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Bleacher Report article on reducing ACL injuries

PaulBlakeTSU : 8/27/2015 6:04 pm
Quote:
Sure, some injuries will always, inevitably occur. But the number of non-contact, soft-tissue injuries could easily be cut in half, or even further reduced.

"You can reduce risk [of non-contact ACL injuries in the NFL] somewhere between 50 and 70 percent," according to Dr. Timothy Hewett, director of biomechanics and sports medicine research at the Mayo Clinic, who has researched knee injuries for over 20 years.

This drastic reduction does not involve abolishing preseason games, eliminating joint practices or boxing players in packing peanuts until the opening-day kickoff. All it takes is an open-minded approach to proven medical research, a minor shakeup of the traditional NFL practice routine and maybe a few plastic milk crates.



The Milk Carton Test

Hewett developed a way to screen athletes who were at high risk for knee injuries while conducting research at Ohio State University. The test was based on years of longitudinal studies of incoming Ohio State athletes and local high school football players. The test starts with a one-foot-high box.

"The reason we use a foot-high box is that I would go out to schools and find a plastic milk carton," Hewett said. "I'd put them out there and have a player drop off the box—not jump forward, just drop as if they're landing."

Players were instructed to leap after landing, and Hewett's researchers carefully studied the movement of the legs, thighs and hips. The modern screening test uses high-speed cameras, motion capture and 3-D imaging, but a low-tech approach can be almost as effective if you know what you are looking for.

"Even if you have a simple cellphone, just take a video of it," Hewett said. "You can see, right before landing, the position of how far apart the knees are. If those knees collapse into half or more of that distance, that player is showing what we call 'ligament dominance.'"



Preseason ACL Injuries Can Be Drastically Reduced. Here's How - ( New Window )
I saw that this morning very interesting  
bigblue12 : 8/27/2015 6:28 pm : link
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Great find Paul...thanks for posting  
ChaChing : 8/27/2015 7:15 pm : link
Quote:
Just about every organization, though, is using an outdated training model, one that trades a marked increase in injury risk for a few extra practice reps. And the 2011 collective bargaining agreement, full of limits and restrictions designed to keep players healthy, is almost certainly making matters worse

This is confirmation of a lot of the points we discussed on that other thread (or likely across several). They said biometric asymmetry, our examples were flat foot / patella / form issues, but also mentioned the need for reps, going to full speed on Day 1 without proper lead in / warm up / stretching day-to-day, in addition to nutrition. NYG is one of 15 team working with Catapult so thats good. Yet it's not just being up to speed on the tech, but also being able to implement them (assuming most teams truly are outdated)

The box test is interesting given it's really a simple review of form. Obv they've always checked out prior injuries (Xray MRI etc), but if this article is true those aren't necessarily complete. Also if the 14-15x increased chance of reinjury is true, we almost have to cut bait with prior ACLs. Tho you'd hope these strategies reduce the number and likelihood even with guys with priors injuries

Last bit, it BAFFLES me how turf exists. Millions a year in salary with the expectation of high performance. Yet more than a few heads - from owner to GM to trainers to coaches all of them highly paid 'experts' - do this in pro sports. We've known for decades turf is bad, WTF is so hard? It's par for the course corporate practice to waste money / not give a shit about EEs. Still doesn't it cost way more to your bottom line to deal with all those injuries (ignoring the effect on Ws)? For the life of me I can't imagine anything but short term savings, that too only if you ignore the importance of your EEs health / performance. Maybe I missing something but...
Interesting but not terribly surprising  
Joey in VA : 8/27/2015 7:47 pm : link
The NFL talks a good game in regards to player safety but it's not terribly progressive technologically. It's why you see Surface plastered on sidelines, they allow sponsors to drive them and not vice versa. Too much $ for goal line technology??? I have a way to do it for about 40% of what the current estimates are but it's not approved yet. Even without that technology where the NFL is getting its estimates is beyond me.

This is a league reverting to ideal gas laws to prosecute a QB through a third party stooge who hasn't got a shred of credibility or technical expertise in the area.

That said, again not surprising. Orthopedists can predict a wide range of things from different ratios (Q ratio for instance can predict lower back issues and hip problems) so I'm not surprised some doctor figured this out. The fact that the NFL can't make $ off of this is why it's not brought to light. Concussions were a non issue until faced with a huge lawsuit then all of the sudden the NFL started caring about helmet design and air regulation in helmets. It's a big crooked enterprise owned by filthy rich disconnected boobs who only chase the $. Ligaments will tear until someone sues the NFL for not being able to walk because they failed to provide proper work place safety guidelines (I'd LOVE to see OSHA get involved and shut the NFL down until they do something significant to change the culture of injuries in the work place).
I posted this here a few years ago, look at RGIII doing a broad jump  
BH28 : 8/27/2015 8:49 pm : link



That is such a weak position for your knees. It could be a number of things, weak hips, flat footedness, etc. But the issue is if you don't retrain to put yourself in a stronger knee position (knee out), you are more susceptible to an ACL injury.
RE: I posted this here a few years ago, look at RGIII doing a broad jump  
Upstate_Giants_fan : 8/27/2015 9:25 pm : link
In comment 12439105 BH28 said:
Quote:



That is such a weak position for your knees. It could be a number of things, weak hips, flat footedness, etc. But the issue is if you don't retrain to put yourself in a stronger knee position (knee out), you are more susceptible to an ACL injury.


Those are pretty disturbing pictures in so many ways. And you kept them for years why?

;)
Thats a good pic thanks BH  
ChaChing : 8/27/2015 9:39 pm : link
But thats what surprises me Joey. I understand the $ factor, where from the top down the NFL (or many pro sports) are not interested in anything but revenue. Its the 'big tobacco' example - if they can knowingly be that level of detriment to humanity for profit, the NFL covering up concussion studies or using turf...no biggie

Still you'd think there's a few coaches trainers execs who aspire to be on the cutting edge if only to succeed at their own job and improve team performance. It's often tough to make changes to process but like the turf example it's almost impossible it's NOT worth the cost (assuming that's the big advantage, not sure what else it could be) over long term injury cost & influence on performance as well as players' general well being. They're obv not out to fail but as a collective certain decisions seem contrary to common sense for almost everyone and for $
Am I the only who has no idea what this guy is trying to describe?  
GeofromNJ : 8/27/2015 10:35 pm : link
"'I would go out to schools and find a plastic milk carton," Hewett said. "I'd put them out there and have a player drop off the box—not jump forward, just drop as if they're landing." Players were instructed to leap after landing, and Hewett's researchers carefully studied the movement of the legs, thighs and hips...."
Rg knee  
mattlawson : 8/27/2015 10:41 pm : link
...
Geo.  
CT Charlie : 8/27/2015 11:13 pm : link
Have a guy jump off a box 15-18 inches high and land on both feet. Videotape it.

If, upon landing, he looks knock-kneed (as RG3's do in the video capture above your post), then you conclude that the athlete is at high risk for ACL problems. If the knees naturally stay apart (same spacing as the feet, or wider), then the athlete probably has strong ligaments and good alignment.

I would add that many specialists theorize that the rash of ACL injuries among women basketball players is caused by the knock-kneed inclination due to their relatively wide hips/pelvis. The V-shape of their legs from hip to knee puts excessive pressure on their ligaments and increases their risk of ACL tears, especially when planting to turn or landing after they jump.
I should have added that when the athlete  
CT Charlie : 8/27/2015 11:17 pm : link
jumps off the box and lands, he's also supposed to do a small upward jump -- sort of bouncing once instead of just "sticking the landing."
CT whats the purpose of that extra bounce?  
ChaChing : 8/27/2015 11:41 pm : link
I suppose to see the full range of motion vs an attempted stick which is less natural

Seems to make sense about WNBA / knock knees. I assume bow legs would be an issue as well, tho I think that condition is less common. That aside from any general posture issues given it's unnatural stress on the spine / core
I'm not a doctor or a physical therapist -- just a coach.  
CT Charlie : 8/28/2015 8:31 am : link
But I suspect the trainer/doctor wants to see the athlete's natural alignment both in landing and in taking off. What does the knee structure naturally "want" to do when rebounding -- changing direction, downward to upward?

Presumably an athlete might "stick" the landing with knees apart, even if it isn't his natural or instinctive position. Having him bounce up diminishes the chance that he would make an unnatural move.
This has succeeded in European soccer  
RB^2 : 8/28/2015 9:28 am : link
AC Milan's Milan Lab was a pioneer in this field. For example, they've been doing the box test for over a decade, except their version is slightly different - they just have the player jump up and land from a standing position. They were then able to predict with a high degree of accuracy whether the player was injury-prone or not.

No club in Europe has extended as many careers as Milan with guys like Maldini, Costacurta, Inzaghi and Seedorf playing at a high level well into their late 30s and even 40s. Clarence Seedorf retired just last year and he was on the cover of my world cup guide - in 1998!
Link - ( New Window )
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