Compared to males, female athletes are at a higher risk of suffering an ACL injury. Genetic factors such as wider hips, quad dominance and even hormones all play a role in this issue. But rather than accepting it as a fact of life, you can take action and prevent an ACL injury from occuring.
The following four tests allow you to assess potential weaknesses, imbalances or mobility issues that may put you at risk for an ACL injury. Take the time to find potential problems and address them to make your knees more durable.
1. Overhead Squat with Bar
Using a simple dowel rod or PVC pipe, hold a bar directly overhead with your elbows straight and lower into a deep Squat. This movement assesses symmetry and mobility at your shoulders, thoracic spine, hips, knees and ankles. Certain deficits cause compensation patterns that worsen your strength and mobility and reinforce poor biomechanics, and may lead to an ACL injury.
Your pelvis may tuck under when Squatting this deep. If it does, you don't necessarily have an issue. It's possible that your pelvis does a butt wink, and Squatting deep will not be your thing.
Minimum requirement: The bar is over top of your head and you're able to Squat until your hamstrings touch your calves with your feet firmly planted on the ground.
How to correct: If you can't keep your feet firmly planted, you lack dorsiflexion. Stretch your large calf muscle and strengthen your anterior tibialis muscle by performing Seated Toe Raises. If your hamstrings don't reach your calves, time to pop a Squat and hold it for more than 30 seconds (with proper form). The time under tension will eventually improve your strength. Once it does, start doing some Deck Squats to strengthen your hips and knees while in deep flexion. Check out the video player above to see a demonstration of the Overhead Squat from strength and conditioning coach Todd Durkin.
2. Forward Lunge
Put both hands behind your neck, keep good posture and lunge forward, keeping your feet in line with each other. This tests for balance and stability, which are critical for keeping your knee strong and stable.
Minimum requirement: Lunge all the way down until your back knee is 2 inches above the floor, then return to standing without losing your balance or allowing your front knee to rotate or shift out of alignment.
How to correct: If your knee rotates inward, you probably have weak glute muscles. Perform Clam Shells and Band-Assisted Side Lunges.
3. Partner-Assisted Glute Ham Raise
While on your knees, have a partner hold your feet to keep them from moving. Slowly lower your torso all the way forward to the floor without breaking at the hips. If you struggle with this exercise, your hamstrings may be weak, which is a precursor for ACL injuries.
Minimum requirement: Lean forward all the way to the floor without falling or breaking at your hips.
How to correct: The test is the fix in this case; simply integrate the movement into your program. If it's too difficult to perform, start with Glute Bridges and Single-Leg Glute Bridges, and gradually progress.
4. Depth Jumps
While standing on a 24- to 36-inch box, drop down to the floor and land in an athletic, bent-knee stance. Landing technique indicates if you have the proper biomechanics to land from a jump or decelerate into a cut—two common causes of ACL injury. Check out Dwyane Wade demonstrating proper form for Depth Box Jumps in the video player above.
Minimum requirement: Land without your knees caving in or shifting forward.
How to correct: Poor landing technique indicates glute weakness or poor core stability. Perform Clam Shells. For core stability, try doing Planks or Ab Wheel Rollouts.
If you can complete each of these exercises without any problems, congratulations. Your knees are durable and you're less likely to experience a non-contact ACL injury. If you have trouble with any of these exercises, it's time to get to work. A little time in the gym beats six to nine months of rehab after surgery.
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