ACLs And Why They Tear

 

The anterior cruciate ligament (ACL) … we all have heard the term and recognize it the most when we see an athlete go down holding the knee.

200,00 athletes tear their ACL every year. That number was recorded some 5+ years ago and it still hasn’t changed to date. And still amongst those numbers a 9:1 ratio of ACL tears belong to females than males.

The age range varies amongst this excruciating tear but the most common sufferers range between 15-45 y/o with (Griffin, 2000 & Chapman, 2001) stating the focus was on youth athletics being the culprit.

Most oftentimes, a greater number of ACL injuries reside in non-contact situations. This is most likely due to factors such as pattern overload and compensation and also insufficient strength and stability. Poor movement in the participation of sport requirements also come into play.

The lesser degree tears are contact injuries where an external force causes the ACL to snap. Football, soccer, rugby come to mind.

These sports represent the higher risk to ACL injuries with contact or not: basketball, soccer, football and skiing.

 

We Must Ask Why Do ACL Tears Occur?

The Female Target

The first assessment area to focus on is the Q angle.

The Q angle is quite evident in wide hips or the outside width of the pelvis. From there look and measure if need be to identify the line straight down to the floor from the outside hip or outer pelvis and then remeasure from the starting point to the knee. The distance between the 2 lines is the Q angle measurement.

Women either naturally and/or from giving childbirth have an average Q angle of 11-15 degrees which is 4-5 degrees greater than males. This position adducts the femur and makes the pathway for a vagus knee (see below) to occur and lead to an all tear.

The second factor to mention is this… we tend to just think of quadricep dominance to be all about females. All athletes at some point in time over compensate through the quads because they have learned to fire the posterior chain. There are other factors to discuss here but that goes beyond this blog today. But getting the glutes to activate and be dominant force is key. Get this we have less stress on the knee.

Lastly, the menstrual cycle monthly visit reads havoc on the ligamentous system and therefore causes laxity in various regions in the body that increase risk to ACL tears.

 

Knee Valgus Angle

A knee valgus angle is defined by the angle formed at the knee joint and you get “knocked knees”.

When athletes are not trained correctly and/or do not have the proper body awareness during functional and sports specific movements, increased knee valgus angles at the knee are common causing significant amounts of stress on the ACL. (Hewett et al, 2006)

 

Early Specialization In Youth Athletics

One of my favorite sayings is, “We can thank the club sports in the world for destroying young athletes.” Why is this so? Back in the day it was an absolute accomplishment to be a 2-3 sport athlete in high school. And as youth athletes we were well rounded by playing a number of sports throughout the year. This indeed developed the whole athlete. A good athlete.

Nowadays,  early specialization equals lack of overall skill development with basic human movements…which in the end we have undeveloped, under-prepared bodies who are over-exposed to one sport they play.

If coaches and parents won’t allow full exposure to developmental movements then inevitably those little athletes will endure more physiological stressors that use to only happen soon the collegiate and professional level. That is why you have so many injuries with kids these days with extreme sprains and tears to tommy john surgeries and UCL complications from throwing sports. Let them participate in multi sports over the year instead of demanding they play one sport as if they are a professional already. What you put them through today will most certainly be borrowed from their tomorrow.

 

Poor Technique and Lack of Muscular Activation/Strength 

One cannot stress the value and need for proper technique with all sports specific movements and the developmental process of building a strength in all musculature groups important for their given sport.

It is common to see several athletes on a field or court performing sports specific movements with poor form…a lot.

Take the time to work on balance, coordination, mobility, strength and stability to with your athletes to decrease risk of injury and elevate their level of performance. That is high performance training. You do this you have less punishing suicides and gassers because they are not performing to ‘your standard’  and less injuries to boot. Killing 2 with one stone lol.

 

Balance and Proprioception Deficits

Balance is defined by the ability for an athlete to maintain stability and control during sports specific and functional movements. Proprioception is the ability for an athlete to understand where the body is in space during a given time both on and off the field.

If you have these one will be better able to demonstrate control in practice and competition.

 

Summary

The best action is prevention and develop your these young kids to be well rounded from the start and as time goes by let them pave their legacy.

Train Like A Pro?

train like a warrior. a navy SEAL. a spartan

train like a linebacker. like a fireman. like a professional.

train like your life depends on it.

the thing i notice most about the individuals who write such things is how rarely any of them are actually professionals – and how few professionals they actually train.

what i am trying to say is that you probably shouldn’t train like a professional – and if you are actually a professional than i assume you are also well versed at identifying internet advice that you would be better off ignoring.

i have said it a million times – training is nothing but a nudge in a direction, it is a step – think of it like directions on a map: your goal is located 134 miles north/northwest. training is the path you take to get there. rarely do any of us take the straight path, and depending on the “terrain” that might not even be the fastest or easiest way to get there. the point of this thought process is to always remember that while someone else’s training can teach you how to approach an obstacle, blindly following directions without understanding the differences in starting place and goals will probably just get you lost, maybe worse.

true professionals are at the sharp end. they have put in the work and (in most cases) physical improvements are becoming incredibly specific and expensive. for the few actual professionals i have trained the gym has a different purpose than most – they are here to be better students for their other coaches. they are here to stay off the injured list, to balance out the side effects of all their technical practice. they are here for fine adjustments, for sand paper – not sledge hammers.

being an amateur is a stage, not a judgement. in general it means that coarse tools are still useful and that the timeline isn’t so demanding – that you can afford to take a winding path, to explore and enjoy the process. as an amateur the benefit of wandering off a path, of trying something new is often worth the time and energy expended. a perpetual amateur is simply someone who is focused more on the journey then the destination – someone who would rather explore a bunch of foothills than summit a single peak. and for those who’s goal is to be the best one day – to reach that summit: recognizing and acting on the fact that you are an amateur will actually be the quickest way to not be an amateur anymore.

being a professional is just a reference of how important the outcome is. if your life or livelihood is dependent on your physical fitness then i am not very concerned with how much you enjoy the training. you can be happy on the podium. look cool at the finish line. you get to come home alive. as an amateur the goal is to learn and to explore. to make mistakes and to find out if this is even the correct path. sure, the goal is to improve – but generally the main goal is to improve in a realm only tangentially related to the task at hand. it is the difference between an intern and a mercenary, and should be approached accordingly.

Cramping? I Got Your Juice

Muscle cramps can bring even the strongest athlete to his or her knees. There are a number of theories as to what causes cramps but we never really get a lot of answers to why they happen.

 

But to quickly jump to what seems to be working, here is the answer to your cramp issue… Pickle Juice.

Whaaaat?

Pickle juice.

Yes.

Why?

How?

Most experts think it’s the vinegar.

It seems as though vinegar pulls sodium and calcium together to eliminate cramping.

Bring a small amount of pickle juice with you on your next training session (2 ounces is usually enough).

Mustard contains vinegar in smaller, but potentially effective amounts as well. However, it has not been as well studied as pickle juice. Packets of yellow and honey mustard are portable on the trail or road, and often easier to consume than pickle juice. Mustard has up to 100 milligrams of sodium per packet and also contains turmeric, which is helpful for muscle soreness and inflammation.

 

Beyond the cramps, pickle juice and mustard provide other benefits for athletes:

Sodium: Adequate intake can improve hydration and reduce cramping, at least in practice. Just 1 tablespoon of mustard has 200 milligrams sodium and 2 ounces pickle juice has more than 400 milligrams sodium. Just 2 ounces of the pickle juice sports drink has about 225 milligrams sodium.

Glycogen Replenishment: Vinegar, which is chemically known as acetic acid, can provide the acetyl group. This is a fundamental building block for the Krebs Cycle and helps to metabolize carbohydrates and fat to produce energy and ATP for cells.

If you’re prone to cramps bring a bottle of pickle juice or packet of mustard to your next training session or race. Consume them at the first sign of cramps and you might be able to keep training or racing and full speed.