The ACL Injury Enigma: We Can't Prevent What We Don't Understand (Summary) (Anterior Cruciate Ligament) (Clinical Report)
Journal of Athletic Training, 2008, Sept-Oct, 43, 5
Journal of Athletic Training
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Multiple risk factors, both modifiable and non-modifiable, are known to manifest within the noncontact anterior cruciate ligament (ACL) injury mechanism. (1) I will primarily address neuromechanical contributions to injury risk, which are often a key focus at meetings of this nature; such factors are amenable to training and, hence, largely modifiable. I hope, however, that as the reader progresses through the document, the critical importance of underlying nonmodifiable factors within the resultant neuromechanical strategy will not be lost. Sexual dimorphism in modifiable neuromuscular factors linked to ACL injury is well documented, with the "female" movement pattern interpreted as riskier. Females, for example, land in a more extended posture, (2) are more quadriceps dominant, (1-3) and demonstrate altered muscle activation and coactivation (4) and greater out-of-plane knee motions (5) and loads (6-9) than males. Neuromuscular training strategies continue to evolve in line with these findings and represent an ever-increasing and equally important research focus. (10-12) Recent epidemiologic data, however, suggest that in spite of these ongoing initiatives and reported early successes, (13,14) ACL injury rates and the associated sex disparity have not diminished. (15) If current prevention methods delivered reasonable efficacy, one would assume that a noticeable reduction in these rates would already be evident. It appears, therefore, that current strategies fail to counter key factors implicated within the injury mechanism. In particular, understanding of the precise contributions of neuromuscular control and resultant biomechanics to the injury mechanism and their integration with nonmodifiable structural and hormonal factors remains limited.
- 2,99 €
- Category: Sports & Outdoors
- Published: 01 September 2008
- Publisher: National Athletic Trainers' Association, Inc.
- Print Length: 11 Pages
- Language: English