Today I’d like to continue discussing last month’s subject, the ACL. At the end of the last post, I said that I would discuss some specific methods to decrease the likelihood of knee injuries. To be honest, if I were to go into great detail on the different and effective methods to prevent knee injuries, I could create an entirely new blog/website totally dedicated to that subject. So, I won’t go into great detail or be super specific, but I will make some general statements and give some examples of things we can all incorporate in training our athletes that will greatly decrease the likelihood of injury.
First thing I touched on last month, and that is that we shouldn’t try to instruct our athletes to always keep the knee in line over the foot at all times, as this is obviously not how it moves when they are participating in their sport. With that in mind, I would say another extremely important method would be to make sure we always train our athletes in a three dimensional manner. For instance, if we are going to have our athletes lunge, we should have them lunge forward, laterally and transversely. Another example could be step ups, and if we are going to have our athletes perform step ups, they should also perform them going forward, laterally and transversely. Along with doing these exercises we should have the arms perform different movements that cause the hips, knees and ankles to react in different ways (ie overhead reaches, twists, lateral reaches, etc). These are the types of movements they’ll be exposed to in their sport.
We shouldn’t just limit our thinking to strength training either. For instance, if we’re helping our athletes develop balance, we need to do it three dimensionally. We should also make sure that when we are helping our athletes develop agility skills, these drills should be done three dimensionally – meaning we should train them going in any direction and changing any direction they may encounter in their sport. One more example could be jump training. No matter what our preferred method of jump training is, we should train the athletes to be able to jump three dimensionally – forward, back, to either side, twisting, etc. It’s not very often that our athletes will be doing a perfect bilateral jump up and down. They are constantly jumping and landing in different directions with different foot placements, both double and single leg. By training them to jump in all directions, both double and single leg, it will prepare the knee to be able to work(both load and explode – decelerate and accelerate) in all directions. The list could go on of different examples.
These are all great examples of how to develop the knee’s ability to move in all 3 planes of motion, which should in turn, lower the likelihood that our athletes get put into a position that their knee won’t be able to handle when playing. Again, I could go into great depth with specific examples of how to train in such a way that we lower the likelihood of the knee being injured, but I hope this discussion will give you all some ideas that you could incorporate with your athletes.
Probably the best part of my post last month was the link I posted to Gary Gray and Joe Tofferi’s Part 1 of their discussion on ACL Prevention. Here is Part 2 of their discussion. Great stuff!
To finish up I wanted to give an example that I feel is a great demonstration of the importance of this discussion on the knee. I love to play basketball and am currently playing in a semi-competitive city league. About 3.5 weeks ago during one of my games, someone(a little on the heavy side…..) landed on the outside of my knee, causing my knee to dive in sharply. When it happened, I heard a big pop as I went to the ground. I wasn’t in a lot of pain, but as I was laying on the ground, I feared the worst after hearing the pop. I was able to get up, and although my knee felt a little weird, I was able to finish the game. Now to take a step back. I started to really do a better job of incorporating this type of training of the knee with myself and my athletes over the last year. I am 100% convinced that if this same situation had taken place a year earlier, I would have torn multiple ligaments in my knee. The commitment to training three dimensionally has really made a huge difference for me performance wise, and in this instance definitely helped to make my injury much less serious than it could have been, and helped me to recover more quickly as well. Back to my story. The next day my knee was extremely sore. However, by the time my game rolled around the next week, I felt almost 100%, and 3.5 weeks later I can’t even tell anything had happened. Obviously I’m not an elite level athlete, but I’m totally convinced that if we put into practice these principles with our training, it will have the same type of impact on our athletes as it had on me.
Lastly, I wanted to share one more thought from this experience. Some strength coaches, physical therapists and others claim that the knee joint does not move three dimensionally. I would contend, especially after this experience, that the knee very clearly moves in all 3 planes. I obviously did something to my MCL with this injury. Whenever I did exercises in that first week that made my knee move in the frontal or transverse plane, I could barely stand it, as it obviously was making my knee move in different planes that targeted my sore MCL.
I strongly believe it’s important that we train our athletes in such a way that their knees don’t get put into positions while playing, that they have not experienced in their training with us. It will make a HUGE difference for them both performance wise, and most importantly, in helping to lower the likelihood of injury.