If you're a soccer player, or if you play any other contact sport, you probably worry about your ACL. It can be devastating to tear this ligament. The anterior cruciate ligament (ACL) is the most common injury in sports and is responsible for more than 200,000 surgeries each year.
The ACL helps stabilize the knee joint and can tear when a person suddenly changes direction or pivots while playing sports. This often happens during an athletic event such as soccer or basketball; however, other activities including jumping rope and even dancing can cause this injury as well.
But how do you keep your knee healthy? This takes place before you even step onto the field. We are going to go over some essential ways to protect your knees below!
Warm ups – Dynamic Stretching is Your Friend
Flexibility is an important part of any athlete's training routine. If your muscles are stiff and tight, they can't contract as quickly or powerfully, making it harder for you to perform well on the field.
Dynamic stretching helps improve flexibility by increasing muscle temperature and improving blood flow through increased oxygen delivery. This makes it easier for muscles to move through their full range of motion without resistance from tightness in the tissue itself.
Examples of Dynamic Stretches
- Squats: 20 reps
- Lunges: 5 reps each leg
- Cat-Cow: 10 reps
Stretching should be done before exercise (to warm up) and after intense strength training sessions (to cool down). Ideally, athletes should spend 10 to 15 minutes warming up with light aerobic activity such as jogging or riding a stationary bike. Another option includes utilizing stretches like those above before engaging in more intense training sessions involving running or sprinting – a practice known as pre-exercise dynamic stretching – and then spend another five minutes cooling down with static stretching after a practice or workout with stretches like those described below:
Examples of Static Stretches
- Forward fold
- Cross-body shoulder stretch
- Downward dog
- Cobra pose
- Glute stretch
Focus on Exercises That Strengthen Muscles Around the Knee
Quadriceps and Hamstrings
Two important muscle groups to focus on strengthening are your quadriceps and hamstrings. These muscles are responsible for extending and supporting your knee, which means they help prevent you from hyperextending your knee during activity.
They also help with balance and stability in activities like running and jumping. Focus on sports specific exercises like the ones listed below to help improve knee stability.
Quad and Hamstring Exercises to Add into Your Routine:
- Single leg romanian deadlift
- Hip thrusts
- Heel slides
- Leg extensions
- Box squats
- Balance exercises
Stretch your hip flexor muscles (also called the psoas) on a regular basis, especially if they're tight or injured (which can lead to ACL injuries). These muscles extend across the front of your hip joint, helping you bend forward at that joint.
They also cross over one another near the top of each thigh bone (femur), so stretching them regularly can help keep them flexible enough to do their job without straining themselves too much – thus putting undue stress on other parts of your leg.
Hip Flexor Stretches
- Kneeling hip flexor stretch
- Seated butterfly stretch
- High crescent lunge
- Knee to chest stretch (lying on back)
- 90/90 stretch
Strengthen calf muscles by doing squats regularly. Squats are an effective compound exercise that helps strengthen all lower body muscles to include quads, hamstrings, glutes and calves.
Calf Strengthening Exercises and Stretches
- Wall stretch
- Downward dog
- Lunging calf stretch
- Heel raises
- Half split stretch
- Calf raises
Avoid Situations That Could Cause an ACL Tear – Body Awareness
According to a study on ACL injuries, it is estimated that 70-90% of ACL injuries occur without contact while conducting movements such as rapid change of direction, landing, and deceleration.
To avoid an ACL tear, you should avoid situations that could cause one. These include:
- Landing awkwardly after a jump
- Running downhill or uneven surfaces
- Wearing shoes or cleats without good traction
- Excessive twisting
- Continuing a workout or practice even when overly fatigued
Landing Awkwardly After Jumping or Changing Direction Suddenly
If this happens frequently during practice sessions, consider reducing the number of jumps made during each session until they are no longer problematic for your knees. Try landing with a softer stance to absorb more force or consider using knee sleeves to keep your knees warm while working out/playing your sport.
Running Downhill or on Uneven Surfaces
Running on uneven surfaces can cause a misstep or cause you to become unbalanced. All it takes is one misstep to injury your ACL and then you are looking at months of recovery. We know it is challenging when you are sprinting to be aware of where you are stepping, however do the best you can when you go into this “beast-mode” to be sure footed and confident of where you are racing too!
The ACL is most often injured when you twist your knee, especially if you do so while landing awkwardly after jumping or changing direction suddenly. If your sport involves a lot of twisting and turning, consider wearing braces or sleeves that limit the amount of movement in the knees.
A good rule of thumb when it comes to ACL and knee injuries is that if something hurts or feels painful, don't do it! You should also listen closely for feedback from your body about how much stress each exercise puts on the knee.
If there's any doubt about whether an exercise is safe for someone with an injured ACL (or if they have any other joint problems), check with their doctor before attempting it again later on down the road once they've healed up some more if an injury has occurred.
Be Cautious During Contact Sports
If you participate in a sport like football or soccer, make sure to wear protective gear at all times. This can include things like knee pads and helmets for head protection; however, keep in mind that these items won't prevent all injuries. Unfortunately, sometimes it is just part of the game!
In addition to wearing proper safety equipment while playing contact sports (which includes shoes with good traction), athletes should also consider playing on grass instead of hard surfaces when possible because this reduces impact on joints such as knees and ankles during the games. We know this is not always possible, so make sure to invest in some quality protective gear.
Soccer and ACL Injuries
Soccer involves a substantial amount of cardiovascular aerobic endurance mixed with many sprints, direction changes, cutting and kicking (if you’re a good player). Because of these demands on an athletes body, soccer is known to have one of the highest injury percentages to ACL’s than other sports. During a soccer match, athletes will average 6-9 miles of running! Players repeat high-intensity sprinting, cutting and directional changes on an average of every 4-6 seconds. That leaves a ton of room for injury if you are not cautious of how you are cutting!
Why Are Female Soccer Players Disproportionately Affected?
Female athletes have a 4-6x increased risk of ACL injuries than males in soccer. Also, girls are eight times more likely to suffer an ACL injury than boys. There are a few theories as to why this is.
Pelvis to Knee Angle
In women, the quadriceps angle “Q-angle” tends to be larger than in men, which is due to differences in pelvic structure and lower limb alignment. The Q-angle is the angle formed by the intersection of two lines: one line drawn from the midpoint of the pelvis to the center of the patella (kneecap) and the other line drawn from the center of the patella to the tibial tuberosity (the bony prominence on the top of the shin bone). A larger Q-angle can increase the risk of certain knee injuries, such as patellofemoral pain syndrome and anterior cruciate ligament (ACL) injuries..
Women have an increased knee valgus, which means that the knees may not come together even when the feet are side by side. This puts greater stress on the knee joint and leads to increased stress on the ligament with increased activity.
Now that you know how to prevent an ACL injury, it's time to learn how to treat one (and hopefully you never have too). The first thing you should do is ice your knee immediately after the injury has occurred. Ice cold water can help reduce swelling and alleviate pain by constricting blood vessels in the area.
However, remember not to apply ice directly against your skin; instead, place a towel between the ice pack and your skin so that it doesn't burn or damage your tissue! It is important to seek medical assistance immediately.
- You should receive proper treatment for your injury. The best way to do this is with the help of a physical therapist or doctor, who can assess the damage and develop a plan of action.
- Your doctor or physical therapist will likely provide you with exercises designed to strengthen the muscles around your knee. They may also recommend wearing a brace while exercising in order to reduce stress on the ACL as it heals, along with any other precautions necessary based on your specific situation (for example: avoiding sports that involve jumping).
- Recovery times vary depending on how severe the tear was when it occurred; however, most people are able to return to their regular activities within six months after surgery if there are no complications during recovery.
As an Athlete – Get Regular Checkups with Your Doctor or Physical Therapist
You should also talk to your doctor or physical therapist about getting regular checkups and enrolled in an injury prevention program. These professionals can help you with exercises that strengthen the muscles in your leg, which can help prevent future injuries. They may also suggest medication, surgery or other treatments for the tear if it doesn't heal on its own.
If you have had an ACL tear, it's important for you to stay active and keep exercising even after treatment has ended. This will help improve circulation around the knee joint and reduce swelling as well as strengthening muscles around the injured area so they won't get weak again in case another injury happens down the road.
In addition to these benefits from exercising consistently over time and remaining cautious when performing activities like running, there are two specific movement and exercise approaches worth mentioning here:
- Yoga/pilates classes
- Focuses on balance and muscle restoration.
- Pool therapy sessions
- Where water provides resistance while providing buoyancy, making it easier on the joints for exercise and recovery.
Even if you're not a professional athlete, these tips can help reduce your risk of injury when playing sports or kicking in soccer.
- Warm up before you start playing. Warm up before each practice or game and do some light stretching exercises to increase blood flow to the muscles around your knee.
- Stretch after each workout session to help prevent ACL tears from occurring by improving flexibility in these areas as well as increasing circulation.
- Strengthen the muscles surrounding your knees with exercises like squats and lunges.
There are a few things you can do to avoid ACL tears. First, make sure to use proper form, avoid high impact activities (if that is not a choice, focus on body awareness with jumping/landing or playing sports), use the right equipment, and warm up before a workout.
Second, stretch and strengthen your leg muscles regularly so they don't get too tight over time (which increases risk of injury).
Finally, get regular checkups with your doctor or physical therapist so they can help monitor progress and injury prevention while providing guidance along the way. By following these tips and being vigilant about your knee health, you can keep playing soccer or football knowing you have implemented the most beneficial preventative methods to date! An ounce of prevention is worth a pound of cure! Remember that.
1.Dedinsky, R., Baker, L., Imbus, S., Bowman, M., & Murray, L. (2017). EXERCISES THAT FACILITATE OPTIMAL HAMSTRING AND QUADRICEPS CO-ACTIVATION TO HELP DECREASE ACL INJURY RISK IN HEALTHY FEMALES: A SYSTEMATIC REVIEW OF THE LITERATURE. International Journal of Sports Physical Therapy, 12(1).
2.Dr. Mark Cullen. (n.d.). Why female soccer players are at higher risk of ACL injuries. Wentworth-Douglass Hospital. https://www.wdhospital.org/wdh/services-and-specialties/orthopedic-care/blog/why-female-soccer-players-are-at-risk-of-acl-injuries
3.Russell, K. A., Palmieri, R. M., Zinder, S. M., & Ingersoll, C. D. (2006). Sex differences in valgus knee angle during a single-leg drop jump. Journal of Athletic Training, 41(2).