Preventing Noncontact ACL Injuries PDF

An Introduction to Understanding and Preventing ACL Injury

Timothy Edwin Hewett, PhD, FACSM

Summary

Part I. The Problem of ACL Injuries

Part Editor: Letha Y. Griffin, MD, PhD

Chapter 1. Incidence of ACL Injury

Stephen W. Marshall, PhD; Darin Padua, PhD, ATC; and Melanie McGrath, MS, ATC

Human Movement and ACL Injury

What Is Incidence?

What Is the Average Incidence of ACL Injury in the General Population?

National Ambulatory Care Surveys

Summary

How Does ACL Injury Incidence Vary by Age and Gender?

How Does the Incidence of ACL Injury Vary By Sport and Gender?

Literature Review Methods

Abstraction of Incidence Data

General Results

Synthesis and Commentary

Conclusions

Recommendations for Future Research

Chapter 2. Does ACL Reconstruction Prevent Articular Degeneration? The ACL Risk Equation

Paul H. Marks, MD; Kurt P. Droll, MD, MSc; and Michelle Cameron-Donaldson, MD

Meniscal Pathology

Osteochondral Pathology

Impaired Proprioception

Biochemical Mediators

Summary and Future Work

Chapter 3. The Costs Associated With ACL Injury

Timothy Edwin Hewett, PhD, FACSM; and Bohdanna T. Zazulak, DPT, MS, OCS

Who Pays for ACL Injury Prevention in the High Risk Female Athlete?

Informing the High Risk Female Athlete

Summary

Part II. ACL Injury Prevention Programs

Part Editor: Timothy E. Hewett, PhD, FACSM

Chapter 4. Components of Prevention Programs

Holly J. Silvers, MPT

Chapter 5. Theories on How Interventions May Influence ACL Injury Rates:

The Biomechanical Effects of Plyometric, Balance, Strength, and Feedback Training

Timothy Edwin Hewett, PhD, FACSM; Gregory D. Myer, MS, CSCS; and Kevin R.  Ford, MS

Single-Component Training

Multicomponent Training

Effects of a Comprehensive Program Combined With Either Plyometric or Balance Training Components

Conclusions and Future Directions

Chapter 6. Preventive Training Programs: Changing Strength Ratios Versus Positions of Muscular Efficiency

Sandra J. Shultz, PhD, ATC, CSCS

Thigh Strength

Hip Strength

Core Strength

Summary

Chapter 7. Effect of Prevention Programs on Performance

Christopher M. Powers, PhD, PT; Christine D. Pollard, PhD, PT; and Susan M. Sigward, PhD, PT, ATC

Performance Measure: Vertical Jump Height

Performance Measures: Agility, Strength and Lunge Distance

Performance Measures: Vertical Jump Height, Single-Leg Hop, Speed, and Strength

Performance Measure: Single-Limb Stability

Performance Measures: Balance, Strength, Single-Leg Hop, Triple Jump, and Stair Hop

Summary

Chapter 8. Congruence Between Existing Prevention Programs and Research on Risk Factors and Mechanisms of Noncontact ACL Injury

William E. Garrett, Jr., MD, PhD; and Bing Yu, PhD

ACL Loading Mechanisms and Risk Factors for Noncontact ACL Injury

Current Training Programs

Future Training Program Development

Chapter 9. Discussion, Summary, and Future Research Goals

Lars Engebretsen, MD, PhD

Part III. Biomechanical and Neuromuscular Mechanisms of ACL Injuries

Part Editor: Timothy Edwin Hewett, PhD,FACSM

Chapter 10. Biomechanics Associated with Injury: Athlete Interviews and Review of Injury Tapes

Tron Krosshaug, PhD, and Roald Bahr, MD, PhD

Defining “Injury Mechanisms”

Describing the Inciting Event

Research Approaches to Describe the Injury Mechanisms

Literature Search

Athlete Interviews

Video Analysis

Conclusions

Chapter 11. Clinical Biomechanical Studies on ACL Injury Risk Factors

Laura J. Huston, MS

Background

Kinematic and Kinetic Differences

Jump Landings

Sidestep and Cutting Maneuvers

Muscular Differences

Altered Muscle Activation Patterns

Conclusions

Chapter 12. Effects of Neuromuscular Training on Lower Extremity Motion Patterns

Bing Yu, PhD; and Marlene DeMaio, MD

Combined Training Programs Including Plyometrics

Chapter 13. Sport-Specific Injury Mechanisms Associated With Pivoting, Cutting, and Landing

Mary Lloyd Ireland, MD

Gender Comparisons

Definitions of Mechanism of Injury

Soccer

Team Handball

Basketball

Gender Differences

Conclusions

Chapter 14. Effects of Muscle Firing on Neuromuscular Control and ACL Injury

Timothy Edwin Hewett, PhD, FACSM; Bohdanna T. Zazulak, DPT, MS, OCS; and Gregory D. Myer, MS, CSCS

Introduction

Differences in EMG Activation Levels Between Males And Females

Summary and Conclusions

Chapter 15. Etiology and Mechanisms of ACL Injury in Alpine Skiing

Bruce D. Beynnon, PhD; Carl Ettlinger, MSME; and Robert J. Johnson, MD

The Epidemiology of Alpine Skiing Injuries

ACL Injury Mechanisms Associated With Alpine Skiing

Summary

Chapter 16. Noncontact ACL Injuries in Dance and Skating

Carol D. Teitz, MD

Muscular Control

Shoe-Surface Interface

Center Of Gravity and Proprioception

Choreography

Miscellaneous

What About Gymnasts?

Summary

Chapter 17. The Role of Biofeedback in Preventing Noncontact ACL Injuries

Julie R. Steele, PhD ; and Bridget J. Munro, PhD

The Role of Biofeedback in ACL Injury Prevention

Biofeedback, Neuromuscular Activity, and ACL Injury Prevention

Biofeedback, Knee Joint Motion, and ACL Injury Prevention

The Role of Biofeedback in Preventing ACL Reinjury

Future Directions for Biofeedback and ACL Injury Prevention

Part IV. Hormonal and Anatomic Risk Factors and Preventive Bracing for ACL Injuries

Part Editor: Sandra J. Shultz, PhD, ATC, CSCS

Chapter 18. Ligament Biology and Its Relationship to Injury Forces

James R. Slauterbeck, MD; John R. Hickox, MS; and Daniel M. Hardy, PhD

Relationships Among ACL Injury Factors

Effects of Tissue Remodeling

Sex, Hormones, and ACL Injury

Chapter 19. Hormonal Influences on Ligament Biology

Sandra J. Shultz, PhD, ATC, CSCS

Sex Hormone Profiles: Not all Menstrual Cycles Are Created Equal

Sex Hormones Effects on Collagen Structure and Metabolism

Sex Hormones and Knee Joint Laxity and Stiffness

Menstrual Cycle and ACL Injury

Summary

Birth Control Hormones, Ligament Biology and ACL Injury

Summary

Chapter 20. Anatomical Factors in ACL Injury Risk

Sandra J. Shultz, PhD, ATC, CSCS; Anh-Dung Nguyen, MS Ed, ATC; and Bruce D. Beynnon, PhD

Notch Size and Width

Generalized Joint Laxity

Anterior Knee Laxity

Anatomical Alignment

Conclusions

Chapter 21. Intrinsic and Extrinsic Forces Associated With ACL Injury: Can Functional Bracing Reduce the Risk of ACL Injury?

Bruce D. Beynnon, PhD; and James R. Slauterbeck, MD

The Biomechanics of Knee Bracing

The Effectiveness of Braces in Preventing ACL, ACL Graft, and ACL-Deficient Knee Injuries

Conclusion