ACL injuries become ridiculously common among athletes from junior high level / high school through professional levels of all sports. My personal thoughts on this issue has much to do with poor training programs most of these children go through. I will not go so in this article, but you want that I want to watch is the best way to prevent knee injuries jumping.
The act of jumping and leaving the floor is not so much the problem. It is that what goes up must come down, and it is not always pretty when it does. mistakenly landing with knees valgus, is a major cause of ACL injuries. Knee hyperextension is another common cause of injuries, but is a little different animal. Hyper Extension injuries are often the result of an inability to control the knee during deceleration so that the body tries to remove the bending of knee fast and ends above the correction in hyperextension. With these noncontact injuries, poor strength is usually at the root of the problem. This article examines the strength training as a way to fight against ACL injuries
Landing effectively involves all of the following :.
- Landing on the balls of the feet push into the heels
- Knees aligned with the medium to outside foot - vs buckling knees (valgus position)
- the hips are back absorption strength - this will improve performance as well if the landing is followed by another jump or sprint any direction
- Slight forward lean of the trunk with the back flat
Basically, it is a good squatting!
many jump programs focus on landing with correct technique but 't address the ability to get in the safe landing position. If an athlete does not have the mobility or strength to get into a position for landing safely with just body weight, how are they ever to do so when the forces are higher? When fighting an opponent for a rebound? What if they happen to land on one leg? You get the point
Looking at the biomechanics of the landing, the following are required :.
- ankle mobility - specifically Dorsiflexion
- Hip mobility and stability
- core stability
- Thoracic spine and shoulder of the mobility and stability - especially for athletes who must go head (rebound, blocking, spiking, serving, etc.)
here where things get complicated. Most coaches and trainers have no idea how to accomplish all of the above, if one or more fails in their athlete (s). Unfortunately, many therapists and athletic trainers there are not quite sure either. Of course, we can mobilize their ankles, working the heart and hips, but how can we put it all together in a way that functional fate. All of the above might be wonderful on the base, but what about when the athlete tries to squat? Many just fall into ½ to ¾ of the way down. You would not believe how many times I heard it, "my therapist / trainer said parallel squat was bad for my knees." Of course, it is still wrong. It is great for them when they learn to do it the right way, and that is what will protect the LCD competition and training.
I do not say that the work on the ankle and hip mobility, core stability, etc. isolation is a bad thing. These things have their place and I have my favorite techniques as well, but they need to be incorporated into the actual activity of squatting. My next article will discuss post-ACL rehab and discuss pre-squat strategies.
The 'Squat Progression' is a technique used as a corrective exercise as part of the functional movement screen, and was first introduced in "Athletic Body in Balance" Gray Cook. This exercise Address each of the bio-mechanical factors listed above while a series of movements
The athlete starts with entering a hamstring stretch and presses the medicine ball to engage the abdominals. It is OK to bend the knees to get palms the ball if necessary. Hold the stretch 10 seconds then drop the hips in a deep squat position. the athlete must continue to try to crush the ball, but it will become much more difficult because he / she falls. in the lower position, the athlete then removes one hand of the ball, turns his head and reached with his arm for 10 seconds. Follow this by reaching with the opposite arm. the movement is finished the athlete takes both arms over and over. the athlete will repeat this increased three times, and then make three deep squats with overhead weapon (feet still on the elevator). Gradually increase the athlete to a smaller elevator and the floor.
the ' squat stretch 'is another exercise I will use when I do not have the equipment available, especially when in the field or in the gym before training sessions. The most basic form of stretching is to start with the feet slightly more than shoulder width apart and facing straight ahead. The athlete goes into a stretch hamstring for 10 seconds by placing hands under the ball inside the foot. Knees are allowed to bend to get into this position if the length of the thigh is a problem. The athlete then falls hips in a deep squat position keeping your elbows between the knees. The goal is to descend below the thighs parallel to the floor with knees apart, feet always pointing straight, and the head and chest up. Hold the stretch for 10 seconds.
common difficulties with any of these exercises include one or both feet turn out, lose balance to the rear, and the inability to get the head and chest up. The athlete may not be able to reach the full depth right away with a great technique but work with it.
Fall squats are an advanced progression of the exercises, and train the athlete to get into position quickly and the ability to slow work. From a standing position, the athlete falls into the deep squat position holding the technique described above. Arms forward is the easiest place to start. Taking the arm above increases the challenge. Arms can be taken from one side or the other to add a rotational force, and further difficulty can be added up with a medicine ball.
A full deep squat is rarely going to be needed in sports, but in order to reach this position with only body weight is important. The deep squat capability gives a "buffer zone" when the forces becomes higher than the landing from spiking a volleyball, making a tackle, or fight for a rebound.
Now, what happens when the athlete must land on one leg?
Landing on one leg still requires a lot of ankle and hip mobility as does land on both feet, but the stability requirements are much more. hip muscles must work harder to absorb the force during landing and to prevent the femur to get into a valgus position creation and knee internal rotation adducts. core stability is also essential to ensure proper alignment of the lower body and maximum protection of the knee.
Training for single leg landing must first start with the strengthening of this model. The single leg squat is the best exercise available to answer the strength of the lower body and trunk and stability with retained athletics and landings at specifically single legs. When done correctly, there is no better exercise to activate the glute medius and maximus to control the internal hip rotation and adduction. Learn to keep steady bottom end, a slow and controlled movement as the single leg squat will go a long way toward preventing ACL injuries.
The most basic form of the single leg squat involves the athlete sitting hips as he / she sat down on a chair and then standing back up. The trunk should be tilted forward and the arms to reach forward to help offset the movement. The supporting leg not of weight should be achieved before. There are several ways to progress this exercise, in particular to increase the depth of the squat and maximize hip and trunk stability.
- Start with a target such as a bench or chair. Sit all the way back and down to the surface in a controlled manner. Lean forward and step back, still on one leg.
- Continue to use a target, but now just slightly touch the surface rather than sitting all the way down.
- gradually decreases the height of the target until the thigh is parallel to the ground. Some of my athletes will break in parallel, but must keep the knee control (what I will do in a minute).
- Add weight holding small dumbbells or a medicine ball in the hands outstretched. A weighted vest could also be increased to increase the load.
- positions change hands. Take the right arm or left, even in front, but always work to maintain proper alignment of the knee.
In the video, I show another advanced progression of the exercise using a neuromuscular training (NRT) reactive technique called "forced pronation." A small corner is under the outside foot to create greater pronation and internal rotation / adduction of the femur. The athlete must fight this position as he or she crouched activation of the ankle and hip to correct the growing muscles. I really used it with rising athletes before returning to their sport.
Now it's time to take a step further and incorporate plyometric exercises in ACL prevention program.
Plyometric training involves faster movements, more explosives, such as jumping exercises to develop speed and power. These exercises can vary from low to high intensity intensity depending on a number of factors. In this situation, the work of low intensity is ideal to start and gradually increase the number of jumps, distance, etc that the technique improves. Jumping and landing with both feet come first, but here I will focus on single leg exercises.
Technique, as always, is critical with these exercises. Here are some things that the athlete needs to think about during the exercises:
- land on the ball of the foot and then sink in the heel
- lands quietly - it means the muscles do the work, a hard landing indicates joints take charge
- land in the single leg squat position - hips are back, the knee is in line with the outside foot, plus the best
clarification is also needed with regard to the designation of the exercises. The term "leap" in terms of plyometric training means going to two feet and land on both feet. drills 'inclusive' involve jumping leg and landing on the other. "Hopping" is to jump and land on the same leg.
I want to emphasize that the athlete should be able to do 10 good squats one leg on each leg before starting plyometrics part of the training. Many athletes, especially women, high land and increasingly difficult risk of injury. I mentioned at the beginning to have a "buffer" zone. The athlete will not normally grounded in a deep squat position one leg, but the ability to do so in a controlled situation means they adapt better unless landings ideals in the game and practice situations.
bounding side - stick the landing: the athlete is standing on the right leg, jumps to the left landing on the left leg. Land on the ball of the foot and sink into a crouch low single leg. Balance 2-3 seconds and the correct position of the knee if necessary before jumping to the right. Start with a total of 10 reps focusing on technique. Gradually increase the height and distance as long as the technology remains strong. This same type of drilling can be done jumping forward, forward and diagonal (45 °), and back and diagonal (45 °).
bounding side - stick 1-2-3: same idea as above, but now the athlete defines three times before sticking the landing in the single leg squat position. This can also be done jumping forward, forward and diagonal (45 °), and back and diagonal (45 °). Five total repetitions.
Single Leg Hopping - stick the landing: the athlete stands on the right leg, jumps and lands on the right leg again try to get in a ½ to ¾ single leg squat position. This can be done before (easier), side and rear (most difficult). When lateral jumps, make sure to go in both directions. Standing on the right leg and left break will be more difficult than jumping right. Stick the landing still 2-3 seconds and work to control the position of the knee. 6-8 reps
Single Leg Hopping - 1-2-3 stick :. Same jumps as above, but now the athlete must jump three times before sticking the landing. 3 max reps for each leg in each direction.
To make things harder, I'll often use 6 "and 12" barriers as obstacles to force the athlete to get more height or distance. Always start with the 6 "obstacles and only move to 12" if the technique remains perfect. If the athlete is fighting to clear the obstacle, he or she will not land correctly.
Reach the arms is another way to challenge the control of the athlete during landing. Hold a basketball or a small medicine ball head or side during these exercises will challenge the trunk and lower limbs.
Sports are unpredictable at best to train for every possible scenario. Work on mobility and hip force to achieve a deep squat, increase single leg strength and learn to control the knee, and then add more strength with plyometric exercises to prepare your athletes for return to sport .
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Joe Heiler PT, CSCS
Joe Heiler MSPT is the owner and manager of content SportsRehabExpert.com, a website dedicated to advancing education rehabilitation and performance professionals. The site focuses on orthopedic and sports physical therapy subjects through webinars, audio interviews, articles, manual therapy and exercise videos, and more.
Joe is also the owner of Elite Performance Physiotherapy and Sports in Traverse City, MI specializes in orthopedics and sports medicine, as well as training of athletic performance. It is Graston Technique (GT) and a certified instructor GT SFMA FMS and trained, and is passionate about a number of soft tissue and manual techniques, including Trigger Point Dry Needling and manipulation.

Latest posts of Joe Heiler PT, CSCS (view all)
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