Monthly Archives: May 2017

Risk Factors and Prevention Strategies for Noncontact Anterior Cruciate Ligament (ACL) Injuries

One out of every 1,750 individuals between the ages of 15- 45 will suffer an ACL injury. While the total number of ACL injuries seen is greater for males, females are up to eight times more likely to sustain an ACL injury when compared to their male counterparts. So, what are some risk factors and what can be done to prevent an injury?
Currently there are several different avenues being researched to find direct links to ACL injuries. The primary risk factors that have been identified are as follows:
  1. Influence of shoe to surface interaction- There has been some problems with keeping consistent variables within this portion of research; however, there does seem to be one primary indicator. The greater the friction between the shoe surface and the ground, the greater the risk. While that information is easy to digest, it’s counterproductive to what an athlete wants/needs for optimal performance.
  2. Anatomical Risk Factors- The male and female lower extremities are built quite differently. The most commonly attributed differences to ACL injuries include increased femoral anteversion, increased Q angle, excessive tibial torsion, and excessive foot pronation. While one or all of these could be contributing factors, there has not been sufficient research to determine the functional movement effects of these differences. Joint laxity and muscular development are also commonly noted possibilities. All of the above are possible considerations; however, none of these factors have been directly correlated to in an increased risk of injury.
  3. Hormonal Risk Factors- There have been several recent research articles that have determined that female sex hormones can influence the composition and mechanical properties of the ACL. A couple of articles have analyzed the specifics of an individual’s menstrual cycle and its effects on injury risk, but there is not enough evidence to be conclusive due to conflicting results. More research is needed prior to making any conclusions specifically about ACL injury risk factors or prevention methods.
  4. Biomechanical Risk Factors- Neuromuscular and proprioceptive control are highly accepted as major factors in an individual’s risk of injury. These control both the conscious and unconscious motor units that are acting during movement and are needed for joint stability. The two primary locations of focus involve the knee as well as the hip-trunk in regards to being risk factors.
  5. Other Notable Risk Factors- From watching video and individual reports, these other risk factors include; deceleration, cutting, and poor movement quality.

Studies have shown that simply wearing a knee brace isn’t the solution, neuromuscular prevention programs are the best solution we have currently available. Ample research is consistently coming out pointing toward neuromuscular prevention programs as significantly decreasing the injury risk for individuals. A two year study of a Division I women’s basketball program saw a decrease of 89%. The techniques used in these programs are not complicated. They most often include learning proper mechanics for landing , cutting, and deceleration through drills and exercises. Kinetic offers multiple programs that offer help with injury prevention, don’t hesitate to ask about how we can help keep you, your child, or your team with a neuromuscular prevention program!


So, it’s a little over a week before District Playoffs begin, and the intensity at practice is the highest it’s been all season. Coach decides to conclude practice with a scrimmage, and it’s getting physical. It’s only practice, but you and your teammates are playing like it’s a playoff game. You advance the ball up the field and cut hard toward the goal. As you plant your right foot, you step on your teammate’s foot, and your right ankle collapses. You feel and hear a “pop”, followed by brief tingling in your foot, then intense pain on the outside of your ankle. You crumple to the ground, writhing in pain. Your teammates rush over to you, followed by the Athletic Trainer. You don’t want anyone to know how much pain you’re in, so you try to stand up, but you’re unable to put any weight through your right leg. Your teammates help you to the sideline, where the Athletic Trainer examines your ankle. After a thorough exam, she cannot be sure, but she believes your ankle is not broken, but that you have a “significant” ankle sprain. After a long night with your ankle wrapped, iced, and elevated, an AM X-ray thankfully confirms that you did not break your ankle. You lower leg is now very swollen and bruised, and you still cannot put any weight on it. How will you possibly be ready for District Playoffs in 10 days!

“I called our family doctor, and he gave me the name of a very good orthopedic specialist”, says your mom, as you hobble into the kitchen. “I made an appointment with Dr. Smith next Monday at four.” “NEXT MONDAY!” you exclaim. “But that’s not for six days, and Districts start that Friday! If I have to wait that long to see a doctor, I’ll never be ready to play!” “This doctor is the best, and it’s the soonest he can see you. We also need time because he wants you to get an MRI of your ankle.” “An MRI”, you question. “Why do I need an MRI? It’s just a sprain.” “The doctor wants an MRI before he sees you, so that’s what we’re going to do.” “Why can’t I just go see Dr. Michelle at Kinetic Physical Therapy? She’s treated me before and knows me really well.” “You have to get a prescription from the doctor before you can go to PT”, your mother reminds you. “Mom, Pennsylvania has Direct Access. I don’t need a prescription.” “Direct Access? What’s that?” asks your mom. “Direct Access means I can go see my physical therapist for up to 30 days without a prescription. And our insurance will pay for it. This way, I can get started on rehabbing my ankle right away. And I know Dr. Michelle will do everything she can to get me ready for Districts.” “Are you sure about that?” asks your mom. “Positive. You can even call Kinetic and ask.” “OK, I’ll call Kinetic right now.”

I don’t have to tell you how this story ends, but I will. You see Dr. Michelle, she evaluates your ankle, gets you started rehabbing immediately, and with her skill, your determination, and a little luck, you’re in the starting lineup for the first District Playoff game.

Yes, this story is fictional, but Direct Access is REAL. Just like you told your mom, the state of Pennsylvania has Direct Access, which allows you to see your physical therapist for up to 30 days without a physician prescription. YOUR physical therapist is a Doctorate level professional, a movement specialist, and a first contact provider. YOUR physical therapist will perform a thorough, FULL BODY examination, identify your movement impairments, and recognize any red flags that may necessitate referral to another health care provider (e.g. your pediatrician). YOUR physical therapist will then work with you to create goals that are important to you, and use those goals to develop a unique, personalized treatment plan. YOUR physical therapist has the knowledge and the skill to help you get back on the playing field and stay there. Did you know that with some common orthopedic conditions, going to a physical therapist first saves you and your insurance company thousands of dollars?

So, the next time an injury puts you on the sideline, don’t stay there long. Contact YOUR physical therapist at Kinetic. We specialize in “moving athletes back to the field”!

How Does Sleep Affect Your Performance on the Field?

We all know that exercising, eating right, and staying hydrated are important components of a healthy lifestyle; however, many forget about other important factors. With the increasing demands of school, students are staying up later and sleeping less. Sleep is an incredibly important component to a healthy lifestyle, but the majority of athletes are not getting the sleep they need. The National Sleep Foundation has developed new sleep times for children, teenagers, and adults with recommendations for 6-13 year olds sleeping 9-11 hours a night, 14-17 year olds sleeping 8-10 hours, and 18-25 year olds sleeping 7-9 hours. With only 15% of teenagers getting the recommended amount of sleep each night, we are seeing many athletes and students functioning at below optimal levels.

Inadequate sleep has detrimental effects on the body, such as: elevating blood pressure, decreasing function of the immune system, reducing memory and cognition, and increasing risk for injuries. How does this affect an athlete though? Reduced sleep also has been shown to reduce production of key nutrients needed for energy, reduces accuracy and quick decision making, increases stress, decreases focus, and limits an athlete’s ability to recover after a hard work-out or game. Getting sufficient rest could make the difference between scoring the winning goal or losing a championship game. Sleep should be a priority for all athletes and students and is something that can easily be achieved by making a few quick adjustments. Avoiding use of laptops and cell phones right before bed, stopping homework and stressful activities an hour before resting, decreasing use of caffeinated beverages/foods in the evening, and not eating within 3 hours of going to bed are easy ways to improve sleep and overall health.

Information can be found on the The National Sleep Foundation website