Preventing ACL Injuries through Movement and Mobility

Did you know that a human who moves better and has a system to test their movements, could be the key to preventing ACL injuries? While exercise is king, it's not just about a specific workout or technique, but honing your ability to move with intention. He looks at the rising incidence of ACL injuries in females due to anatomical and hormonal differences, driving home the importance of personalized assessments, especially for athletes.

Dr. Alec Spano, PT, DPT, CSCS, Cert DN discusses the importance of movement screens to pinpoint potential problem areas, and the role of strength, mobility, and flexibility in ACL injury prevention. Females, in particular, tend to have more flexibility but also experience more ACL injuries, emphasizing the need for stability and strength in the full range of motion. Don't miss out on this episode, where Dr. Spano encourages proactive action and the importance of knowing your body's movement to prevent potential injuries. Get proactive and let's save some athletes from ACL injuries these upcoming seasons!

Check out the associated blog at: Preventing ACL Injuries

ACL Injury Prevention Research Articles:

Nessler T, Denney L, Sampley J. ACL Injury Prevention: What Does Research Tell Us? Curr Rev Musculoskelet Med. 2017 Sep;10(3):281-288. doi: 10.1007/s12178-017-9416-5. PMID: 28656531; PMCID: PMC5577417.

Sadoghi P, von Keudell A, Vavken P. Effectiveness of anterior cruciate ligament injury prevention training programs. J Bone Joint Surg Am. 2012 May 2;94(9):769-76. doi: 10.2106/JBJS.K.00467. PMID: 22456856.

Book a discovery call today with Hercules Performance and Physical Therapy in Vero Beach, FL

https://www.herculesppt.com/contact

Also check us out on Facebook and Instagram:

@herculesppt
@dralecspanodpt
https://www.facebook.com/profile.php?id=100088835923718

Call, text, or email us at:

(772) 291- 5164

[e-mail]

Episode Transcript

Speaker 1 (00:01):
Welcome to the Hercules Performance and
Physical Therapy Podcast.
I'm your host, dr Alex Vano,and today we're going to talk
about injury prevention for ACLinjuries.
There's been a big push in thefield for preventing ACL tears
before they happen and there's alot of back and forth on.
Can we actually influence that,how to re-influence that, and

(00:25):
what is it that we can believein sort of the literature that's
out there?
I think the best way toapproach this is from a more of
a common sense kind ofperspective where, if we look at
most things that have somephysical nature to it sports,

(00:46):
just general activity, andmovement, higher level sports,
no matter what it is exercise isking.
Even if we're talking abouthealth, blood pressure
regulation, just being healthyin general has some degree of
exercise, helps it.
So when you look at literaturethat says, oh, it may help, it

(01:07):
may not think about it this wayIsocize is going to help you be
a better, healthier human, it'sgoing to help prevent ACL
injuries.
Now, the problem with that iswhere someone comes up to you
and says I'm going to give youthis one exercise that's going
to solve your ACL or it's thisone specific thing, and that's

(01:30):
just not true In general, beinga better, stronger mover is
going to improve the likelihoodthat you won't injure your ACL,
and there's some certainpositions that we look at that
may be more indicative.
But the biggest thing is do youunderstand how to move?

(01:51):
So maybe you're a high schoolathlete or you know a high
school athlete that's on thefield cutting and whatnot.
Have them get assessed.
If they can't stand on a singleleg, we can't hop equally on
both sides.
If we can't cut properly, ifwe're just weak in general, yeah
, we're going to set ourselvesup for an ACL tear, and the
unfortunate part about it is, ifwe look at females versus males

(02:14):
, females tend to have a biggerincidence due to some of the
angles and hips and some of thehormonal differences between
males and females.
So it's extra important,especially for our soccer
players or lacrosse players aswell, to just get assessed.
There's simple movement screensthat can be done for anyone with

(02:35):
anything, but especially forACLs where we go hey, this looks
a little off.
Why don't we work on this alittle bit and try as best as we
can to create a plan thatprevents us from tearing an ACL
when we're a junior in highschool and we're vying for that
D1 scholarship where it couldhave just been hey, let's learn

(02:59):
to cut a little better.
Let's improve this single legstrength.
Maybe you played a bunch ofsoftball back in the day and you
have one side that's strongerthan the other.
Let's make sure they'rebalanced right.
And again, there's more to thatthan just hey, am I strong
enough on one side versus theother?
There's general, am I just astrong mover?
There is also mobility.
Right, we're really stiff inthe hips and we can't rotate

(03:21):
that well through the hips.
We might be putting our kneeinto compromised positions and
I'd say that is probably abigger thing that I see and I
often use mobility in terms ofhey, are you strong enough and
flexible enough in that position?
Not just hey, I have a ton offlexibility.
A lot of the females that wework with in general have a

(03:42):
little bit more flexibility inmost of my males, but yet the
ACLs tend to happen.
Acl injuries tend to happenmore in females.
Again, it depends on theathlete, but it could be that
they don't have stabilitythrough that hip.
We don't have strength throughthat full range.
So there's a lot of factorsthat go into it.
But bottom line, you must beassessed.
If you don't know how you'removing and how that translates,

(04:05):
you could be sending yourself orinjury or you're not doing
everything you can.
And it's not good enough tojust go into the gym and do
whatever.
If you're buying for a spot, ifyou're trying to become a lead
at something or you really trulydon't want to get hurt, you've
got to approach this with alittle bit more of a systematic
manner and that's what I'd say.
That's where I'll say there'sbeen some meta analysis and I'll

(04:25):
attach them in the show notesbelow.
Meta analysis is a fancy way ofsaying there's a bunch of
studies and they compiled themand basically what they found
was that exercise, specificallyneuromuscular reeducation, which
is a fancy way of saying, hey,do we know how to move?
Can we actually put ourselvesinto position?
So think about some big, stiffathlete who moves very poorly.

(04:51):
We've all seen them in a gym.
They can't squat below parallel, they don't know where their
body is in space.
They're strong, but they reallylook awkward moving
Neuromuscular reed goes hey, canwe take this strong athlete and
make them move better, make itlook better, and can they
control that?
I think that's a big part of it.
Can you actually feel whatyou're trying to do.

(05:12):
If we can improve that, thatcan lead to better outcomes.
In terms of hey, can we reduceinjury at this point?
Can we reduce ACL tears, whichis huge?
So, using that model of hey,can we have the motor control?
Can we move well to saveourselves from injuries down the
line?
That's big.
The one thing they did say inthere was there's no, and I said

(05:35):
this earlier, I alluded to it.
It's an exercise thatdetermines whether you'll not
have an injury or not, and thatgoes for anything, but
specifically for ACLs, because Ithink we see a lot on the
internet about I just improvedmy quad string, I'm good If I
just can balance on one side, ifI can just this and this and

(05:56):
this, and that's not true.
It's a whole body approach.
There's even been things thatcome out that say the way your
core activates and the sicknessyou can create in pelvic
position can actually help yourhip move better, which can help
the stabilize the knee better,et cetera, et cetera.
Look, just make the whole bodymove better, right?
If you can't get in the certainpositions, you can't get into

(06:16):
the bottom of a squat and you'rerunning around playing lacrosse
.
That might be a good indicatorthat your hips don't move well
and you don't have enoughstrength to express it when you
were more expressing it withmore force on the field, right.
So that's a long way of sayingbasically.
All these studies say hey, wecan reduce the likelihood of
injury, especially in ACLs andyounger athletes.

(06:37):
However, there's no oneapproach fits all.
It's creating a system ofmovement where we go hey, you
move like this.
This is what I normally seewith athletes who are good, move
well and appear to have thequalities of someone that won't
injure themselves down the line.
It's making look like that,within your anatomy limits, so

(07:01):
that you can become not only abetter athlete on the field cut
harder, move faster but we'realso in better position.
So that way we give your knee,your ACL, the best fighting
chance it has in those momentsthat it needs to turn on right.
I think one of the things thatACL brings up is what is the ACL

(07:24):
for?
Acl is sort of the brakes onyour knee where we get into a
certain position and at the lastmoment we're cutting really
hard, specifically when we pushoff and we're cutting in.
That's easier to see on video,obviously, but for planting the
foot and cutting.
Let's say you plant with theleft and cut to the right.

(07:46):
There's times where our hip canstabilize our knee, can knee
musculature can do what it needsto to keep the knee in a good
position.
But there's also times where,hey, we're not thinking we have
the ball, we're cutting, we'reabout to be tackled and we're
just not in a good position.
That's where the ACL takes over.
To try to block that.
The problem comes when we're inreally bad positions.

(08:09):
We do that all the time.
We could be setting ourselvesup for an injury and that's
where we go.
Hey, let's see how we'reactually cutting.
Maybe this is something I cancue you for, or, better yet, you
just don't have the strength inthat hip to be able to put
yourself into a good position.
Let's at least be able to getinto that good position.
That way we can most of thetime, utilize that mechanism.

(08:32):
So again, injury prevention forACL is totally possible.
Is it a 100% thing?
No, there's nothing that existsin that capacity.
But will it reduce thelikelihood?
Absolutely.
Is there better systems thanothers?
Not, according to research.
But if you're moving well andyou're strong throughout your

(08:54):
body and you look like anathlete on all limbs and
positions, you're going to setyourself up for good things
ahead.
So I think I've covered a lot ofhow injury prevention can help
with ACL.
Meaning, if you're in theoff-season and you're an athlete
that cuts you're a lacrosseplayer, a football player, I'll

(09:16):
even go as far as to sayfootball definitely football.
But I'll go as far as to saybaseball, even volleyball,
sports like that Just getassessed in the off-season and
create a plan that not onlymakes you stronger and perform
better on the field becausethere's a lot of people who are
doing that but hey, we need tosee how you're moving and let's

(09:37):
see you're moving safely.
And if you have indicators thatyou're not, let's work on it.
Let's create a plan, and that'sa structured plan that goes hey
, let's use Sally, sally, yourhip isn't strong enough.
You don't have enough mobilityon that side.
In general, you can't evenbalance on that leg, but somehow
you're cutting on the field.

(09:58):
Let's address that in theoff-season that when you get
into game time we don't have acatastrophic injury that takes
us out.
So if you need help assemblingthat, if you need help testing
that, reach out to us.
I'll link my discovery callbelow and let's see if we're a
good fit to help you.
Especially in the off-seasonwould be an ideal time to do

(10:22):
this, but again, if we're inseason and you know that there
could be indicators, simplethings can be done right in the
moment that can again cue you tobe in better positions, that
can help to stave off thatCareer ending, possibly college
sports ending injury.
If you have any questions onpreventing ACLs, some of the

(10:46):
protocols that we use, some ofthe testing, reach out to us at
that link below Schedulediscovery, call with us and if
not, we'll see you next time onthe podcast.
All right guys, have a greatrest of your day and as the
holiday season approaches here,I hope I wish you best of luck
in your endeavors, travels andcelebrations.

(11:07):
All right guys, till next time.