The Dreaded ACL
It is hard to come by anyone who plays sports that hasn’t heard of the
term “ACL”. Unfortunately, people know of the ACL in negative terms,
as in a ligament in the knee that was torn and possibly reconstructed with
surgery.
The ACL is the “Anterior Cruciate
Ligament”. Each knee has an ACL, and it
is one of four major ligaments of the knee
joint. The term “cruciate” refers to “cross”,
as the anterior cruciate ligament crosses
in front of the posterior cruciate ligament
(PCL) forming an “X” that connects the
femur (upper leg bone) and tibia (lower leg
bone). (Figure 1)
The ACL is one of the primary stabilizers of the knee and keeps the joint
intact during rotational movements. While an awkward blow to the knee
can result in an ACL tear, ironically the majority of ACL tears occur with no
physical contact. Simply having the foot fixed in one spot while the body
rotates around it can lead to the ligament tearing.
On dryland, this can occur when one stops to change direction suddenly, or
pivots off of one leg and turns the body the opposite direction. It can also
happen when landing from a jump on an uneven surface (or on someone’s
foot) and having the knee joint twist.
On the ice, ACL tears are rare as compared to other injuries, but they do
happen. Similar to on land, a sudden change of direction, especially with
the skate blade fixed in the ice, can lead to the ligament tearing.
In general, females are much more prone to having ACL tears than male
counterparts. This is especially seen
in sports like soccer, basketball, and
volleyball. There are many reasons for
this. It is believed that the combination
of the wider hips, more inward directed
knee caps (knock knee), and pronated
feet tend to facilitate a greater torque
on the ligament itself. (Figure 2) This
posture tends to be exacerbated when
landing from a jump.
The good news is that there are training programs that are easy to
implement and quick to complete that have shown to decrease the chances
of an ACL tear.
These programs not only focus on increasing the strength of the surrounding
muscles (quadriceps and hamstrings), they also emphasize landing with
a more vertical posture that minimizes the knock knee and foot pronation.
These program found their origins in the sport of soccer but have complete
carry over to ice hockey and all other sporting activities. A few of the
exercises are shown in Figure 3. The full set of exercises and ACL injury
prevention programs can be found at either of the following two web pages:
FIFA 11:
https://www.kort.com/uploadedFiles/KORT/Content/
Services/Sports_Medicine/Concussion_Management/
FIFA-the-11-Booklet.pdf
Dr. Jeff G. Konin The Rehab Doc
Figure 2
Figure 3
Figure 1 PEP Program:
https://la84.org/a-practical-guide-to-the-pep-program/
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/FIFA-the-11-Booklet.pdf
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/WWW.FLORIDAHOCKEYLIFE.COM
