Sport-specific Techniques to Prevent ACL Tears

Daniel Kamenetzky, Sport Methodologist and Kinesiologist

In the epidemiology of youth sports we observe with consternation that the injuries are in the raise and getting more severe. This is happening even when the science and technology sectors are dedicating huge amount of effort and money in trying to prevent it.

Among all the injuries, the torn ACL is one of the most concerning today. When this injury happens, the result is a devastated athlete that frequently has to give up his/her athletic aspirations. It generates great complains from the media, the sports management, coaches and parents about the equipment used, the playing surface, the sport characteristics and more.

One fundamental cause of the ACL injury is the athlete’s sport specific technique. In my practice, I had the opportunity to rehabilitate and help to return to competition several ACL injured athletes from different sports. After the analysis of many variables to discover possible cause/s of the injury, I consistently found the same fundamental issues: the athlete does not understand how to properly use his/her sport tools (shoes among others) and also performs inefficiently his/her sport’s technique.

To illustrate my comment please observe the two young athletes below that I had the opportunity to evaluate and rehabilitate. As you know, one of the main causes of ACL tear is the rotation of the femur in the opposite direction respect of the tibia.

To allow a quick and safe body rotation to kick the ball or throw the shot, the athlete has to pivot on his/her toes (and this is why the characteristic distribution and shape of the cleats). But when the cleat is completely in contact with the ground (see pics), it prevents movement of the foot and the point of rotation is translated from the toes to the knee. Therefore this two athletes continuous to be at risk of ACL injury.

The numerous wrong repetitions, thanks to the absence of proper instruction, and the biological limitations related to the growing process of the young athlete creates the perfect mechanical, biochemical and structural environment for the damage to happen. We can’t know yet, with the available information, if the injury is a one and unique time event or a situation that happens after the knee is stressed for a prolonged time (the last one is my strongest hypothesis in most of the cases). What it is sure is that the more the athletes repeat a wrong movement, the more they increase the risk of damage. This is why is so important that we teach and educate our young athletes in how to properly perform the sport technique.

My conclusion is that the most of the ACL and many others injuries are an “educational problem”. In order to prevent those injuries our attention should be in improving the coaching quality before to get concerned about the sport technology. We should be focusing our efforts mainly in educating coaches, performing adequate sports evaluations and training controls and improving the talent selection process to create a safe sport practice.

Daniel Kamenetzky, Sport Methodologist and Kinesiologist
Athlete Development Program
Sport Medicine Center for the Young Athlete
UCSF Benioff Children's Hospital Oakland

Daniel Kamenetzky is a kinesiologist and biomechanist at UBCMCYA. Daniel's specialties include Applied Sciences to Performance, Sports Evaluations and Movement Reeducation and Rehabilitation.