Knee Injury Prevention Guideline


Knee and ACL injuries commonly occur in sports such as soccer, ultimate, and rugby. Athletes may require months to even more than a year to recover and to be able to return to play. There is a vast amount of literature describing a number of ways on how to prevent knee and ACL injuries. However, the most effective prevention strategies are the ones that are based on scientific evidence, a thorough assessment made by the coach and medical team, and the individual's input.


Strongly suggested by research, programs most beneficial in preventing injuries consist of flexibility drills, running drills, strength training, core strength, and plyometrics. Each session should last approximately 20 minutes with a goal of exercising a minimum of 30 minutes per week. Programs should be implemented through out the year from preseason to regular season. Although most research studies focused on athletes between the ages of 12 and 25 years, these programs may benefit older individuals.

Recommended Exercises

Dynamic Stretches:

1) Toe Taps: Standing tall, kick one leg up and touch your toes to the palm of your hand. Alternate legs. Repeat 10 times on each side.
2) Reverse Lunge & Hop: Step back with one leg until you get into a lunge position. Swing the back leg forward until your knee is bent at a right angle by your chest. Maintain an upright body and repeat on the other side. Perform 10 repetitions on each side.

3) Calf Stretch: Standing tall on one leg, extend the other leg forward with only the heel in contact with the floor. Gently bend forward at the hips and feel a stretch along the front leg. Hold for 30 seconds and repeat on other leg. Perform 3 times on each side.

Running Drills: 

Perform running drills such as forward and backward running or bounding. Watch Physiotherapist Claire lead two athletes through a series of running and other dynamic drills below.

Strength Training: 

Two-legged Squat:

Starting with tall posture, engage your core below the belly button by drawing the inner core muscles towards the spine without arching the low back. With arms in a ready position do a two legged squat with your body weight distributed equally over both feet. Don’t go any lower than a ninety degree bend in the knees, keeping your knees in alignment with your second toe and over your heels as much as possible. Hold for a good long second and then straighten back up with your butt muscles to the start. Do three sets of fifteen repetitions daily.

Advanced Superman Deadlifts:

Start by holding on to a 5 pound dumbbell on the same side as the leg that you are going to extend back on. With nice tall posture, engage your core below the belly button. Keeping your spine flat, bend forward at the hips while you extend the leg back and reaching forward with the opposite arm and holding onto the 5 pound dumbbell with the other hand. Remember to keep that hip down on the side you’re extending the leg back on. Do 3 sets, 10 repetitions, holding for 3 seconds.

Split Squat Jumps:

Start with a nice tall posture and your inner core pulled in to keep your low back flat. Engage your back leg into extension by pushing the back forefoot into a solid bench or a chair supported against a wall. With your arms in the ready position bend the knee to 90 degrees by bringing the butt down and then jump back up. Keep your thigh strong by preventing the knee from buckling inwards. Keep your knee over the heel and don’t let it go over your toes. Do 3 sets of 10 on each side.

Core Strength Exercises:

1) Planks: Begin on the floor resting on your forearms and knees. Extend both legs until your whole body forms a straight line from the top of your head to your feet. Engage the core and glute muscles. Begin by holding this position for 30 seconds. Progress to 60 seconds or more to increase difficulty.


2) Glute Bridge: Begin on the floor with your back flat, legs bent at approximately 90 degrees and both feet on the ground. Place both arms to the side then engage your core as you lift your hips up. Hold for a second or two at the top as you squeeze your glute muscles.

Plyometrics

1) Box Jumps: Use a box that is around your knee height or higher. Stand in front of the box with your feet shoulder-width apart. Bend slightly downwards, swing your arms back, then swing them forward and explode up off the ground onto the box. Repeat 10 times.


2) Lateral Skater Jumps: Begin by standing on one leg and bend the other leg. Jump sidewards and land on the leg that was bent. Then switch sides. Repeat 10 on each side.

References:
https://www.ufvcascades.ca/2018/01/cascades-mens-soccer-program-to-host-id-camp/
https://www.jospt.org/doi/full/10.2519/jospt.2018.0509

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