Dr. Nessler shares his calling and passion for injury prevention and performance enhancement using the most current research and technologies available. As a passionate educator, he is driven to share with all the latest peer reviewed journals in sports medicine and orthopedics and what that means to how we train and treat our athletes.
Monday, April 30, 2018
Does Previous Knee Injury Impact Performance & What Can We Do About It? - Part IV
Throughout the course of this blog series we have been
discussing if a previous knee injury impacts We believe the answer to this question is
pretty clear that yes, previous knee injury does impact current and future
performance.We know this to be the case
in Division I athletics (Rugg et al Am J Sports Med 2014) and in professional
athletics (Mai et al Am J Sports Med 2017).We also know that football players are impacted to a greater degree than
basketball players and hockey players respectively.We further discussed what the literature
indicates what we should be assessing to prevent these injuries (Johnson et al
Am J Sport Med 2018) and whether or not fatigue plays a role in injury.
This is all great information to have but if
we don’t know what to do with this information or more importantly how to
impact it, what does it matter?In this
week’s blog, we will dive into that question.What can we do about it?
future athletic performance.
In this discussion, we will look at two different recent
studies.The first looking at whether or
not injury prevention programs truly impact injury rates.Lopes et al Am J Sport Med 2018performed a
systematic review with meta-analysis on whether injury prevention programs
impact biomechanics of landing tasks.
The Effects of Injury Prevention Programs on Biomechanics of Landing
Tasks: A Systematic Review with Meta-analysis.
Synthesize the evidence on the effects of injury prevention programs on landing
biomechanics as they relate to ligament, quadriceps, trunk and leg dominance
theories associated with ACL risk.
Methods:Six databases were searched for studies that
investigated the effects of injury prevention programs on landing tasks
biomechanics.Prospective studies that
reported landing biomechanics at baseline and post IPP were included.
Results: 28 studies met the criteria which included a total of
466 participants.Most studies
Young female athletes
Bilateral landing tasks
Factors that improved after implementation of injury
prevention program include:
Peak knee abduction moment decreased
Hip flexion angles at initial contact increased
Peak hip flexion angles increased
Peak knee flexion increased
Peak knee flexion moment decreased
Conclusion/Discussion:Based on the results of this systematic
review, the exercises used in injury prevention programs might have the
potential to improve landing biomechanics.Peak knee abduction moment decreased which indicates that injury
prevention programs influence a desired movement strategy.This may help athletes overcome movements
which result in excessive frontal plane motion of the knee resulting in
dangerous ligament loads.The results of
this study lead the authors to further suggest that the results of these
programs may be enhanced when they are developed based on the athlete’s
baseline profile deficits.
Based on this current systematic review as well as previous
literature, we know that injury prevention programs can have a significant
impact on biomechanical risk factors.That said, it would seem logical that some may work better than
others.We know from the previous
Johnson et al study discussed in the previous portion of this series that we
should be assessing the ability to control dynamic valgus in single limb
performance.Based on this, it would
make sense that programs that focus on controlling this frontal plane motion
would be more effective.So, next week
we will dive into that by taking a look at the by Omi et al Am J Sports Med
2018. Also, please make sure to check out our new website at www.iceperform.com where our goal is to help you help others. #ViPerformAMI
Dr. Nessler is a practicing physical therapist with over 20 years sports medicine clinical experience and a nationally recognized expert in the area of athletic movement assessment. He is the founder | developer of the ViPerform AMI, the ACL Play It Safe Program, Run Safe Program and author of a college textbook on this subject. Trent has performed >5000 athletic movement assessments in the US and abroad. He serves as the National Director of Sports Medicine Innovation for Select Medical, is Vice Chairman of Medical Services for USA Obstacle Racing and movement consultant for numerous colleges and professional teams. Trent is also a competitive athlete in Brazilian Jiu Jitsu.