We’ve received a few e-mails over the last week asking what we do specifically for preventing ACL injuries. Mike Boyle once said it best ,”There is no such thing as ACL prevention training. There is just smart training and dumb training.”
That’s really been our philosophy too. Here are a couple of things we do that we consider smart training, especially for female athletes:
1) Add functional strength
That’s probably the most important component of our training program. If an athlete is too weak to control his/her own body weight when they’re cutting, they’re obviously going to put their knee in situations that can result in injury. However, you just can’t add strength. You have to have it in the right patterns, and it must be proportional. Most female’s quadriceps are much stronger than their hamstrings. That imbalance puts the knee at risk. You also must train the pattern, not the muscle. Strengthening the hamstring in a healthy athlete with seated hamstrings curls is useless because it’s not functional. During basketball, the hamstring never works in isolation; it moves with other muscles in movement patterns. Deadlifts, RDLs, SLDLs, and hip thrusts are much better options.
2) Improve mobility
Females tend not to have as much mobility issues as males. However, if there is a mobility issue, then there is probably a compensation occurring somewhere in the body that puts the athlete at risk for an injury. For instance, if an athlete can’t get in the deep position in a bodyweight squat whether because of decreased mobility in the ankle or the hip, the body will try to get the mobility from another joint. Unfortunately, the majority of time it’s from the knee. Gray Cook, creator of the FMS, always fixes mobility issues first. He won’t even look at a strength or stability issue if he finds out the athlete lacks mobility.
3) Single-leg functional exercises
When an athlete goes from two legs to one leg, the entire movement changes. Stabilizers become much more involved, certain muscles are “turned on” more than others, and most importantly, compensations between the two limbs cannot occur . When one limb is stronger than the other, the athlete increases his/her risk for injury. If you only do bilateral exercises, you never see unilateral deficiencies.
Most sporting activities involve single-leg work. Sprinting is basically extremely quick single-leg transition. Changes of direction mostly involve single-leg strength, as does most jumping that occurs in basketball. So even if you don’t understand the biomechanical and physiological differences, it even passes the “common sense” test.
4) Landing and cutting technique technique
This is probably the component that’s ignored the most at the high school level, and taught first at the collegiate level. Why? My guess would be that it takes a little more knowledge about biomechanics than most coaches have. Who really wants to study moment arms, joint angles, and torque? That’s what collegiate strength coaches are for.
We can’t put these huge engines in kids, and not teach them how to use the brakes. Unfortunately, that’s what is happening. We have to teach the kids to land softly, absorbing the force through the muscles, to drop the butt during deceleration, and to make sure the athletes have the correct force angles during change of direction movements. Strength alone won’t cut it. Starting, stopping, jumping, and cutting are learned techniques, just like shooting and dribbling are. Strength alone doesn’t improve those skills, so why would we think it will improve these?
5) Glute medius activation
This is another tip I got from Mike Boyle/Gray Cook. The glute medius is a small muscle that sits on the lateral side of the glute maximus (non-technical location). Of its many functions, its primary function is hip abduction which provides stability in the frontal plan during running and jumping. Unfortunately, because of today’s society, this muscle is usually extremely weak and inactive. A weak, inactive glute medius leads to valgus collapse. Valgus collapse makes an athlete more prone to knee problems. Most traditional exercises don’t effectively work the glute medius because it’s too easy to compensate with a stronger, larger muscle. Every workout we do starts with a glute medius activation exercise, which is usually lateral band walks.