Posted November 17, 2015
Alan Doyle from Portmarnock Physio talks through the subject of anterior cruciate ligament (ACL) injuries and how people can go about preventing the injury.
People often ask me why do so many people have cruciate ligament injuries?
The knee is a hinge joint, its meant to flex and extend in one direction only (a small amount of rotation is also permitted) During gaelic football, hurling, rugby etc, athletes are constantly twisting and turning which sometimes loads the ACL beyond its capability resulting in tear or complete rupture of the ligament, often requiring surgery. It could be said that the ACL is not fit for its purpose as far as sport is concerned. 70% of ACL injuries are non-contact injuries.
I often hear “there were never this many ACL injuries in my day !”
I think ACL injuries have always been occurring as long as people have been playing sport. Physio’s and Doctors are much better at recognising ACL tears. This combined with an increase in accessability to MRI scans there is a much shorter time to diagnosis than there was 20 years ago. However, it is true, the number of ACL injuries is increasing slowly. So maybe we are not doing enough to prevent them.
So how do we go about preventing ACL injuries?
The literature reports females as having a 4 to 10 times higher incidence of ACL injuries. If we are to prevent cruciate ligament injuries we need to understand what it is about young female athletes that predisposes them to having more injuries than males.
Females tend to grow a lot quicker than males. A females skeleton (bones) grows much quicker relative to their muscles and tendons. This causes females to have much less control of their bodies during landing or turning. For example: if you ask an 11 year old girl to squat, she may do this with an excellent technique. If you ask the same girl to squat when she is 15 then all of a sudden she demonstrates a knee valgus position or a knock knee position because she is no longer able to control the movement of her own body as well as she used to. A knee valgus position at the time of injury has been recognised as the single biggest risk factor for going on to have an ACL injury.
So how do we prevent this ?
There are some simple functional tests which can be done to identify those athletes who are most likely to suffer an ACL injury. The 10 second tuck jump assessment and counter movement jump test are a good way of identifying deficits in neuromuscular control during movement. Unfortunately most people do not address these issues until it is too late. Have a look at the very short video below to see if you can spot the knee valgus mechanism on landing.
With the appropriate training athletes can significantly reduce the risk of injury. Thankfully at Naomh Mearnóg we are certainly moving in the right direction. This year the gym has been refurbished and Cliodhna O’Connor is working hard with several of the teams to promote strength and conditioning among players. Myself and my colleague Robbie Doyle are both Chartered Physiotherapists and are available to see any members or non-members suffering from any musculoskeletal problems. Having access to these facilities and services I think is vital to keep up with the evolving athleticism of the modern game.
This article has been written by Alan Doyle from Portmarnock Physio. Portmarnock Physio is run by Alan and his colleague Robbie Doyle, both Chartered Physiotherapists. The guys specialise in a range of physiotheraphy services, their clinic is located at the Naomh Mearnóg GAA clubhouse and appointments can be made by calling 089 4549553 or through portmarnockphysiotherapy.com
Main image taken from GAA.ie