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H ARMELING P HYSICAL T HERAPY

H ARMELING P HYSICAL T HERAPY. PREVENTING ACL INJURIES IN FEMALE ATHLETES. Presented By: Peter Harmeling, MED, PT, SCS, ATC Steve Nutter, MSPT, ATC, CSCS Jim O’Brien, DPT. JUNE 25, 2009. ANTERIOR CRUCIATE LIGAMENT. GENERAL STATISTICS.

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H ARMELING P HYSICAL T HERAPY

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  1. HARMELINGPHYSICAL THERAPY PREVENTING ACL INJURIES IN FEMALE ATHLETES Presented By: Peter Harmeling, MED, PT, SCS, ATC Steve Nutter, MSPT, ATC, CSCS Jim O’Brien, DPT JUNE 25, 2009

  2. ANTERIOR CRUCIATE LIGAMENT

  3. GENERAL STATISTICS • FEMALES ARE 4-6 X MORE LIKELY THAN MALES TO SUSTAIN AN INJURY TO THE ACL • TYPICAL PROCESS: TEAR / SURGERY / RETURN TO SPORT 6 MONTHS TO 1 YEAR • 10 X MORE LIKELY TO DEVELOP OA LATER IN LIFE AFTER AN ACL INJURY

  4. REASONS FEMALES ARE MORE AT RISK ANATOMICAL DESIGN MUSCLE IMBALANCES

  5. FEMALE ANATOMICAL DESIGN • WIDER PELVIS, INWARD KNEE ANGLE, PRODUCES MEDIAL STRESS • RESULTS: • INCREASED MEDIAL KNEE MOTION DURING JUMPING / LANDING / CUTTING • DIFFICULTY REACTING TO MEDIAL KNEE MOTION • STIFFER / STRAIGHTER LANDINGS

  6. FEMALE ANATOMICAL DESIGN WIDER PELVIS + INWARD KNEE ANGLE = MEDIAL STRESS AT KNEE

  7. STEP DOWN

  8. INCREASED MEDIAL STRESS LANDING JUMPING

  9. STIFF LANDING

  10. STIFF LANDING

  11. GOOD JUMP

  12. GOOD VS BAD CUTTING

  13. GOOD VS BAD CUTTING

  14. MUSCLE IMBALANCE QUAD TO HAMSTRING RATIO MALE 2:1 / FEMALE 5:1 LANDING • 3X GREATER HS ACTIVITY IN MALES • GREATER QUAD IN FEMALES

  15. MUSCLE IMBALANCE WEAK HIP ABDUCTORS AND DEEP ROTATORS

  16. MUSCLE IMBALANCE

  17. MUSCLE IMBALANCE

  18. TRAINING • PROPER TECHNIQUE IS CRITICAL!!!!!! • DO NOT REINFORCE BAD HABITS • STOP IF FATIQUED • INCREASE QUANTITY (Reps / Intensity) WHILE MAINTAINING QUALITY

  19. TRAINING FEEDBACK • VERBAL FROM COACHES “Knees Out”, “Soft Knees”, “Balls of Feet” • VISUAL FEEDBACK Mirrors

  20. BASIC PROGRAM WARM UP ALWAYS WARM THE BODY UP TO STRETCH….DON’T STRETCH TO WARM UP

  21. BASIC PROGRAM KEY STRETCHES Hamstrings, Quads, Calfs, Hips Should do 3 – 4 reps Hold for 15 to 20 seconds

  22. STRETCHES Hamstring Calf 3 – 4 x with 15 to 20 sec hold

  23. STRETCHES Hip Flexor Quad 3 – 4 x with 15 to 20 sec hold

  24. BASIC PROGRAM KEY STRENGTHENING EXERCISES HAMSTRINGS: Standing Curls, Machine, Ball / Bridge, Russian HS Curls

  25. STRENGTHENING Standing HS Curls

  26. STRENGTHENING HS Curl Machine

  27. STRENGTHENING HS Ball Curl Bridge

  28. STRENGTHENING Russian HS Curl

  29. BASIC PROGRAM KEY STRENGTHENING EXERCISES HIPS: Side Leg Lifts Ball Squats w/ Band Sidelying “Clams”

  30. STRENGTHENING Side Leg Lifts

  31. STRENGTHENING Ball Squats w/ Band

  32. STRENGTHENING Sidelying CLAMS

  33. PLYOMETRIC TRAINING ATHLETIC POSITION FEET SHOULDER WIDTH APART HIPS / KNEES SOFTLY FLEXED BALLS OF FEET CHEST OVER KNEES HEAD / EYES UP

  34. PLYOMETRIC TRAINING ATHLETIC POSITION

  35. PLYOMETRIC DRILLS VERTICAL JUMPS FRONT / BACK JUMPS SIDE / SIDE JUMPS BOX JUMPS / DROPS SCISSOR JUMPS SINGLE LEG JUMPS IN PLACE / FRONT TO BACK / SIDE TO SIDE

  36. PLYOMETRIC DRILLS VERTICAL JUMPS FRONT / BACK JUMPS SIDE / SIDE JUMPS

  37. PLYOMETRIC DRILLS BOX JUMPS FRONT VIEW

  38. PLYOMETRIC DRILLS BOX JUMPS SIDE VIEW

  39. PLYOMETRIC DRILLS BOX DROPS

  40. PLYOMETRIC DRILLS BOX DROPS

  41. PLYOMETRIC DRILLS SCISSOR JUMPS

  42. PLYOMETRIC DRILLS SINGLE LEG JUMPS IN PLACE / FRONT TO BACK / SIDE TO SIDE

  43. AGILITY DRILLS • FORWARD / BACKWARD SHUTTLE • DIAGONAL RUNS • BOUNDING (HIGH KNEE DRILL)

  44. SUMMARY • ACL INJURY > IN FEMALE ATHLETES • NO SPORTS FOR 6 MONTHS TO 1 YEAR • TRAINING PROVEN TO MINIMIZE CHANCE OF INJURY • STRENGTHEN HAMS AND HIPS • PRACTICE…PRACTICE….PRACTICE • FEEDBACK FROM COACHES / TRAINERS

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