One of the most common knee injuries is an anterior cruciate ligament (ACL) sprain or tear.
Partial tears of the anterior cruciate ligament are rare; and most ACL injuries are complete or near complete tears.
The ACL can be injured in several ways, like changing direction rapidly, stopping suddenly, slowing down while running and landing from a jump incorrectly and there are certain risk factors, such as gender and sport training that can increase your risk of suffering an ACL injury.
Scott Herron, MD, board certified orthopedic surgeon and a member of the Medical Staff at Temecula Valley Hospital is here to discuss the best ways to train your knees to help prevent ACL injuries.
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Training Methods to Prevent ACL Injuries
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Learn more about Dr. Herron
Scott Herron, MD
Dr. Scott Herron completed medical school at Michigan State University in 1990, completed a residency at USC in 1999 and a fellowship at Jewett Orthopaedic Clinic in Orlando Florida for Knee Reconstruction/Sports Medicine in 2000. He is Board Certified by the American Board of Orthopaedic Surgery. Dr. Herron is a former Selection Committee Member for the Capital One Bowl and is a former Associate Team Physician for the Orlando Magic, NBA team.Learn more about Dr. Herron
Transcription:
Training Methods to Prevent ACL Injuries
Melanie Cole (Host): One of the most common knee injuries is an anterior cruciate ligament sprain or tear. Athletes who participate in high demand sports like soccer, football and basketball might be more likely to injure their anterior cruciate ligament or their ACL. My guest today is Dr. Scott Heron. He’s a board certified orthopedic surgeon and a member of the medical staff at Temecula Valley Hospital. Welcome to the show, Dr. Heron. Tell us a little bit about the physiology of the knee and what does the anterior cruciate ligament do?
Dr. Scott Heron (Guest): Good morning, Melanie. Thanks for having me. The ACL or anterior cruciate is a very common injury. Actually, in the United States we see over 150,000 injuries every year. It’s one of the most common injuries that we see and it’s actually very important because if you injure that ACL, if you feel the pop when you’re playing sports or doing an activity, it’s something that you want to be seen for and be addressed immediately.
Melanie: What puts you at risk for an ACL injury? Are there certain people that are more at risk than others?
Dr. Heron: Surprisingly, you would think that ACL injuries are occurring with contact sports that we’d see a higher amount of contact injuries but the majority of those injuries are non-contact types of issues. Sudden deceleration, sudden stop and go on the corridor or the playing field is what we usually see. Women, girls tend to have more injuries than the guys do. One of the things that I work on is education on how to prevent the anterior cruciate injury, especially in the female athlete.
Melanie: Is there a reason that we know of why females and soccer players and young girls seem to be more at risk for these injuries?
Dr. Heron: They tend to be more at risk just because of the anatomy. So, the hips are going to be a little bit wider in the female compared to the male, the inner quadriceps muscle, that part of your thigh muscle on the inner aspect of your knee tends to be a little bit weaker and so, as a result, rotational mechanisms can predispose that ACL, that supporting ligament in the center of the knee joint to actually rupture or pop. One of the things that’s very important is what we call plyometric training. There are a lot of things that can be done to prevent the ACL. I treat a lot of ACL injuries and it would be very rewarding for me to help athletes and active individuals to get back to their sport or activity. But, I think one of the main things that people forget in the conversation about ACL’s is how to prevent it. Plyometrics is a very interesting concept that helps to strengthen muscles. It’s basically, if you think about jumping off of a small platform and if you ever see a commercial where people are training jumping up and down off of a small platform, that’s basically plyometrics. It helps to improve the strength and stability of the knee. Also, using balance training, using those wobble boards or balance boards helps to prevent and strengthen the knee, especially the hamstring, the back of your thigh muscle so that you don’t get that ACL injury in the future.
Melanie: That’s great advice, Dr. Heron. It really is. Plyometrics and getting people to train those muscles so it’s not so subject to injury. If they feel like they have injured it, do they ice it? Do they wrap it? Do they come to see you right away? What do you like people to do if they feel like they’ve sprained or strained their ACL?
Dr. Heron: Most things, when you’re playing in a sport or doing some type of activity, are going to resolve on their own if it’s a sprain or a minor ache. Typically, with an ACL injury, you feel a pop and you know that there’s something wrong. An ACL injury, typically, swelling occurs in the joint the first day. A meniscus tear, which we aren’t really talking about today so much, those tend to swell. They take a few days to swell. With ACL injuries, there’s a pop and you know there’s something wrong. My knee gave out, my knee gave way, “I had to be helped off the field or the court” and it’s very apparent to that individual that there’s something wrong. You want to ice. Ice is going to help get rid of the swelling. You want to use some type of elastic wrap, a compressor wrap. That will help to reduce that swelling. If you can’t put pressure down on your leg, you should have someone help you off the field and seek medical attention right away.
Melanie: When does it require surgery?
Dr. Heron: Well, it depends. Typically, for younger, active individuals, there’s excellent evidence to support surgery to repair that ACL. If someone is not so active and they are walking, well, that might not be a candidate for an operation. Typically, for people 18-35, very active or if that person is very active at 55, that’s someone that is a great candidate for an ACL. I will also emphasize to your listeners that just because you had an ACL, it’s not an emergency. So, we tend not operate on a so-called “hot knee.” So, when the knee is swollen, we want that swelling to come down because it helps to reduce that risk of scar tissue that can form if you go in immediately on a hot knee.
Melanie: We’ve spoken about plyometrics and cross training a little bit, Dr. Heron. Since those ligaments, the anterior cruciate ligament help to control that flexion and that extension of your knee, do you want people doing certain other exercises? Keeping the quads strong and the hamstring stretch? Do any of these things help to prevent these injuries that you see so often?
Dr. Heron: They do. The high intensity plyometric exercises are probably the key in helping to reduce the number of ACL injuries. You really want to perform those exercises at least once a week for a minimum of six weeks. There’s several exercise that you can do. Not just the plyometrics. Balance training and you really want to improve that single leg core strength and stability. That’s the key. When I see athletes, when I see patients in the office and they ruptured the ACL, the first thing I’m going over with them after your surgery, we want to make sure that your other knee is strong, too, so we can prevent that from going out as well. It’s very key. A combination and a lot of the high school coaches and the college coaches, they understand this and many of the newer programs are being integrated as the coaches are working in their warmups. For example, jumping over a soccer ball or landing in the correct position during practice--that’s an example of a plyometric exercise to be incorporated with just the regular practice session.
Melanie: So, in just the last few minutes, Dr. Heron, what should people that might have an ACL injury think about and why should they come to Temecula Valley Hospital for their care?
Dr. Heron: First and foremost, we want to make sure the patient is well taken care of. If you do have an injury, if you feel that pop, if you feel that sudden deceleration activity you want to take care of it. The ACL, the anterior cruciate, helps to prevent further damage in the knee. We call that “meniscus protected”. There are shock absorbers inside the knee and if the knee is wobbly, if it’s loose, then you can get that whole cascade of effects where not only is the ACL torn but the shock absorbers will eventually go as well. So, it’s very important to take care of that ACL. Make sure it’s strengthened. Make sure it’s reconstructed. We have plenty of information on our website www.teamaos.com where it goes into further detail about ACL reconstruction, ACL prevention for the recreational athlete and beyond.
Melanie: Thank you so much. You’re listening to TVH Doc Talk with Temecula Valley Hospital. For more information please visit temeculavalleyhospital.com. The physicians are independent practitioners who are not employees or agents of Temecula Valley Hospital. The hospital shall not be liable for actions or treatments provided by physicians. This is Melanie Cole. Thanks so much for listening.
Training Methods to Prevent ACL Injuries
Melanie Cole (Host): One of the most common knee injuries is an anterior cruciate ligament sprain or tear. Athletes who participate in high demand sports like soccer, football and basketball might be more likely to injure their anterior cruciate ligament or their ACL. My guest today is Dr. Scott Heron. He’s a board certified orthopedic surgeon and a member of the medical staff at Temecula Valley Hospital. Welcome to the show, Dr. Heron. Tell us a little bit about the physiology of the knee and what does the anterior cruciate ligament do?
Dr. Scott Heron (Guest): Good morning, Melanie. Thanks for having me. The ACL or anterior cruciate is a very common injury. Actually, in the United States we see over 150,000 injuries every year. It’s one of the most common injuries that we see and it’s actually very important because if you injure that ACL, if you feel the pop when you’re playing sports or doing an activity, it’s something that you want to be seen for and be addressed immediately.
Melanie: What puts you at risk for an ACL injury? Are there certain people that are more at risk than others?
Dr. Heron: Surprisingly, you would think that ACL injuries are occurring with contact sports that we’d see a higher amount of contact injuries but the majority of those injuries are non-contact types of issues. Sudden deceleration, sudden stop and go on the corridor or the playing field is what we usually see. Women, girls tend to have more injuries than the guys do. One of the things that I work on is education on how to prevent the anterior cruciate injury, especially in the female athlete.
Melanie: Is there a reason that we know of why females and soccer players and young girls seem to be more at risk for these injuries?
Dr. Heron: They tend to be more at risk just because of the anatomy. So, the hips are going to be a little bit wider in the female compared to the male, the inner quadriceps muscle, that part of your thigh muscle on the inner aspect of your knee tends to be a little bit weaker and so, as a result, rotational mechanisms can predispose that ACL, that supporting ligament in the center of the knee joint to actually rupture or pop. One of the things that’s very important is what we call plyometric training. There are a lot of things that can be done to prevent the ACL. I treat a lot of ACL injuries and it would be very rewarding for me to help athletes and active individuals to get back to their sport or activity. But, I think one of the main things that people forget in the conversation about ACL’s is how to prevent it. Plyometrics is a very interesting concept that helps to strengthen muscles. It’s basically, if you think about jumping off of a small platform and if you ever see a commercial where people are training jumping up and down off of a small platform, that’s basically plyometrics. It helps to improve the strength and stability of the knee. Also, using balance training, using those wobble boards or balance boards helps to prevent and strengthen the knee, especially the hamstring, the back of your thigh muscle so that you don’t get that ACL injury in the future.
Melanie: That’s great advice, Dr. Heron. It really is. Plyometrics and getting people to train those muscles so it’s not so subject to injury. If they feel like they have injured it, do they ice it? Do they wrap it? Do they come to see you right away? What do you like people to do if they feel like they’ve sprained or strained their ACL?
Dr. Heron: Most things, when you’re playing in a sport or doing some type of activity, are going to resolve on their own if it’s a sprain or a minor ache. Typically, with an ACL injury, you feel a pop and you know that there’s something wrong. An ACL injury, typically, swelling occurs in the joint the first day. A meniscus tear, which we aren’t really talking about today so much, those tend to swell. They take a few days to swell. With ACL injuries, there’s a pop and you know there’s something wrong. My knee gave out, my knee gave way, “I had to be helped off the field or the court” and it’s very apparent to that individual that there’s something wrong. You want to ice. Ice is going to help get rid of the swelling. You want to use some type of elastic wrap, a compressor wrap. That will help to reduce that swelling. If you can’t put pressure down on your leg, you should have someone help you off the field and seek medical attention right away.
Melanie: When does it require surgery?
Dr. Heron: Well, it depends. Typically, for younger, active individuals, there’s excellent evidence to support surgery to repair that ACL. If someone is not so active and they are walking, well, that might not be a candidate for an operation. Typically, for people 18-35, very active or if that person is very active at 55, that’s someone that is a great candidate for an ACL. I will also emphasize to your listeners that just because you had an ACL, it’s not an emergency. So, we tend not operate on a so-called “hot knee.” So, when the knee is swollen, we want that swelling to come down because it helps to reduce that risk of scar tissue that can form if you go in immediately on a hot knee.
Melanie: We’ve spoken about plyometrics and cross training a little bit, Dr. Heron. Since those ligaments, the anterior cruciate ligament help to control that flexion and that extension of your knee, do you want people doing certain other exercises? Keeping the quads strong and the hamstring stretch? Do any of these things help to prevent these injuries that you see so often?
Dr. Heron: They do. The high intensity plyometric exercises are probably the key in helping to reduce the number of ACL injuries. You really want to perform those exercises at least once a week for a minimum of six weeks. There’s several exercise that you can do. Not just the plyometrics. Balance training and you really want to improve that single leg core strength and stability. That’s the key. When I see athletes, when I see patients in the office and they ruptured the ACL, the first thing I’m going over with them after your surgery, we want to make sure that your other knee is strong, too, so we can prevent that from going out as well. It’s very key. A combination and a lot of the high school coaches and the college coaches, they understand this and many of the newer programs are being integrated as the coaches are working in their warmups. For example, jumping over a soccer ball or landing in the correct position during practice--that’s an example of a plyometric exercise to be incorporated with just the regular practice session.
Melanie: So, in just the last few minutes, Dr. Heron, what should people that might have an ACL injury think about and why should they come to Temecula Valley Hospital for their care?
Dr. Heron: First and foremost, we want to make sure the patient is well taken care of. If you do have an injury, if you feel that pop, if you feel that sudden deceleration activity you want to take care of it. The ACL, the anterior cruciate, helps to prevent further damage in the knee. We call that “meniscus protected”. There are shock absorbers inside the knee and if the knee is wobbly, if it’s loose, then you can get that whole cascade of effects where not only is the ACL torn but the shock absorbers will eventually go as well. So, it’s very important to take care of that ACL. Make sure it’s strengthened. Make sure it’s reconstructed. We have plenty of information on our website www.teamaos.com where it goes into further detail about ACL reconstruction, ACL prevention for the recreational athlete and beyond.
Melanie: Thank you so much. You’re listening to TVH Doc Talk with Temecula Valley Hospital. For more information please visit temeculavalleyhospital.com. The physicians are independent practitioners who are not employees or agents of Temecula Valley Hospital. The hospital shall not be liable for actions or treatments provided by physicians. This is Melanie Cole. Thanks so much for listening.