Whilst the primary focus of many clients is weight loss or body composition-related goals, it is becoming more and more common to train sport-specific clients. When we consider the female client who participates in sport, research shows a 5-7x greater occurrence of non-contact ACL injuries.
ACL injuries require 9 months of rehabilitation before a return to sport can occur; it is therefore advantageous to employ specific drills, skills and exercises to help prevent the occurrence of such injuries.
Research indicated that the majority of non-contact ACL injuries in females occur through deceleration or change of direction when the lead foot is planted. It is believed that the increase knee valgus observed in females, coupled with tibial rotation, is the main mechanism predisposing females to ACL injuries.
Declaration and change of direction activities are common in most team sports, including football, netball, hockey and rugby to name a few. Any program therefore looking at developing a female client who participates in sport at any level should include work to prevent such injuries.
What Should We Include To Reduce The Risk Factors?
- Hamstring Strengthening exercises – stiff leg deadlifts, deadlifts and Nordic hamstring curls should form the backbone of training programs. It is worth noting that the exercises are only as effective as the client’s form. Too often hamstring work is poorly conducted, negating any possible benefit.
- Plyometric exercises – the ability to have good mechanics on landing and in dynamic motion has been shown as an excellent strategy for preventing ACL injuries. Literature has actually shown reductions of up to 88% in ACL injury rates from neuromuscular training programs.
- Warm ups have been suggested as a good time to train clients in efficient movement patterns. This includes ensuring that female clients are displaying good alignment between the hip, knee and ankle. Including dynamic explosive movements at the end of warm up periods also appears to be an effective period of time to emphasise good knee flexion on landing.
Example Warm Up with Built In ACL Pre-hab
The A portion of the warm up begins to raise the client’s heart rate, activate and mobilise the relevant joints.
- A1. Jog out 30m
- A2. Walking Lunges 30m (focus on alignment)
- A3. Back Squats x 15 (check Glutei strength and level of knee Valgus)
- A4. Hamstring Leg Swings
- A5. Side Shuffle, Squat Position
- A6. Glutei Bridge x 12 (5s isometric hold in shortened position)
The B phase of the warm up continues to activate and mobilise the relevant musculature plus potentiate the body ready for training.
(Repeat A’s x 2)
- B1. Drop Jump into squat landing x 10
- B2. Jog 30m
- B3. 180 degree jumps (focus on soft landings) x 8
- B4. Jog 30m
- B5. 2 foot lateral jump into one foot landing
(Repeat B’s x 2)
The C Phase sees the inclusion of further proprioception drills more focused at preventing ACL injuries.
- C1. Standing single leg balance (20s each side)
- C2. One legged hops x 10 per leg
- C3. Two footed jumps at 45degree opposing angles x 10
(Repeat C’s x 2)
The above warm up can be completed in as little as 10 minutes and is a small sacrifice to pay for a significant reduction in ACL injuries. Once the client has been trained in the warm up process and displays competency, the personal trainer can advise the client arrives early and completes the warm up prior to training, so the time training is maximised.