Anterior cruciate ligament (ACL) tears are a common and devastating injury, especially in athletes.  If you regularly watch any sports or sport news shows, you’ll see a new player sitting out for a season with an ACL tear seemingly every week.  ACL tears occur more commonly in sports like basketball, football, and soccer that involve a lot of contact and running, but any sport where you have to run, jump, or cut is likely to put someone at risk.  After tearing an ACL, it typically takes at least 6 months before someone is cleared to perform some light version of sport-related activity, and that’s being generous.  Return to sport typically isn’t recommended until 9 months or later.  That’s a lot of time to lose to an injury!

ACL tears typically occur when the knee is quickly or forcefully moved into what’s called a valgus position, which is basically when one knee moves towards the midline of the body.  In sports, this can occur frequently while running, cutting, or jumping.  For reference, the knee should either be on a line between the ankle and the hip or directly over the ankle during these motions.

Injury prevention certainly isn’t an exact science, but there are things that can be done to reduce your chance of injury.  There are a number of factors that can predispose someone to ACL injury.

Here are ways to help reduce the likelihood of an ACL tear:

• Ankle Mobility¹ – Particularly ankle dorsiflexion (bringing the foot closer to the shin).  One of the best predictors of an ACL tear is poor ankle mobility.  The ankle joint acts like a train track for your knee – the better your ankle mobility, the longer your knee can stay on the rails.
• Hip Strength and Control² – If the ankle serves as the train tracks, the hip is the conductor.  The hip will direct the knee along the rails, changing the direction as long it is strong and engaged enough to do so.
• Conditioning³ – A train is only able to go so far without a good engine.  In terms of the body, having excellent conditioning allows you to maintain your best performance for long durations.  This means keeping your form and positioning on point throughout a game.  ACL tears are more likely to happen when someone is fatigued, so make sure your always working on your conditioning.

So how you do you implement all this?  Single leg exercises (think lunges, step ups, jumping) are great for developing hip strength and control, so long as there is intent of keeping the knee over the ankle, which can in turn help ankle mobility.  For conditioning, emphasize sport-specific movements.  If your sport has a lot of running, that’s what you’ll want to stick with.  Make sure that you’re working on more than just jogging, though.  Think about going in multiple directions at various speeds.

ACL tears are tough to deal with, but there are proven steps you can take to reduce your chances of having one occur.  If you have more questions about how to implement these ideas and exercises, seek help.  Physical therapists and some strength and conditioning coaches are good sources of information for performance and preventative exercises.

Got questions?  Feel limited in what you’re able to do?  The staff at Limitless Physical Therapy in Eugene, OR can show you how to be limitless. Contact us to connect with on of our PTs. Or follow us on Facebook.

***The above information, including text, images, and all other materials, is provided for educational purposes only, and not as a replacement or supplement to professional medical advice.  Please contact a certified healthcare professional or your primary physician for any personal concerns.

1. Fong CM, Blackburn JT, Norcross MF, McGrath M, Padua DA. Ankle-dorsiflexion range of motion and landing biomechanics. J Athl Train. 2011 Jan-Feb;46(1):5-10. doi: 10.4085/1062-6050-46.1.5. PubMed PMID: 21214345; PubMed Central PMCID:PMC3017488.

2. Pollard CD, Sigward SM, Powers CM. ACL Injury Prevention Training Results in Modification of Hip and Knee Mechanics During a Drop-Landing Task. Orthop J Sports Med. 2017 Sep 8;5(9):2325967117726267. doi: 10.1177/2325967117726267. eCollection 2017 Sep. PubMed PMID: 28959697; PubMed Central PMCID: PMC5593213.

3. Cortes N, Greska E, Kollock R, Ambegaonkar J, Onate JA. Changes in lower extremity biomechanics due to a short-term fatigue protocol. J Athl Train. 2013 May-Jun;48(3):306-13. doi: 10.4085/1062-6050-48.2.03. Epub 2013 Feb 20. PubMed PMID: 23675789; PubMed Central PMCID: PMC3655743.