Soccer players– what scares you more: open water swimming with the possibility of sharks and jellyfish around, or tearing your Anterior Cruciate Ligament (ACL) at the start of season? I’d bet it’s the latter.Â
What if I told you that I know a way to decrease risk of ACL injury by 50%? You’re in luck, because I’m about to unlock that secret for you.Â
Before you can know how to defeat an opponent, you first must know the opponent. Same is true with ACL injuries. Who is most at risk? How often does it occur? Why is this such a common foe for young soccer players? Once we know this information we can then ask ourselves how we can prevent the injury from occurring in the first place.Â
Who is most at risk?
So, who’s at the highest risk for an ACL injury? Well, there are two categories: non-modifiable and modifiable risk factors that contribute to adolescent ACL tears.
Non-modifiable factors
Non-Modifiable Risk Factors: Some factors that can’t be changed, like sex, age, and injury history, can increase your risk of an ACL tear.
Sex:
Anatomical differences in females make them more prone to ACL tears, especially when combined with poor biomechanics, which we’ll cover under modifiable risk factors.
Age:
ACL tears are more common during certain stages of life.
- Females: Early teenage years due to hormonal changes during puberty.
- Males: Late teenage years.
Injury History:
A past ACL tear is one of the most significant risk factors. Around 30% of athletes who’ve had one ACL tear will experience another, often in the opposite leg.
Modifiable factors
Now, let’s talk modifiable risk factors. Think biomechanics, insufficient quad strength, weak hip muscles—the list goes on. But fear not, because knowledge is power, and armed with the right information, we can significantly reduce these risks.
Biomechanics: The way we move and respond to load
- Insufficient quad strength with difficulty controlling body during deceleration, pivoting, cutting actions
- Insufficient hip strength leading to lack of dynamic knee controlÂ
Fatigue:
- Sudden increase in training load with/without insufficient caloric intake.
- Low quality and/or quantity of sleep. Studies show that adolescent athletes who average less than 8 hours of sleep at night are 1.7X more likely to experience injuries!Â
Psychological Readiness:
- Lack of confidence in bodies ability to perform coming back from injury.Â
What we know from the research
Research supports the implementation of ACL injury-prevention 6-weeks pre-season as well as sustained strength training 2x/week for at least 20 minutes per session throughout the season. There are four well-studied ACL injury-prevention programs:Â
- Prevent injury and Enhance Performance (PEP)
- The 11+
- Perform+
- The Knee Control Program
All the programs have four key foundational components which include plyometrics, strength (quad, hip, adductors, hamstrings), core stability, and balance. Here are a few ideas to get you started:Â
- Plyometric exercise: Square hops
- Strength: Rear foot elevated split squat
- Core stability: Plank on soccer ball
- Balance: Runners march with soccer volley
1. Square Hops:Â
Square hops are one of my favorite plyometric drills because you can do them pretty much anywhere. Using the corners of the soccer field, lines on a court, tape on the ground, or for creative points, lay your soccer socks on top of each other to make an X. See how many times you can hop into each quadrant of a 4×4 square grid in 30-60 seconds clockwise, then counter clockwise. Goal: 2-3 sets total.Â
To advance exercise: Try it with one leg at a time
2. Rear Foot Elevated Split Squat:Â
If I could only do one strength exercise for the rest of my life, this might be it. A rear foot elevated split squat is a great way to strengthen the quads and glutes (protect the knees!), and improve balance (you spend a lot of time on one foot kicking a soccer ball!). Place one foot behind you on a box, bench, or chair. Balancing on one leg, squat down (holding weight for extra challenge). Repeat 6-10 times on each leg.Â
3. Plank on Soccer BallÂ
When you hear the word “plank” do you cringe? If so, grab a soccer ball to add some spice to it! Keep your hips, ankles and shoulders in one line. Hold for 30-60 seconds. Repeat 3-4 times.Â
4. Runners March + Soccer VolleyÂ
You’ll need a partner for this one! (Add a BOSU for an extra balance challenge.) Starting balancing on one leg, reach down to touch your toe, come back up to a single leg stance, your partner will toss the ball to you. Volley it back all while balancing on one leg. Feel the burn!Â
Related Article: Secrets Unveiled: How to Minimize the Risk of an ACL Tear
Where to start?
Don’t let your worst nightmare become a reality. Let’s team up to ensure you step onto the soccer field feeling confident and ready to tackle anything that comes your way. What are you waiting for? Give us a call for an appointment and let’s score big together! Â
Not ready for a full appointment or on the fence about an injury prevention program? I invite you to click below to ask me any questions you have about your knee health and training in general, on the house!
By Morgan Lash, PT, DPT, CSCS
