Mai et al Am J Sports Med 2018, the authors looked at the impact that an ACL injury has on athletic performance and the length of professional career in NFL, NBA, NHL and MLB players. Not only was NFL players performance decreased for 2 years after the ACL but their professional career was also cut short by 2 years on the average. In a systematic review published by Mohtadi et al Am J Sports Med 2017, their study found similar results. That although most players return to play, performance measures and stats across the board were reduced following an ACL injury. So the obvious question becomes, how do we prevent knee injuries in athletics? So how do you know how your team is going to do? Look at their preseason ACL and knee injuries. In the last 5 years alone, there has been an average of 23 ACL injuries prior to week 1 of the NFL season. 23 ACL injuries occurring in preseason camp. This is more than 1/3 of the ACL injuries that occur during the entire season occur before an official snap has been taken in an NFL game.
Throughout the course of this blog, we provided some thoughts and research on several factors that contribute to altered biomechanics or pathokinematics that put athletes at risk for an Anterior Cruciate Ligament (ACL) injury. In a recent study by Johnston et al Am J Sports Med 2018, they performed video analysis of 156 ACL injuries during the 2013-2016 seasons. What they found was 72.5% of these injuries were non-contact in orientation, meaning no contact with another player or object. This is important because these are the ones that we could potentially impact and reduce. Upon review of the video of each of these non-contact ACL injuries, what they found was the limb was in a dynamic valgus position. As pictured below, this can happen when an athlete plants their foot and cuts to the opposite direction. The limb falling into this position under high loads and high speeds results in a rupture of the ACL.
In the Johnson study, this led the authors to suggest that we need develop programs that create control of these motions under athletic loads. We may think this is isolated for professional athletes, but in a recent study by Owusu-Akyaw et al Am J Sports Med 2018, the authors determined this is the same position the lower limb is in when non-professional high school and college athletes suffer a non-contact ACL injury.
Throughout the history of this blog, we have attempted to correlate these same pathokinematics to not only ACL risk but also to changes in athletic and team performance. The previously mentioned studies further highlight this. In this authors mind, there are two ways in which these injuries impact performance; directly or indirectly.