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ACL Prevention: Programs & Results Mike Flynn, MS ATC LAT.

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Presentation on theme: "ACL Prevention: Programs & Results Mike Flynn, MS ATC LAT."— Presentation transcript:

1 ACL Prevention: Programs & Results Mike Flynn, MS ATC LAT

2 Purpose To provide a simple, common sense approach to preventing ACL and lower extremity injuries.

3 Intended Result To identify the key elements to consider when developing a program. To understand the components of a prevention program. To demonstrate how to effectively implement these components into a program.

4 Injury Stats 100,000 to 462,000 ACL injuries in the US every year! 85 percent of ACL injuries, regardless of gender, are non-contact! Higher occurrence in females! ( up to 9 times more likely than males)

5 When Injuries Happen Planting & Cutting Landing Stops Pivoting Rapid Deceleration

6 Prevention Stats Bert Mandelbaum, MD, Santa Monica Orthopedic and Sports Medicine Research Foundation - PEP –Female high school soccer players 2000 season –1,041 in training group, 2 ACL injuries –1,902 in control group, 32 ACL injuries 2001 season –844 in training group, 4 ACL injuries –1,092 in control group, 35 ACL injuries

7 Prevention Stats Giuliano Cerulli, MD, Santa Maria Hospital associated with the University of Perugia in Italy –900 high-level male soccer players over three seasons 600 in training group, 10 ACL injuries 300 in control group, 70 ACL injuries

8 Prevention Stats Tim Hewett, PhD, Director of the Sports Medicine Research Institute and Human Performance Laboratory, Children’s Hospital Research Foundation in Cincinnati – Sportsmetrics, WIPP –Female athletes 366 in training group, 2 ACL injuries 463 in control group, 10 ACL injuries

9 Prevention Stats Oslo Sports Trauma Research Centre, Santa Monica Orthopedic and Sports Medicine Research Foundation, and FIFA – 11+ (2008) –1055 in the training group, 121 lower ext. injuries –837 in the control group, 143 lower ext. injuries

10 Prevention Stats Swedish Football Association – female soccer players from age (2009) –2085 athletes in the control group –2479 athletes in the intervention group 64% reduction of ACL injury rate

11 Prevention Stats Uppsala Primary Care, Uppsala County Council – HarmoKnee (2010) –777 in training group –729 in control group 77% lower incidence of any knee injury 90% lower incidence of non-contact injury

12 Prevention Stats Chicago Public Schools – 90 Coaches (2011) –755 athletes in control group –737 athletes in intervention group 35% reduction in overuse lower extremity injuries 44% reduction in acute non-contact lower extremity injuries 34% reduction in non-contact ankle sprains All the athletes with non-contact lower extremity injuries resulting in surgery were in the control, all ACL injuries.

13 Prevention Stats FIFA & Male Basketball Players yrs (2012) –14 of 80 players in the FIFA 11+ group were injured –17 of 40 players in the other group had injuries

14 Prevention Stats Meta-analysis 8 Studies Analyzed –At least 10 minutes of neuromuscular training, 3 times/wk –An ACL tear risk reduction of; 52% in female athletes 85% in male athletes

15 Program Components Form Runs Dynamic Flexibility Core Strength Balance/Proprioception Agility Explosive Strength Sport-specific conditioning

16 Form Runs Skips Carioca High Knee Butt Kicker Side Shuffle Serpentine Run Plant & Cuts 180’s & 360’s

17 Dynamic Flexibility Knee Hugs Hurdle Walks Crawling Series –Inch Worm –Spiderman Lunge Series

18 Balance/Proprioception Single Leg Balance –Standing –Side to Side –Rotation Hop & Sticks –Double Leg –Single Leg –Multi-Directional

19 Agility Foot Ladder –Forward –Backward –Sideways Sprint it out to a stop!

20 Explosive Strength Plyometrics –Landing –Jump Ups –Double Leg Hops –Single Leg Hops –Bounds –Alternate Leg Box Jumps

21 Strength Core strength –Basic Core Bridge Series Lunge Series

22 Sport-Specific Conditioning Make it look like the game!!

23 Putting It All Together! Form Runs Basic Core Balance/Proprioception Dynamic Flexibility Agility Explosive Strength Conditioning

24 Retention Program Duration Study – UNC (2012) –140 youth soccer athletes (11 to 17) All participated in either a 3 month or a 9 month program 84 (60%) showed improved LESS scores 3 months following the completion of the programs only the extended duration group retained their improvements

25 References Umile Giuseppe Longo, MD, MSc; Mattia Loppini, MD; Alessandra Berton, MD; Andrea Marinozzi, MD, PhD; Nicola Maffulli, MD, MS, PhD, FRCS(Orth); Incense Denaro, MD. The FIFA 11+ Program Is Effective in Preventing Injuries in Elite Male Basketball Players A Cluster Randomized Controlled Trial. Am J Sports Med May 2012 vol. 40 no Padua DA, DiStefano LJ, Marshall SW, Beutler AI, de la Motte SJ, DiStefano MJ. Retention of movement pattern changes after a lower extremity injury prevention program is affected by program duration. Am J Sports Med Feb;40(2): Sadoghi P, von Keudell A, and Vavken P. Effectiveness of Anterior Cruciate Ligament Injury Prevention Training Programs. J Bone Joint Surg Am. 2012; 94:1-8.

26 References Cynthia R. LaBella, MD; Michael R. Huxford, MEd, ATC; Joe Grissom, MPP; Kwang-Youn Kim, PhD; Jie Peng, MS; Katherine Kaufer Christoffel, MD, MPH. Effect of Neuromuscular Warm-up on Injuries Female Soccer and Basketball Athletes in Urban Public High Schools. Arch Pediatr Adolesc Med. 2011;165(11): Martin Hagglund, PhD; Markus Walden, MD, PhD; Isam Atroshi, MD. Preventing knee injuries in adolescent female football players – design of a cluster randomized controlled trial. BMC Musculoskeletal Disorders 2009, 10;75. Kiani A, Hellquist E, Ahlqvist K, Gedeborg R, Michaelsson K, Byberg L. Prevention of Soccer-Related Knee Injuries in Teenage Girls. Arch Intern Med. 2010;170(1):43-49

27 References Albaugh J, Friedman J, Cody S, Ganley T. Joint Efforts. Training & Conditioning, 20.3 April 2010 Alentorn-Geli E, Myer GD, Silvers HJ, Samitier G, Romero D, Lazaro-Haro C, Cugat R. Prevention of non-contact anterior cruciate ligament injuries in soccer players. Knee Surg Sports Traumatol Arthrosc Aug;17(8):857-8 Soligard T, Myklebust G, Steffen K, Holme I, Silvers H, Bizzini M, Junge A, Dvorak J, Bahr R, Andersen T. Comprehensive warm-up programme to prevent injuries in young female footballers: cluster randomized controlled trial. BMJ 2008;337:a2469 Vern Gambetta, Bettering the Odds, Training & Conditioning, 13.5, July/August 2003 Vern Gambetta, Leap of Strength, Coaching Management, 8.3, April 2000 Guillermo Metz, Restoring the Balance, Training and Conditioning 9.3 April 1999

28 Thank You! Contact Information:


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