ACL injury prevention | We all have a friend or family member who has torn that pillar of knee ligaments, the ACL. Fortunately, the prognosis after anterior cruciate ligament surgery is so good that most people eventually return to their sports of choice. But what many people don’t know about ACL injury prevention is that, down the line, “their knees are still no good,” as Maria Borg, supervisor of CU Sports Physical Therapy & Rehabilitation, put it.
Those with ACL injuries have a higher incidence of arthritis and are prone to reinjure their surgically repaired ACL, explained Borg.
“Bottom line is we need to prevent them instead of repair them,” she said.
Borg has long been aware of research that showed how these ACL tears or sprains, the most common types of knee injuries, could be prevented through proper neuromuscular training. But she was at a loss as to how to persuade young athletes to take the time to learn and perform this important type of training for ACL injury prevention.
Then, at an American College of Sports Medicine Conference, Borg learned about a warm-up exercise program created by FIFA, the world soccer organization, which was being used for soccer players age 14 and up. The program, called FIFA 11+, was based on research showing that those who performed this specific set of agility, plyometric and core-strengthening exercises just two to three times a week experienced a 30 to 50 percent reduction in ACL injuries. That got Borg’s attention.
“I thought ‘We need to get this in the hands of amateur soccer players, kids, and weekend warriors to see if we can help to reduce the risk of injury,’” she said. ACL injuries, she explained, usually occur during non-contact incidences in sports such as soccer, volleyball, lacrosse and skiing.
She contacted her friend Jon Goldin-Dubois, Executive Director, Colorado Rapids Youth Soccer Club (formerly the Colorado Fusion Soccer Club) and spoke to him about implementing the ACL injury prevention program with young athletes aged 10 to 14. He was immediately on board.
Although most ACL injuries don’t occur until about age 14, Borg felt it was important to target athletes before they were at risk to help increase strength and flexibility. That way, by the time they were playing at the level where ACL injuries were more common, they would be strong enough to avoid injury.
“In my opinion, you can’t start early enough,” said Borg.
Borg, along with certified athletic trainer Andrea Fetzer and physical therapists Matt Carlson, PT, and Liz Walley, PT, launched the program in the spring of 2012, training the coaches and players on 10 girls’ teams. They used a modified version of the FIFA 11+ program they considered more appropriate for the age group they were working with. After they got the format down, they added the boys’ teams as well.
The program was so successful, they continued on in the fall, training 25 boys’ and girls’ teams, and plan to continue into the 2013 season. Borg and her colleagues are also planning to add a research component, focusing on injury-prevention techniques for preadolescent female athletes.
“I really believe in this. I think it’s a great program,” said Borg.
Chiara Del Monaco, who leads business development at the hospital’s Women’s Integrated Services in Health (WISH) and is the mother of three young Rapids soccer players ages 11 (twins) and 13, is a fan of the FIFA 11+ program. She says her children, who’ve been playing soccer since age four, have never had an injury, but that they complain of soreness and knee pain at the end of every season. “I’m very concerned about injuries,” Del Monaco says. “Once [an ACL] injury happens the kid is compromised forever.”
She’s thinks the new injury-reduction program should be a “necessary part of any young athletes’ training,” Del Monaco said.
Melissa Russell, a veteran soccer coach who has been with the Rapids youth program coaching 11-and 12-year-old girls for four years, said she had never considered a training program necessary for young girls. In high school and college clubs, she’d seen a lot of injuries, but not at the pre-teen level. But she’s a convert. The program makes them better soccer players, she said. “The girls are stronger and faster, and they cut quicker and faster,” Russell said.
She added that, since the program has been implemented, she’s noticed that the girls come back faster from injury and don’t experience as much pain.
As word spread about the success of the program with the Rapids, other schools and sports clubs have inquired about the training for ACL injury prevention.
“We could expand exponentially; it just depends on time,” says Borg.