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Soccer Takes Nerve to Avoid Knee Injuries

If you could reduce your chances of having a knee injury while playing soccer, would you do it? There's a new training program that has proven effective in preventing anterior cruciate ligament (ACL) tears. The ACL ligament in the knee can be injured during practice or competitive games. An ACL tear can happen with or without contact with another player.

A large study in Italy showed that when players received specific exercise training, ACL injuries were reduced dramatically. In a group of 300 players who did not receive this training, 70 wound up with ACL injuries. By comparison, only ten players who'd gotten the training reported ACL injuries.

How did the exercise training work? The researchers recognized the need for a program that included more than just the knee. They included the upper body, hip, knee, and ankle. There were exercises to improve the speed and strength of muscle contractions. Getting a total body response is essential in reducing or counteracting the strain that could otherwise cause an ACL injury.

Exercises to fine-tune the knee and ankle joints were also included. Inside each joint are two separate mechanisms that tell the joint where it is and how it is moving. These are called proprioception (sense of position) and kinesthesia (sense of movement). These mechanisms allow the athlete to make quick changes in speed and direction. They are especially important in a game like soccer and can be developed with coordination training, jump training, and a special training board.

The training board is a round disk or rectangular-shaped board with a half ball attached underneath. It challenges balance and weight shifting. By standing on one foot, athletes in this study had to keep the board balanced. This required using many different foot, ankle, and knee positions. Repeating the movements reduced the muscle fatigue that can interfere with proprioceptive responses. 

Giving soccer players an exercise program to prevent ACL injuries is important. ACL injuries cause the most days absent from play and cost more than most injuries. The exercise routine should put the athlete in situations that require fast reactions to expected and unexpected changes. This helps the player respond quickly when suddenly pushed off balance by another player. The player also responds more quickly and with greater strength when making sudden changes in direction or speed.

Next time you watch a soccer team, you'll have a new appreciation for what they are doing while running up and down the field. Think about the finely tuned mechanisms in the joints and muscles that allow them to stop on a dime and head in the other direction.

References: G. Cerulli, MD, et al. Proprioceptive Training and Prevention of Anterior Cruciate Ligament Injuries in Soccer. In Journal of Orthopaedic & Sports Physical Therapy. November 2001. Vol. 31. No. 11. Pp. 655-660.

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