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ACL Prevention Strategies Part III

 


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In the second part of this series, I discussed preparing to land on one leg. It's not a perfect world so the ideal two foot landing is not always practical. The single leg squat exercise is a great way to develop the strength and control needed to land in a protected position no matter the situation. Now it's time to take it a step further and incorporate plyometric drills into the ACL prevention program.

Plyometric training involves quicker, more explosive movements, such as jumping drills, to develop speed and power. These exercises can range from low intensity to high intensity depending on a number of factors. In this situation the lower intensity work is ideal to start and gradually increase the number of jumps, distance, etc as technique improves.

Technique is critical with these exercises. Here are a few of the things the athlete needs to think about during the drills:

  • land on the ball of the foot then sink into the heel
  • land quietly - this means the muscles are doing the work, a hard landing indicates the joints are taking the load
  • land in the single leg squat position - hips are back, knee is in line with the outer foot, the deeper the better.

Some clarification is also needed when it comes to naming the exercises. The term ‘jump’ in plyometric training terms means to go off two feet and land on two feet. ‘Bounding’ drills involve leaping off one leg and landing on the other. ‘Hopping’ involves leaping and landing on the same leg.

Let me also stress that I want the athlete to be able to do 10 good single leg squats on each leg prior to beginning the plyometric portion of the training. Many athletes, especially females, land high and hard increasing the risk of injury. I talked in part I about having a ‘buffer’ zone. The athlete will not normally have to land in a deep single leg squat position, but the ability to do so in a controlled situation means they will adjust better to less than ideal landings in game and practice situations.

Lateral Bounding - stick the landing: the athlete stands on the right leg, leaps to the left landing on the left leg. Land on the ball of the foot and sink into a low single leg squat position. Balance 2-3 seconds and correct knee position if needed prior to bounding back to the right. Start with 10 reps total emphasizing technique. Gradually increase the height and distance as long as technique remains strong. This same type of drill can be done bounding forward, forward and diagonal (45 deg), and backward and diagonal (45 deg).

Lateral Bounding - 1-2-3 stick: same idea as above, but now the athlete bounds three times before sticking the landing in the single leg squat position. This can also be done bounding forward, forward and diagonal (45 deg), and backward and diagonal (45 deg). Five total repetitions.

Single Leg Hopping - stick the landing: the athlete stands on the right leg, leaps and lands on the right leg again trying to get into a 1/2 to 3/4 single leg squat position. This can be done forward (easiest), lateral, and backward (most difficult). When hopping lateral, be sure to go both directions. Standing on the right leg and hopping left will be more difficult than hopping right. Stick the landing 2-3 seconds again and work to control knee position. 6-8 reps.

Single Leg Hopping - 1-2-3 stick: same hops as above but now the athlete must hop three consecutive times before sticking the landing. 3 reps max each leg in each direction.

To make things more challenging I will often use 6" and 12" hurdles as obstacles to force the athlete to get more height or distance. Always start with the 6" hurdles and only progress to 12" if technique remains perfect. If you struggle to clear the hurdle, you will not land correctly.

Reaching with the arms is another way to challenge the athlete's control upon landing. Hold a basketball or small medicine ball overhead or to one side during these drills to challenge the trunk and lower extremity.

Sports are unpredictable at best so train for every possible scenario. Work on mobility and hip strength to achieve a deep squat (part I), increase single leg strength and learn to control the knee (part II), and finally add more force with plyometric drills to prepare yourself for your sport.

Joe Heiler PT, CSCS is a physical therapist specializing in sports medicine and orthopedics in Traverse City, Michigan. As a certified strength and conditioning specialist he has worked with athletes at all levels improving speed, power, and strength. Check out more great articles, exercise videos, audio interviews, and more from top physical therapists, athletic trainers, and sports performance coaches at http://www.sportsrehabexpert.com

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