Anterior Cruciate Ligament Injuries

anterior cruciate ligament injury tear

What’s up ? This is THE stephane ANDRE. With my training, I’m interested in biomechanics to avoid injuries. I read « Sport Medicine Media Guide » and I learned some good stuff.

Knee is the largest and most complex joint of the body. There are 4 primary ligaments (with their muscles and tendons) and secondary ligaments for the knee to function properly. Here are the ligaments of the knee : there are 2 ligaments on the side the medial collateral ligament (MCL) and the lateral collateral ligament (LCL) and two crossed ligaments in the center of the knee, the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL).

Anterior cruciate ligament connects the front top part of the shine bone to the back bottom part of the thigh bone and keeps the shin bone from sliding forward.

anterior cruciate ligament

Injury

anterior cruciate ligament injury tear

There are several ways to have an injury to the anterior cruciate ligament :

  • The injury can be done because of a direct hit on the knee, which often happens in team sport.

  • The injury can be done without contact with an object in a situation where the knee forced to be in a abnormal position, which causes a tear in one or more ligaments of the knee. Or when an athlete in the race change direction. Or when an athlete make a hyperextend of the knee when landing a jump, which often happends in agility sports.

Diagnostic

In the majority of cases, the doctor is able to identify what is the injured ligament. But the knee can also be injured at the joint on the surface and in this situation, it’s more difficult to diagnose because of knee swelling. To make an accurate diagnosis, it will be necessary to use a MRI scan or arthroscopy.

Prevent

There are several fast, powerful movements that lengthen (eccentric phase) and shorten (concentric phase) a muscle. These prevention programs are for injuries without contact. These exercises are to improve the nerves/muscle control of the knee. These prevention programs use plymetrics, balance and strength/stability exercises.

Plymetrics

It’s a fast, powerful movement that lengthens (eccentric phase) and shortens (concentric phase) a muscle. The concentric phase increases the muscle power. Here is an example, an athlete who jumps from a box and immediately jumps into the air after touching the floor.

Balance

Balance exercices are done with the wobble or balance board. It’s also possible to perfom exercices by throwing a ball with a partner while balancing on one leg.

Strength/stability

To improve single-leg core strength and stability, there are excellent exercices such as jumping and landing on one leg with the knee flexed and momentarily maintaining this position.

Surgical treatment

In the past, there was a technique that consisted of stitching the ligament together but it was rarely successful. Currently, the technique involves reconstructing the anterior cruciate ligament by building a new ligament from tissue taken from one of the other tendons around the knee or from on organ donation. This tissue passed through drill holes in the thigh bone and the shin bone, and then ancored in place to create a new anterior cruciate ligament. Over time, this transplant becomes mature and becomes a new living ligament in your knee.

Recovery

recovery

Rheabilitation of the knee after the reconstruction of the anterior cruciate ligament requires time and work. To have a complete function, this can last between 6 weeks and 6 months depending on the severity and level of activity. Rehabilitation rate may take time depending on the specific requirements of the sport/physical activity of the individual.

The overall success rate of the anterior cruciate ligament surgery is very good. A lot of study show that more than 90% of patients are able to return to sport without symptoms of knee instability. It’s true that some patients complain of stiffness and pain after surgery, that is why it’s necessary to make an aggressive rehabilitation until the new surgical technique to reduce these problems.

Statistics

  • One of the most commonly injured ligament in the knee

  • Female athletes participating in basketball and soccer are 2-8 times more likely to suffer anterior cruciate ligament injury.

  • Athlete who suffer anterior cruciate ligament injury at increased risk of arthritis development later in life.

Subscribe to my newsletter and share this article if you think it can help someone you know. Thank you.

-Steph

Deadlift Correctly (Part 2)

deadlift

I you didn’t read the Part 1, click here

I read an Nerd Fitness article  and I learned good stuff.

Setup

As you know, there are several versions of deadlift that can match your training goals or your body type but the conventional deadlift is great for starting to learn the basics.

Attention : It’s important to do 1-2 sets warm-up with the barbell without weights. As with squat, this warm-up allows you to prepare joints and muscles.

  • Adds weights and uses collars for safety

    If you’re a beginner, only use 2-26-4.6kg (5-10lbs) plates to make easy to adjust the weights on the barbell. When you have better understood the movement and how your body reacts you can use plates of 20kg (45lbs).

  • Stand with your feet at the width of your hips

    The spacing of your feet is about 20-30cm (8-12 inches) and your toes are slightly outside about 5-10 degrees.

  • Look at the ground

    Place your feet under the barbell so that the barbell almost touches your ankles. The barbell must be on the node of your laces

  • Without moving the barbell or your hips

    Lean forward to take the barbell. Your legs are slightly bent. Your hands should be slightly outside your legs without touching them.

  • Hold the barbell

    Move your hips down so your shins touch the barbell. Stop moving your hips when your shins touch the barbell. Squeeze your torso and keep your back straight to have your back in a neutral position.

  • Your back in a neutral position

    Your back shouldn’t be rounded or hyper extends. If you feel like you don’t have your back in a neutral position, don’t hesitate to ask a friend or a gym’s member to make a video of you with a smartphone while you’re doing deadlift. This will allow you to correct your technique.

    In addition to your spine, uses the upper back’s muscles to help to lift your chest up (swagger).

    Your shoulders should be slightly in front of the barbell and your arms should be straight and perpendicular to the ground.

As each person has unique body, the person next to you will have a different starting position than you and this is normal. Think about it : if a person has long arms, will this person have exactly the same position as a person with short arms ? No.

Deadlift

deadlift movement

  • Ready to lift

    Be focus and squeeze all your body’s muscles

  • Deep breathing

    Take a deep breath and keep your chest up with all your body squeezed ant put all the weight on your heels and on the ball of your feet.

    Imagine driving your feet through the ground.

Here are the important points in this part of the movement :

  1. All the weight must be on your heels and on the ball of your feet. During the movement, you should be able to move your toes.

  2. Your whole body moves slowly at the same speed. Your butt shouldn’t get up faster than your torso.

  3. Be focused on directing your torso and putting the weight on your heels.

  4. Your arms should stay straight during the movement. Your arms only serve to hold the barbell, not pull it.

  5. The barbell stay in contact with all your body. The barbell is a few millimeters from your legs while your lift it. Powerlifters put socks on their shins and chalk or baby powder on their thighs to avoid cuts and scratches The barbell’s trajectory during the movement is a vertical straight line.

  6. Squeeze your glutes. When the barbell goes over your knees, squeeze your glutes to move your hips forward.

  7. When you stand, open your chest as if you’re proud (like a king/queen). Keep your spine in a neutral position (straight back) and all your body tight.

To lower the barbell

As with lifting the barbell, all your body needs to move at the same time.

Your body is always contracted, unlocks your hips and knees and lower the barbell by controlling the movement slowly.

If you unlocks your knees first, you’ll do weird movements that will force you to round your lower back.

deadlift low back rounded

Keep your body contracted until the barbell touches the ground. The majority of deadlift injuries appear during the descends of the barbell. People are so pleased to have lifted a heavy weight that they relax their bodies and lower the barbell with poor technique. It’s important to control movement with your contracted body throughout exercise.

Note

In deadlift the most risky moment is the eccentric part (descending the barbell). This is the part that will give you the most DOMS (delayed onset muscle soreness).

That’s why several personal trainers advise their athletes to throw the barbell on the ground, especially for athletes who must be at 100 % for a competition in a few days.

Share this article if you think it can help someone you know. Thank you.

-Steph