ACL injuries. Who is responsible? Are you?
This post could be one of many as this topic will no doubt be discussed more and more over the next few years. I’m not 100% sure how to start but I heard this quote on Avengers and find it very fitting
. “Everyone creates what they fear the most”
Every coach and athlete wishes to reduce injuries, we want high performance and low injuries. Research is done into the field and findings show that strength is injury preventative and also enhances performance. (1,2) So now what? …. LETS GET STRONG! REALLY STRONG!
Before I get started let me state that I strongly encourage strength training and am not at all saying stop, have a read, hear me out and think about it. ACL injuries are increasing, as is performance but at what cost? Is there a smarter way?The incidence of ACL surgery in females significantly increased from 10.36 to 18.06 per 100,000 person-years between 1994 and 2006, while that in males rose at a slower rate, with an incidence of 22.58 per 100,000 person-years in 1994 and 25.42 per 100,000 person-years in 2006. (3)
I believe that we are focusing too much on lifting in strength training and not enough on skills and conditioning.
1 .Too much focus on lifting during strength training? Strength training is great; it will build increased power, speed and muscular size. BUT are we able to control these increases. Are we improving our brakes as we improve the engine and build a more robust body.
I believe the three possible strength training related factors influencing ACL injuries are (1) not focusing on the brakes enough, (2) not understanding the effect of increased body weight on injury risk and (3) the psychological effect of increased muscle mass. The first two factors go hand in hand, the increase in body weight that comes as a result of strength training and not focusing on how to control it. It's simple when you think about it. You would give a car more power without making sure the brakes can stop it effectively. So we need to change our focus from "How much can you lift?" to "How much can you lower and control effectively?" Secondly.Increased body weight results in increased ‘inertia’. Inertia is defined in the image below. My argument is this - if we increase our ability to produce force in a straight line we then have more momentum and in conjunction with increased body weight we have a much higher inertia value when it comes to changing direction.
This requires high amounts of forces from many muscles but also places stress on ligaments and joints that aren’t strengthened the same during traditional strength exercises. If the muscles cant handle these loads and overcome the inertia of the body then ligaments are stressed and if ‘over –loaded’ they will rupture. Lastly when we get big and strong we can feel invincible, we can feel like we could run through a brick wall. Which is sometimes what we try to do when we should instead use evasive skills as opposed to trying to muscle through a 6 foot 5, solid front rower. 2. Not enough ‘skills & conditioning’ training. Agility is highly skill related (4) and the body needs more ‘conditioning’ than just strength. We should look at joint range of motion but also mobility, stability and proprioception at these ranges. If we increase in one area but not in the other than this creates an imbalance that inevitably results in injuries. Prior to the large focus in resistance training was highly specific and resulted in high skill development in agility and cutting maneuvers, as that was the focus. Go around, not through as what seems to be the focus at the current time. We need to bring back things like jumping and landing drills and cutting practice, coaches need to watch and assist with cues to increase the efficiency of movement resulting in reduction in injuries this way. Mobility and other movements should be part of training to vary the load on the body but also assist with joint health. If we have a larger range in which our joints can move and produce force we become more powerful but also will have less injuries as force can be absorbed just was well as it is produced. If we have better awareness of joint position especially in the awkward position we will be better able to brace and protect ourselves, reducing injuries. Final Thought. For the health of our athletes, children and friends I feel we need to reconsider our focus when it comes to strength and conditioning. Can we build strength and power differently? How much strength do we really need? Have we got a healthy body and joint in which to build on? You wouldn’t build a house on a poor foundation so why develop an athlete if they haven’t got the foundation yet? Keep thinking and working towards a better community. Any feedback please get in touch. Jordan