The number of anterior cruciate ligament (ACL) tears athletes at all levels
and in all types of sports are experiencing continues to represent a dynamic
challenge for sports medicine. Not only are ACL injuries severe in nature,
they also bring with them the looming prospect of re-injury. As research
has shown, any athlete who has suffered a tear to the ACL is automatically
10 times more likely to tear the ligament on the opposite knee, or re-injure
the same knee. We as orthopedic specialists strive to find a way to avoid
these daunting statistics all together, and I am confident that it all
begins BEFORE the ACL injury with preventative strategies.
Studies have shown us that the population at highest risk for tearing the
ACL is teenage girls ages 14-18. Typically participating in high school
sports, it may be easy to conclude that these young athletes simply lack
access to proper athletic training and/or resources. BUT even pro athletes
in peak physical condition and with unlimited access to the very best
trainers, coaches, and sports medicine doctors, still often find themselves
the unsuspecting victims ACL tears. This begs the question, WHY are these
injuries happening, what can we do to treat them effectively and how can
we ultimately prevent them from happening altogether? In order to answer
these questions, it’s vital to identify and understand all of the
contributing factors leading up to the injury so we can implement a prevention
program that has the right focus.
This is where the PEP (Prevent injury and
Enhance
Performance) program comes into play. We know that rehabilitation is KEY
to healing, regaining stability of the knee joint, and returning to play
after ACL surgery, so why not design an injury prevention program that
encompasses this type of training and practices to
prevent ACL injuries in the first place, not just a program that is put into action
after an injury. Yes, it
is possible to undergo a successful surgery, complete a great rehabilitation
program and regain previous function of the knee joint, but even so, the
risk for re-injury remains.
The goal of the PEP program is to avoid these risks by
preventing injury and enhancing performance. So how is this done? The program consists
of a warm up, stretching, strengthening, plyometrics, and sport-specific
agilities – a 15-minute training routine that is performed just
three times a week. These exercises are designed to address the potential
deficits in the strength and coordination of the muscles that surround
and support the knee joint, as well as the hip joint. We designed the
program NOT to solely focus on the knee itself, but to take into consideration
and offer solutions for other possible precursors for ACL tear, and this
is why the program has become so successful. In a study of 60 men’s
college soccer teams, players who performed the preventative PEP program
were 66% less likely to tear an ACL during the season and this is great news.
Paying particular attention to prevention strategies and the PEP program
is a strong framework for decreasing the amount of ACL tears among all
sports and athletic levels. We want our athletes and coaches to understand
the need for and direct their focus into habilitation and not just RE-habilitation.
In doing so, I have no doubt that athletes will perform at their utmost
fitness level and significantly reduce their risk for injury – all
while staying in the game!
Sources:
http://mmqb.si.com/2013/09/20/bert-mandelbaum-acl-prevention
http://smsmf.org/smsf-programs/pep-program
https://www.facebook.com/DrBertMandelbaum/videos/vb.1432706326991641/1742484732680464/?type=2&theater