Ski season is upon us and that means time to train and get fit. Time to make sure those knees
are ready for the twists, the jumps, the landing and the fresh powder! One of the biggest injury
risks this time of year are ACL sprains and tears. Continue reading to find out more about this
injury and find out if you are ready to ski injury free!

The incidence of ACL injury is higher in people who participate in high-risk sports such as
basketball, football, skiing, and soccer. Previous ACL reconstruction is also a risk factor for ACL
injury, both in the surgically reconstructed ACL graft and in the healthy, opposite knee. There
are several non-modifiable factors that increase the risk for an ACL tear, such as genetics,
female gender (sorry ladies), ligamentous laxity and ACL size. There are also
environmental-related factors such as weather, playing surfaces and footwear that are also not
easily modifiable. The number one extrinsic risk factor that has been linked to an individual’s
risk for an ACL tear is the Jump-Landing test1. Physically active men and women who land with a stiff knee or in a knee valgus position (“knock-kneed” position) are at a higher risk of an ACL tear. But good news! We CAN modify this with efficient lower extremity strength and balance
and proper body control. So, what can we do? Research shows that neuromuscular and proprioceptive training appear to decrease the incidence of injury to the knee and specifically the ACL. Activities such as balancing on a BOSU ball or wobble board and one-legged exercises can help challenge our proprioception (the ability to sense stimuli arising within the body regarding position, motion, and equilibrium). We can also improve our neuromuscular and proprioceptive training through lower body strengthening exercises such as squats and lunges. Making sure that a person’s quad strength is balanced with his or her glute and hamstring strength is imperative. The last way to reduce the risk of landing incorrectly is to incorporate plyometric training to specifically improve take-off and landing techniques with drills such as broad jumps, squat jumps and box jumps.

Screening and rehabilitation programs are effective at identifying those who will best benefit
from ACL prevention training. The Physical Therapist at Elevation Chiropractic and Wellness can determine your weaknesses, your balance deficits and evaluate whether your jump-landing technique puts you at risk. We want to help the high risk candidate with a prior ACL injury, poor jump landing mechanics, ligamentous laxity, and perhaps a family history, as these are all many variables that can lead to an ACL injury.

5 Go-To exercises for Improving Lower Body Strength:

Come to Physical Therapy at Elevation Chiropractic and Wellness to learn more!

Bridges

Lying on back with knees bent. Keep back flat and squeeze glutes to raise hips off the floor. Hold for 5 seconds making sure you are using your glutes and not your low back. 3×10.

Single Leg RDL

Hip hinge on one leg and tip over kicking out opposite leg. Keep core tight. Should feel standing glute and hamstring engaging.

2 Way Lunges

Step back at an angle. Toe touch the floor and stand back up. Repeat by doing a curtsy step back, toe touch the floor, and return to starting position. 3×10 each direction.

Squats on BOSU

Squat down to a comfortable range and hold for 30 sec. Repeat 4 times.

Lateral Band Walking

Sit back through your hips, keep your knees out and sidewalk one direction for 10 steps and then the other for 10 steps, 4x. Should feel outer glutes working.

Reference: Jump-Landing Mechanics After Anterior Cruciate Ligament Reconstruction: A Landing Error Scoring System Study David Robert Bell, PhD, ATC, Mason D. Smith, BS, ATC, Anthony P. Pennuto, MS, Mikel R. Stiffler, BA, and Matthew E. Olson, BS, ATC

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