WBB ACL Program:
1 Year Later
Jennie Sertterh ATC
Paul Pursley PT
Basic Anatomy
Basic Anatomy
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Primary rotary stabilizers
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Least amount of stress is between 30 – 60 degrees flexion
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Most ACL tears happen at 20 – 30 degrees of flexion
ACL Fast Facts
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Females are 2 – 8x more likely to tear ACL
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NCAA Injury Surveillance from 1989 – 99 showed females were 3.5x
more likely to tear
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Significant greater rates in basketball
ACL Fast Facts
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Female basketball players are 2 – 8x more likely to tear their
ACL’s over male basketball players
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70% of ACL injuries are non-contact
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Estimated 350,000 ACL injuries/year in US
Mechanism of Injury
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Pivoting/Cutting
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Knee straight/awkward landing
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Hyperextension
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Deceleration
WHY????
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Q – Angle
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Females tend to have wider hips;
makes legs go in valgus
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More force on ACL with rotational
forces
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Female Anteversion
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Less developed VMO
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Females have 4 degrees greater
genu valgum compared to males
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External Tibial Torsion
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Forefoot Pronation
WHY????
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Intercondylar Notch
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Females are more narrow
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“A” shaped notches are more at
risk to tear
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ACL impinges on medial border of
lateral femoral condyle during valgus stress of the knee
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Neuromuscular
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Muscle Recruitment
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Females fire quadriceps over
hamstrings
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Strong quadriceps and weak
hamstrings
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Less hamstring and gluteus medius
activation
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Use quadriceps more = decreased
hip abductors which increases knee valgus
WHY????
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Biomechanics
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Females tend to run more straight legged
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Landing
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Females tend to land with straight leg
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Females land more upright, less hip and knee flexion, excessive
knee valgus at knee = decreased control of joint and increase forces at the knee
WHY????
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Hormones
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Controversial
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Hard to link
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Tears occur more frequently during the ovulation stage (10 – 14)
during the menstrual cycle
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Ligaments are more lax during the ovulation cycle
Current Literature
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Mandelbaum et al. July 2005, Am J of Sports Med.
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Hunt Valley II Meeting January 2005
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Hewett et al. 1999, Am Orthopaedic Society of Sports Med.
Our Epidemic…
The Intervention
Initial Testing
Sample Activities
Sample Activities
Sample Activities
Preliminary Results