Neururomuscular Training Paper

Every Tuesday and Thursday, Dr. Alpert wakes up at 6:30 AM, which allows him enough time to brew his morning coffee and prepare for the day all before making his first cut in the operating room at 8:00 AM. He performs his surgeries at either Ashton Surgical Center in Hoffman Estates, IL on Tuesday, or at Algonquin Road Surgical Center in Lake In the Hills, IL on Thursday. “I typically have surgeries from eight in the morning to about two in the afternoon, which allows three to five patients per day depending on the procedure. Every time I have an ACL reconstruction, I turn on my some of my favorite oldies music to get me in the groove.” During a typical ACL reconstruction, Dr. Alpert scrapes out the old, ruptured ACL and swaps it with a graft that is most commonly obtained from the hamstring or the patellar tendon. “I prefer to use the hamstring, especially with women. The procedure classically takes about an hour and a half to complete, and the patient is able to start rehab the next day. With ACL tears being such a frequent injury among female athletes, particularly in non-contact sports, it is currently being researched just why that is.”

This paper will review the work of others in regarding women’s higher rate of anterior cruciate ligament (ACL) injury in comparison to men. Evidence regarding these elevated rates includes alternated motor control strategies, differences in sex hormones, differences in knee flexion angles, and core strength differences in men and women athletes. Numerous studies have produced correlating data in reference to women’s higher susceptibility to knee injury during upper level athletics. Although it seems unpreventable a couple of different preventative measures have been suggested to reduce the number of knee injuries a year. These measures include supplements and active correction training of muscle movements, also a higher degree of weight training in the athletic curriculum for women’s athletics. I have personally witnessed the benefits from some of these preventative measures and can credit at least weight training as a preventative measure. There could always be more testing to see how these injuries could be better prevented in female athletes due to the fact that our knowledge of prevention is still vague at times. ACL injuries are one of the most common injuries in female athletes and also have one of the longest recoveries time periods in comparison to other injuries.

Dr. Boden of the Orthopedic Center in Rockville states, “Young women are two to eight times more likely than their male counterparts to injure their ACL.” Although there are some factors that put others at a higher risk of tearing their ACL, like this gender one, ACL tears are common and can happen

The magnitude of the problem is clear, as a high incidence of ACL injury, particularly in young athletes. Recent evidence suggests that more than half of athletes who undergo ACL surgery are unable to return to their preinjury level of function after ACLR surgery. Return to sports activities remains a very difficult topic. Thus the research regarding the rehabilitation process of athlete after

Studies have also shown that women in particular, unfortunately have a disadvantage in life when compared to male counterparts, and that is one pertaining to their higher risk for ACL injury. Due to a neuromuscular imbalance that is concomitant with overactive quadriceps strength compared to hamstring strength, females tend to place more stress on the ACL. Accordingly, this increases the pressure on the ACL leading to a higher prevalence of injury that will arise more on the female spectrum than that of the male (Myer et al., 2009). Furthermore, this is important to be aware of for female athletes and for the Physical Therapists who treat them in efforts to provide educational information regarding the relationship of stronger hamstrings correlating to a lesser chance of ACL injury. Personally, I have worked with athletic females in the past as a personal trainer and while I was not strengthening hamstrings with the direct objective to prevent an ACL injury, I was cognizant of the notion that a balanced quadriceps and hamstring ratio was necessary to avoid lower extremity injuries as a

Female athletes who participate in these high-risk sports demonstrate a 4 to 6 times greater rate of ACL injuries than males participating in the same sports (Hewett, 2000;

The more games a person plays, the more their muscles weaken and can be susceptible to a tear. For those athletes younger than the college level, around fourteen to eighteen, the rate of non-contact ACL injuries is twice as high as males. Athletes are at a higher risk of suffering an ACL injury during a game compared to during practice (Renstrom, 2008, pg. 2).

In female basketball players, neuromuscular, hormonal, and anatomical factors were considered internal factors that were the cause of non-contact ACL tears. Muscle weakness in the gluteus maximus and hamstring muscles along with poor dynamic

With an ever increasing number of people becoming involved with athletic activities, there is an increasing number of injuries occurring which can be devastating for the individual. Most of the injuries that affect athletes occur in one of four structures in the human body: bones, muscles, tendons, or ligaments. Because ligaments attach bone to bone and play a major part in providing stability for joints, the major stabilizing ligament in the knee, the anterior cruciate ligament (ACL), assists in performing everyday actions of the human body including sitting, standing, walking, running, dancing, and participating in other sports. The injury that specifically affects this ligament is very serious and always

Lowering this rate would allow female athletes of all levels to have a lower probability of ACL injury. Sex difference has proven that female athletes are more likely to have an ACL injury than males. Since we are unable to change our sex (intrinsic factor), the focus must then be placed on the factors that can be modified. A list of these factors include: preparation, skill acquisition (from a young age), and playing style (Ireland, 1999). The factors listed are all controllable extrinsic factors, focusing on these and the partially controllable factors could aid in the prevention of ACL injuries in

There have been many studies done to explain the higher rate of ACL injury in female athletes. The most convincing findings relate to knee kinematics and neuromuscular control. In a study of 20 subjects (10 male and 10 female) forces from jump tasks were recorded using 3-D videography and force plates. One conclusion from the study was that force on the ACL was greatest during the landing phase of a jump tasks. Females frequently showed more leg extension and valgus movements during the landing phase, which also puts more stress on the ACL (Chappel et all, 2002). A similar study found that internal rotation combined with valgus movement creates

Over the past couple years, female soccer players are starting to increase and now account for 10% of the 265 million active players in the world.1 With the higher percentage of female soccer players comes the greater risk of anterior cruciate ligament (ACL) injury. It is reported that the ACL injury rate is up to six times higher in female players than in males.1 Previous studies have shown that there is no difference in offensive and defensive players or between goalkeepers and other players, but there might be a connection between pressing and contact and non-contact injuries.1 The purpose of this study was to “identify the most common type of situation associated with ACL injury in female soccer players.”1 The

Since the media does not emphasize the severity of female athlete injuries when the player experiences them, the athlete needs to learn post-treatments to help speed up the recovery time. Learning treatments for the injuries that a female athlete incurs may also help prevent any future injuries. Thomas says, “plyometric exercises, proprioception, agility, overall biomechanics corrective exercises” (Thomas). When a female is injured while playing a sport, they should go through rigorous exercises to recover properly from the injury and to prevent any further injuries. The coaches that coach the female athletes should be informed of how to help the athlete recover from the injury and learn ways to guide the other players on the team how to

This essay deals with the current treatments, rehabilitation procedures and onsets following anterior cruciate ligament (ACL) injuries. Within this essay, there will be information including the causes, characteristics, and symptoms of ACL injuries. Throughout the United States, there are estimated to be 200,000 ACL injuries per year with 100,000 of those injuries being treated through ACL reconstruction (Evans, Shaginaw, & Bartolozz, 2014). With a satisfactory ACL reconstruction outcome between 75%-97%. From the 10%-15% failure rate of ACL reconstruction, the primary fault is due to technical mistakes at 70% (Samitier, Marcano, Alentorn-Geli, Cugot, Former, & Moser,

This article is a systematic review, meaning it is an overview comparison of multiple other articles that involve specific studies being done on the participants. Based on the results of this article, it is unclear if psychological interventions are beneficial to athletes after ACL surgery. Visual imagery allowed for physical function improvement, but not an improvement in overall health-related quality of life. It also decreased re-injury anxiety. Guided imagery and relaxation decreased pain significantly, and increased rehab self- efficacy. Although these are all positives, there is also a negative effect to all of the psychological interventions mentioned above. More studies need to be done to give an accurate interpretation as to if psychological interventions prove to be overall beneficial for postoperative ACL individuals. This information could be helpful for any healthcare professional who is attempting to use psychological rehab techniques because if the methods are not working, it might be time to consider different options for that aspect of