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

Hanging Leg Raises

hanging leg raises

What’s up ? This is THE stephane ANDRE ! I read a Frederic Delavier’s book « Strength Training Anatomy » and I learned good stuff.

Suspended on a chin-up bar :

  • Inhale and back up your knees as high as possible by approaching your knees to your torso.

  • Exhale at the end of the movement

This exercise works :

  • The iliopsoas, rectus femoris, tensor fasciae latae when you raise your legs.

  • The rectus abdominis and a little less obliques work when you move your knees to your torso.

To target the work on abs, it’s advisable to make small oscillations of thighs without never having the knees below the horizontal.

Attention

Rotations of the torso to the machine are proscribed for people suffering from low back or having already had a herniated disc.

Variant

hanging leg raises variant

By raising your knees on the side alternately to the right and to the left, obliques work more intensely.

Abdominal lumbar balance

It’s necessary to work in a balanced way the abdominal’s muscles and the back’s muscles (erector spinae). A lack of tone of hypertonicity of one of these two muscle groups can create a bad posture, and over time, create pathologies.

Example

Hypertonicity of the lower part of the erector spinae (sacro lumbar mass) with a hypotonicity of the muscles of the abdomen, will create a hyperlordosis with an abdominal ptosis. This postural defect can sometimes (if it is taken in time) be diminished by exercises of reinforcement of the abdominal muscles.

Conversely, hypertonicity of the abdominal muscles with loosening (hypotonicity) of the erectors spinae, especially in the upper part (multifidus spinae, longissimus, iliocostalis), will create a kyphosis (rounding back ) with loss of lumbar vertebral arch. This postural defect can sometimes (if it taken in time) be diminished by exercises of reinforcement of erectors spinae muscles.

Hypertonicity erector spinae muscles lumbar vertebral arch Hypotonicity abdominal ptosis

Kyphosis Hypotonicity erector spinae muscles lumbar vertebral arch Hypertonicity abdomen

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

-Steph

Machine Crunch

machine crunches

I read a Frederic Delavier’s book « Strength Training Anatomy » and I learned good stuff.

Sitting on the machine with your hands holding the handles. Your feet wedged under the pads :

  • Inhale and round your back to bring your torso to your thighs.

  • Exhale at the end of the movement

This exercise is excellent because it allows you to adjust the weight relative to your level. You can use lightweights if you’re a beginner or heavyweights, without risk, if you’re an athlete.

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

-Steph

High Pulley Crunch

high pulley crunches

I read a Frederic Delavier’s book « Strength Training Anatomy » and I learned good stuff.

Kneeling with the bar behind your neck :

  • Inhale and round your back to bring your torso toward your thighs

  • Exhale at the end of the movement

rectus abdominis

This movement is never done with heavyweights. The goal is to focus on the sensation to better target the work on abs and mainly rectus abdominis.

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

-Steph

Abs Stretching

abs stretching anatomy

What’s up ? This is THE stephane ANDRE ! I read a Frederic Delavier’s book « Strength Training Anatomy » and I learned good stuff.

Lying on your stomach on your hands with your arms extended :

  • Straighten up your chest slowly by tilting your head back slightly

  • Maintain this position for few seconds while breathing slowly to feel the stretching of your abs.

Variant

It’s possible to make this movement with your hands on a bench and your feet on the floor, or you’re lying on your back on a big ball (Swissball).

Note

Stretching of abs can be an important element in some sports like throwing sports, especially the javelin. In this type of sports, it’s essential to have good flexibility and a good abdominal amplitude to make the movement perfectly.

Attention

Abs stretching are to be avoided in case of lumbar pathology.

different pelvis position man woman anterior superior iliac spine pubic tubercle anatomy

abs pregnant woman child belly weight antomy

Note

The position tilted forward (anteversion) of women’s pelvis allows a portion of the child’s weight to be transferred to the abs. By analogy, abs muscles can be compared to a « hammock ».

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

-Steph

Gym Ladder Sit-Ups

gym ladder sit ups

I read a Frederic Delavier’s book « Strength Training Anatomy » and I learned good stuff.

Hook you feet in the gym ladder with your thighs vertically. Your back to the floor and your hands behind your head :

  • Inhale and raise your torso as high as possible by rounding your spine.

  • Exhale at the end of the movement.

This exercise mainly works rectus abdominis and a little bit internal and external obliques.

rectus abdominis

abs muscles anatomy

It’s good to know that farther is your torso from the gym ladder and hook your feet lower, this increases the mobility of the pelvis. This allows a greater range of motion and works more flexors muscles of the hips (iliopsoas, rectus femoris and tensor fasciae latae).

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

-Steph

Crunch

crunch

I read a Frederic Delavier’s book « Strength Training Anatomy » and I learned good stuff.

Lying on your back with your hands behind your head. Your thighs vertical with your knees bent :

  • Inhale and lift your shoulders off the floor by bringing your knees closer to your head by rounding your back.

  • Exhale at the end of the movement

This exercise works mainly rectus abdominis

To work more intensively your obliques, you can bring alternately your right elbow to your left knee and your left elbow to your right knee.

crunch

crunch bench

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

-Steph

P.S. If you’re in Miami and you like Caribbean food, go to my cousin’s bistro to eat Haitian food. Click here