Knees and Better Brakes (107)

As I sipped at a fresh mug of coffee a young woman crutched her way past with a couple of friends. She needed the crutches due to the large knee brace on her right leg. I assumed that there was ACL ligament damage or surgery without knowing the actual history. If it was, such injuries can be life changing or career ending or all activity ending. I assumed the ACL ligament because it is in the news these days, particularly with female athletes. Actually, the issue and its gender diff’s have been in the medical journals for some time. These are reported injuries that make it to the hospital…how many other people have knee injuries and simply stop doing the activity?
The ACL is a critical knee ligament and like other ligaments does not go back to its original length once stretched or torn. The causes are many and are basically either contact or non-contact. Many of the non-contact variety are linked to sports or dance that use random unpredictable cuts, evasions, and stop-start actions at speed. Keep in mind that some of these activities may involve 10km or more of running…with more multi-directional than straight pathways. So, fatigue is a factor. So is faulty movement patterning overemphasising one area in a chain of motion over another. There are also instability and imbalance issues, especially when there is side dominance like racquet swings, throwing, or kicking.
All of this takes place in the presence or absence of tissue maturity. It takes years for tendons and ligaments to mature and have the ability to stiffen and thicken for specific skills. The force-velocity factors of the activity may simply overwhelm the connective tissues and place undo stress on joints. At the speeds encountered damage to joints is done before the person can react, as anyone who has had an ankle sprain will know. If the knee joint feels vulnerable or if the athlete senses that the joint cannot withstand the forces, they have the choice of avoidance or compensating, but often a competitive drive will override those options.
Ok, doom and gloom aside, and the quests for more effective surgery, bracing, and rehab, I ask if there are options for preventing or minimising catastrophic joint injuries. Not much we can do about collisions and uneven terrain. I believe that (and research does bear this out) we can better prepare athletes for the repetitive landings and cut moves that are part of the activity. Preparation includes changing faulty landing patterns, increasing capacity, improving precision, and reducing fatigue interference. If you take these attributes into training then the specific skills can be repeated more often and create a stronger, resilient base of performance. Take a look at the exercise included at the top…it’s a rebound stance that involves a quick action rebound in a lunge pose - the rear foot is the controlling factor here. The stride can be pushed out faster and harder to a degree as the stop action gains in capability and capacity. This a development exercise from a series of several programmes produced for Poly2Plyos called Better Brakes 3 (069). It sits in the Special Focus category. This one doesn’t have the highest force-velocity component but does allow for better neuromechanical patterns to develop and feeds more complex moves. It can be adapted for different angles and rhythms. To be effective it takes application and a mindset that doesn’t wait for injury, doesn’t accept injury as inevitable, and works to change the body into a better version of itself. Now, that’s a challenge for us all!