: Approximately two-thirds of anterior cruciate ligament (ACL) tears are sustained during noncontact situations when an athlete is cutting, pivoting, decelerating, or landing from a jump. Some investigators have postulated that fatigue may result in deleterious alterations in lower limb biomechanics during these activities that could increase the risk of noncontact ACL injuries. However, prior studies have noted a wide variation in fatigue protocols, athletic tasks studied, and effects of fatigue on lower limb kinetics and kinematics. Purpose: First, to determine if fatigue uniformly alters lower limb biomechanics during athletic tasks that are associated with noncontact ACL injuries. Second, to determine if changes should be made in ACL injury prevention training programs to alter the deleterious effects of fatigue on lower limb kinetics and kinematics. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review of the literature using MEDLINE was performed. Key terms were fatigue, neuromuscular, exercise, hop test, and single-legged function tests. Inclusion criteria were original research studies involving healthy participants, use of a fatigue protocol, study of at least 1 lower limb task that involved landing from a hop or jump or cutting, and analysis of at least 1 biomechanical variable. Results: Thirty-seven studies involving 806 athletes (485 female, 321 male; mean age, 22.7 years) met the inclusion criteria. General fatigue protocols were used in 20 investigations, peripheral protocols were used in 17 studies, and 21 different athletic tasks were studied (13 single-legged, 8 double-legged). There was no consistency among investigations regarding the effects of fatigue on hip, knee, or ankle joint angles and moments or surface electromyography muscle activation patterns. The fatigue protocols typically did not produce statistically significant changes in ground-reaction forces. Conclusion: Published fatigue protocols did not uniformly produce alterations in lower limb neuromuscular factors that heighten the risk of noncontact ACL injuries. Therefore, justification does not currently exist for major changes in ACL injury prevention training programs to account for potential fatigue effects. However, the effect of fatigue related to ACL injuries is worthy of further investigation, including the refinement of protocols and methods of analysis.

scholarly journals The Use of Augmented Information for Reducing Anterior Cruciate Ligament Injury Risk During Jump Landings: A Systematic Review

2018 ◽  
Vol 53 (9) ◽  
pp. 844-859
Author(s):  
Cortney N. Armitano ◽  
Justin A. Haegele ◽  
Daniel M. Russell
Keyword(s):  
Systematic Review ◽  
Anterior Cruciate Ligament ◽  
Injury Prevention ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Prevention Programs ◽  
Factors Associated ◽  
Methodologic Quality ◽  
Anterior Cruciate ◽  
Acl Injury Prevention

Context:  A comprehensive systematic review of the literature on the use of augmented information in anterior cruciate ligament (ACL) injury-prevention programs to improve jump-landing technique was conducted. The use of motor-learning concepts could provide more robust means of preventing ACL injuries. Objective:  To systematically summarize the effectiveness of augmented information in improving the biomechanical factors associated with an increased risk for ACL injury. Data Sources:  Articles were retrieved using the electronic databases of PubMed, MEDLINE, CINAHL, and Google Scholar and 3 lines of truncated search words: (a) lower extremity, knee, ACL, and anterior cruciate ligament; (b) prevention, injury prevention, and prehab; and (c) augmented information, augmented feedback, feedback, cue, and instruction. We also performed a hand search of the reference lists of the screened articles. Data Extraction:  We independently assessed the methodologic quality using the Cochrane Group on Screening and Diagnostic Test Methods list. Articles were placed in 1 of 3 augmented-information categories: prescriptive, feedback, or transition. Articles were also categorized based on whether the information likely encouraged an internal or external focus of attention. Data Synthesis:  The searches identified a total of 353 studies, of which 18 were included. Most researchers found that augmented information could lead to technique changes to reduce the biomechanical risk factors associated with ACL injury. The average methodologic quality of the studies was 11.8 out of 17, with a range from 8 to 15. The authors of only 7 studies examined retention of the improved techniques. Conclusions:  The evidence suggests that augmented information can be used to significantly improve the biomechanical indicators associated with ACL injury and to enhance current ACL injury-prevention programs. Combined prescriptive and feedback information that encouraged both internal and external foci led to the largest retention effect sizes.

scholarly journals Alpine Ski Racing Injuries

2019 ◽  
Vol 11 (3) ◽  
pp. 265-271 ◽  
Author(s):  
Mitchell C. Tarka ◽  
Annabelle Davey ◽  
Geordie C. Lonza ◽  
Casey M. O’Brien ◽  
John P. Delaney ◽  
...  
Keyword(s):  
Risk Factors ◽  
Injury Prevention ◽  
Injury Risk ◽  
Cruciate Ligament ◽  
Injury Rate ◽  
Acl Injury ◽  
Prevention Strategies ◽  
Level Of Evidence ◽  
Acl Injuries ◽  
Ski Racers

Context: This article reviews the epidemiology of alpine ski racing–related injuries, risk factors, mechanisms of injury, and injury prevention strategies. Evidence Acquisition: Pertinent literature from peer-reviewed publications from 1976 through 2018. Study Design: Clinical review. Level of Evidence: Level 5. Results: The rate of injury in alpine ski racing is high. In general, knee injuries are the most common, with anterior cruciate ligament (ACL) disruptions being the most significant in terms of time loss from sport. Three specific mechanisms of ACL injury in alpine ski racers have recently been described (slip-catch, dynamic snowplow, and landing back-weighted). In contrast to other sports, female ski racers are not clearly at greater risk for ACL injury, especially at the highest level of competition. A high percentage of ski racers are able to return to their previous level of competition after ACL injury. Risk factors for injury and methods of injury prevention have been proposed; however, the rate of injury, particularly ACL injuries, has not decreased significantly. Conclusion: Alpine ski racing has a high injury rate. ACL injuries in particular remain problematic. Further study is needed to identify modifiable risk factors and implementation of injury prevention strategies.

scholarly journals Latest Trends in Neuromuscular Training to Prevent Anterior Cruciate Ligament Injury: A Literature Review

2021 ◽  
Vol 30 (4) ◽  
pp. 412-418
Author(s):  
Kwang-Jin Lee ◽  
Keun-Ok An
Keyword(s):  
Injury Prevention ◽  
Prevention Program ◽  
Training Programs ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Neuromuscular Training ◽  
Warm Up ◽  
Injury Prevention Program ◽  
Anterior Cruciate ◽  
Acl Injury Prevention

PURPOSE: Anterior cruciate ligament (ACL) injuries are the most common in sports and have doubled in the past 20 years. This study aimed to analyze the latest trends and changes in training programs for ACL injury prevention.METHODS: In this study, literature was searched using academic search sites, such as ‘PubMed’, ‘Google Scholar’, and ‘Wiley Online Library’. The literature published between 2015 and 2021 was used.RESULTS: Eleven papers were selected based on the literature selection criteria. Five warm-up exercise papers and six ACL injury prevention training program papers emphasized neuromuscular training.CONCLUSIONS: The ACL injury prevention program can be applied in warm-up exercises and training programs. It consists of an exercise form that includes multidimensional components such as plyometrics, muscle strength, balance, and agility. The key to the ACL injury prevention program is to reflect multidimensional components in neuromuscular training and to obtain a significant effect, and it is recommended to participate in regular training for 12-18 sessions and at least 6 months. In addition, it is suggested to utilize the ACL injury prevention program presented in this study until an individual study for ACL injury prevention by sports type is conducted.

scholarly journals Poor Motor Coordination Elicits Altered Lower Limb Biomechanics in Young Football (Soccer) Players: Implications for Injury Prevention through Wearable Sensors

Sensors ◽  
2021 ◽  
Vol 21 (13) ◽  
pp. 4371
Author(s):  
Stefano Di Paolo ◽  
Stefano Zaffagnini ◽  
Nicola Pizza ◽  
Alberto Grassi ◽  
Laura Bragonzoni
Keyword(s):  
Injury Prevention ◽  
Lower Limb ◽  
Motor Coordination ◽  
Inertial Sensors ◽  
Cruciate Ligament ◽  
Vertical Jump ◽  
Wearable Sensors ◽  
Acl Injury ◽  
Anterior Cruciate ◽  
Acl Injury Prevention

Motor coordination and lower limb biomechanics are crucial aspects of anterior cruciate ligament (ACL) injury prevention strategies in football. These two aspects have never been assessed together in real scenarios in the young population. The present study aimed to investigate the influence of motor coordination on lower limb biomechanics in young footballers during an on-the-pitch training. Eighteen juvenile football players (10 y ± 2 m) were enrolled. Each player performed a training drill with sport-specific movements (vertical jump, agility ladders, change of direction) and the Harre circuit test (HCT) to evaluate players’ motor coordination. Wearable inertial sensors (MTw Awinda, Xsens) were used to assess lower limb joint angles and accelerations. Based on the results of the HCT, players were divided into poorly coordinated (PC) and well-coordinated (WC) on the basis of the literature benchmark. The PC group showed a stiffer hip biomechanics strategy (up to 40% lower flexion angle, ES = 2.0) and higher internal-external hip rotation and knee valgus (p < 0.05). Significant biomechanical limb asymmetries were found only in the PC group for the knee joint (31–39% difference between dominant and non-dominant limb, ES 1.6–2.3). Poor motor coordination elicited altered hip and knee biomechanics during sport-specific dynamic movements. The monitoring of motor coordination and on-field biomechanics might enhance the targeted trainings for ACL injury prevention.

Effect of Hip-Focused Injury Prevention Training for Anterior Cruciate Ligament Injury Reduction in Female Basketball Players: A 12-Year Prospective Intervention Study

2018 ◽  
Vol 46 (4) ◽  
pp. 852-861 ◽  
Author(s):  
Yorikatsu Omi ◽  
Dai Sugimoto ◽  
Setsurou Kuriyama ◽  
Tomohisa Kurihara ◽  
Kenji Miyamoto ◽  
...  
Keyword(s):  
Injury Prevention ◽  
Prevention Program ◽  
Acl Injury ◽  
Injury Incidence ◽  
Intervention Period ◽  
Basketball Players ◽  
Acl Injuries ◽  
Injury Prevention Program ◽  
Acl Injury Prevention ◽  
Observation Period

Background: Programs to prevent anterior cruciate ligament (ACL) injuries in female basketball players are scarce. Also, ACL injury prevention training that focuses on hip joint function has not been reported. Purpose: To determine the effectiveness of a hip-focused ACL injury prevention program in female basketball players. Study Design: Cohort study; Level of evidence, 2. Methods: A prospective intervention study was conducted for 12 years. Incidence rates of ACL injuries were collected in the first 4 years (observation period) from college female basketball players. After the observation period, a hip-focused ACL injury prevention program was implemented for 8 years (intervention period). A total of 309 players (mean ± SD age, 19.6 ± 1.2 years; height, 163.7 ± 5.6 cm; weight, 59.1 ± 5.1 kg; body mass index, 22.0 ± 1.4) were tracked in the observation period and compared with 448 players (age, 19.6 ± 1.1 years; height, 162.6 ± 5.8 cm; weight, 58.0 ± 5.7 kg; body mass index, 21.9 ± 1.5) who participated in the intervention period. Athlete-exposures (AEs), ACL numbers and mechanisms of injury (MOIs), relative risk (RR), absolute risk reduction (ARR), numbers needed to treat (NNT), and compliance were analyzed. Results: There were 16 ACL injuries (13 noncontact MOIs) in the 4-year observation period, whereas 9 ACL injuries (8 noncontact MOIs) were recorded in the 8-year intervention period. The overall ACL injury incidence was 0.25/1000 AEs in the 4-year observation period compared with 0.10/1000 AEs in the 8-year intervention period, respectively. Compared with the 4-year observation period, significant RR reduction was observed (0.38; 95% CI, 0.17-0.87; P = .017) with ARR and NNT of 0.032 (95% CI, 0.027-0.037) and 31.6 (95% CI, 27.1-37.7), respectively, in the 8-year intervention period. The noncontact ACL injury incidence was 0.21 per 1000 AEs during the 4-year observation period compared with 0.08/1000 AEs in the 8-year intervention period, which also showed significant RR reduction (0.37; 95% CI, 0.15-0.92; P = .026), with ARR and NNT of 0.024 (95% CI, 0.020-0.029) and 41.3 (95% CI, 34.6-51.3), respectively. The mean compliance rate during the intervention periods (8 years) was 89%. Conclusion: A hip-focused injury prevention program demonstrated significant reduction in the incidence of ACL injury in female collegiate basketball players.

scholarly journals Anterior cruciate ligament injury: towards a gendered environmental approach

2021 ◽  
pp. bjsports-2020-103173
Author(s):  
Joanne L Parsons ◽  
Stephanie E Coen ◽  
Sheree Bekker
Keyword(s):  
Anterior Cruciate Ligament ◽  
Injury Prevention ◽  
Cruciate Ligament ◽  
Injury Rate ◽  
Acl Injury ◽  
Ligament Injury ◽  
Sex And Gender ◽  
Anterior Cruciate ◽  
And Gender ◽  
Acl Injury Prevention

BackgroundThe anterior cruciate ligament (ACL) injury rate for girls/women has not changed in over 20 years, and they remain 3–6 times more likely to experience injury compared with boys/men. To date, ACL injury prevention and management has been approached from a sex-based biological point of view which has furthered our understanding of injury risk factors, mechanisms, and prevention and rehabilitation programmes. However, the traditional sex-based approach does not take into account the growing recognition of how sex and gender (a social construct) are ‘entangled’ and influence each other.ObjectiveThis paper discusses the curious absence of gender as an influencer in the dialogue surrounding ACL injuries. We propose adding gender as a pervasive developmental environment as a new theoretical overlay to an established injury model to illustrate how gender can operate as an extrinsic determinant from the presport, training and competition environments through to ACL injury and the treatment environment.ApproachWe draw on social epidemiological theories of the embodiment of gender and health to provide plausible examples of how gender may influence ACL injury, and demonstrate the opportunity for new, interdisciplinary research in the field.ConclusionOver 20 years of research has failed to decrease the ACL injury rate disparity between girls/women and boys/men. Embedding gender in the study of ACL injury will heighten awareness of possible influences outside the traditional biological elements, challenge us to think about the inextricable ‘entanglement’ of sex and gender, and inform more effective approaches to ACL injury prevention and treatment.

Experiences of returning to elite alpine skiing after ACL injury and ACL reconstruction

2014 ◽  
Vol 26 (1) ◽  
pp. 69-77 ◽  
Author(s):  
Birgitta Nordahl ◽  
Rita Sjöström ◽  
Maria Westin ◽  
Suzanne Werner ◽  
Marie Alricsson
Keyword(s):  
High School Students ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Alpine Skiing ◽  
Structured Interviews ◽  
School Students ◽  
Physical Ability ◽  
Acl Injuries ◽  
Elite Level ◽  
Passive Strategies

Abstract Aim: To explore the experiences of alpine skiing at the elite level after anterior cruciate ligament (ACL) injury and reconstruction. Design: A qualitative approach where semi-structured interviews were conducted, and an analysis of the manifest content was performed. Participants: Five ski high school students, two male and three female skiers, who had suffered ACL injuries and undergone ACL reconstructions. Results: Seven categories were identified. The participants described their perceived opportunities with regard to returning to alpine skiing after ACL injury and reconstruction as something positive to do with self-belief, being mentally and physically prepared, regaining confidence in their own ability, being given time and using active strategies. In contrast, perceived barriers to a return to elite alpine skiing gave rise to negative feelings, for example, fear, disheartenment, a total lack of or ambivalent confidence in their own ability and the use of passive strategies. Conclusion: The two male skiers returned to alpine skiing. They reported confidence in their own ability, active strategies and support on all levels, as well as enhanced physical ability. The female skiers did not return to their pre-injury level of competitive alpine skiing. They stated a lack of support on all levels, deterioration in their physical ability and two out of three reported passive strategies and no or ambivalent confidence in their own ability. The most important factors were family support, support on all levels, access to a physiotherapist and time given.

scholarly journals No Association Between Risk of Anterior Cruciate Ligament Rupture and Selected Candidate Collagen Gene Variants in Female Elite Athletes From High-Risk Team Sports

2018 ◽  
Vol 47 (1) ◽  
pp. 52-58 ◽  
Author(s):  
Einar Andreas Sivertsen ◽  
Kari Bente Foss Haug ◽  
Eirik Klami Kristianslund ◽  
Anne-Marie Siebke Trøseid ◽  
Jari Parkkari ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
High Risk ◽  
Elite Athletes ◽  
Cruciate Ligament ◽  
Team Sports ◽  
Acl Injury ◽  
Acl Rupture ◽  
Acl Injuries ◽  
Genes Encoding ◽  
Anterior Cruciate

Background: Several single-nucleotide variants (SNVs) in collagen genes have been reported as predisposing factors for anterior cruciate ligament (ACL) tears. However, the evidence is conflicting and does not support a clear association between genetic variants and risk of ACL ruptures. Purpose: To assess the association of previously identified candidate SNVs in genes encoding for collagen and the risk of ACL injury in a population of elite female athletes from high-risk team sports. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 851 female Norwegian and Finnish elite athletes from team sports were included from 2007 to 2011. ACL injuries acquired before inclusion in the cohort were registered by interview. The participants were followed prospectively through 2015 to record new complete ACL injuries. Six selected SNVs were genotyped ( COL1A1: rs1800012, rs1107946; COL3A1: rs1800255; COL5A1: rs12722, rs13946; COL12A1: rs970547). Results: No associations were found between ACL rupture and the SNVs tested. Conclusion: The study does not support a role of the 6 selected SNVs in genes encoding for collagen proteins as risk factors for ACL injury. Clinical Relevance: Genetic profiling to identify athletes at high risk for ACL rupture is not yet feasible.

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