Researchers believe that incorporating evidence-based prevention methods can decrease the incidence of ACL ruptures, but an understanding of the etiology and mechanisms of sports injury are a necessary to do this (Posthumus, 2009).
The highest prevalence of extrinsic ACL injuries tends to occur in organized sports especially adolescents participating in pivoting type sports such as football, basketball, and team handball (Bahr & Krosshaug, 2005). In addition to any intrinsic factors and adolescent may have, or predisposing factors, environmental factors surrounding organized sports can also play a role in injury. For example, weather conditions (slippery surface), type of surface sport is played on (grass vs. pavement), proper footwear, and protective bracing (Posthumus, 2009).
A growing concern regarding these injuries and the populations that incur them is that these injuries increase the risk of osteoarthritis (Bahr & Krosshaug, 2005). In fact, after ten years, around half of all people that have suffered from an ACL injury show signs of osteoarthritis, and studies show that almost all of these ACL injury sufferers will have osteoarthritis after 15-20 years irrespective of treatment choice (Bahr & Krosshaug, 2005). In preventing osteoarthritis, having good muscle function is key, but it isn't understood very well if reconstructive surgery to repair muscle function is helpful (Ageberg et al., 2008).
III. CARING for, and INJURY PREVENTION in the ACL
There are many intervention programs that are being used in an attempt to reduce the risk of ACL injuries most of which are geared toward addressing neuromuscular function (Grindstaff et al. 2006). For example, plyometrics, strength training, balance training, core training, and stretching are all techniques that are being used to better train the body for sport on muscular strength and neuromuscular level in order to enhance technique with great success (Grindstaff et al., 2006). These training techniques also improve agility and increase awareness of foot and...
However, limited knowledge of injury causation inhibits knowing exactly which training component is the most important in preventing knee and ankle injuries (Bahr & Krosshaug, 2005).
In conclusion, understanding more about possible intrinsic and extrinsic factors that can impact an athlete is crucial in order to develop more effective preventative methods for ACL injuries (Bahr & Krosshaug, 2005). Prevention isn't only about avoiding the high costs of surgery and associated medical costs, it is also about preventing time lost in recovery and away from activities that a person loves, as well as being able to maintain a healthy lifestyle.
In addition to understanding potential risk factors, it is also important to understand the biomechanics of the musculoskeletal system of the athlete who is performing the sport, and the biomechanical demands of the sport (Bahr & Krosshaug, 2005). The factors involved in the athletic event that correlates with the injury needs to be assessed in detail with regards to playing situation, the athlete, the actions of the opponents in the play (Bahr & Krosshaug, 2005). Along with this, an analysis of the body and joint mechanics that preceded the event and were involved in the event at the time of injury occurrence also needs to be evaluated (Bahr & Krosshaug, 2005). In summary, a combination of further scientific studies, good reporting and analysis of injury events and their occurrence will be invaluable to improving injury prevention, and knowing which prevention techniques are best given a set of risk factors, whether they be predisposing risk factors, or extrinsic risk factors.
Ageberg, E., Thombe, R., Neeter, C., Gravare Silbernagel, K., Roos, EM. Patients With Anterior Cruciate Ligament Injury Treated With Training and Surgical Reconstruction or Training Only: A Two to Five-Year Followup. Arthritis Care & Research. 2008; 59(12):1773-79.
Bahr, R., Krosshaug, T. Understanding injury mechanisms: a key component of preventing injuries in sport. Br J. Sports Med. 2005; 39:324 -- 329.
Grindstaff, TL., Hammill, RR., Tuzson, AE., Hertel, J. Neuromuscular Control Training Programs and Noncontact Anterior Cruciate Ligament Injury Rates in Female Athletes: A Numbers-Needed-to-Treat Analysis. Journal of Athletic Training. 2006; 41(4):450…
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