Last week we began the discussion to see if this is the position just for professional players or do younger athletes also present with a similar position during non-contact ACL injuries. For this discussion we looked at recent study by Owusu-Akyaw et al which analyzed bone bruise patterns in younger athletes. Based on these results, the dynamic valgus position (flexion, valgus and internal rotation) is a position that results in ACL rupture in male and female athletes under high loads. Based on the results of both of these studies, then it would make sense that we must find ways to assess this in our athletes. To do so, we should look at the literature and see what is currently being used to assess athletes for risk.
One test that is being used to assess athletes for risk is the single leg hop test for distance. During this test, the athlete stands on the leg to be tested. They will then hop as far as possible and land on the same limb. This is repeated on the contralateral limb. This is typically performed three times and the distance is measured for each. Using the average of the three, the assessor is looking for limb symmetry (being equal on both sides) within 85%-90%. The assumption is that if limb symmetry is achieved that the athlete is not at risk. This is a common tool that is being used to assess risk in pre-participation physicals and for return to play following ACLR.
Or, could an athlete perform this test and be 95% symmetrical and still demonstrate the movement patterns shown here. The assumption is that with all of the hop tests (single leg hop for distance, triple hop for distance and lateral hop) that symmetry = good biomechanics. But is this the case? What we see anecdotally is this is not the case.
This is what we see but what does the literature tell us. Next week we will look into this. Make sure to stay tuned. Please make sure to check out our new website at www.iceperform.com where our goal is to help you help others. #ViPerformAMI