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Wednesday, February 15, 2017

ACL Injuries in Women Footballers - Win the Battle!

There were another 2 or 3 season ending knee injuries in the AFLW season this week and it;s not just the AFLW season they'll miss, but the entire year for local footy and work.

It could potentially cost them next years AFLW season as well depending on the severity of the injury and how successful and seamless the recovery process is.

I probably should have done this post as one of the initial blogs for Women's footy but I did touch on it in my inaugural women's football post.

I'll re-post a few of the main points from that post real quickly.

DECREASED RELATIVE STRENGTH

During adolescence, males get stronger as their bodies get heavier from natural development so relative strength can improve at the same rate. In females, their strength levels can cease development while their bodies continue to get heavier and develop, essentially decreasing relative strength and leaving women athletes unable to control their bodies optimally to stay out of injury risk zones.

INCREASED FLEXIBILITY

Females naturally have more pliable and flexible muscle and connective (ligaments/tendons) tissue. This can lead to hyper mobility which can be an injury risk if not "corrected" through ample stability training. It also results in slower contraction time which can leave you vulnerable during max velocity movements.

To paint this picture think of tight rubber band versus and loose rubber band. When pulling them back to slingshot forward, which is pretty much how propulsion/sprinting works, you obviously don't need to pull back the tighter band as far as the loose band. The unfortunate thing here is that you want to go as hard as you can and when the loose rubber band can't tighten in time to sling your forward, you'll loose all joint stability and the connective tissue are out under huge strain to to do this job and snap!

I would be very hesitant to stretch any female at all, let alone footballers.

MENSTRUAL CYCLE

A week or 2 ago I posted anout what happens to the female body on phyioslogicval and pscological level through the the 28 day mentrual cycle.

As mentioned above, womens bodies are extremely pliable but at various times during your cycle, you can become extra, extra pliable - obviously a recipe for diaster if not accounted for during your training.

VARYING BODY SHAPE

This isn't exclusive to women but it can probably have more of an affect of what you're strengths and weakness will be compared to men. The ideal build for a female runner is small breats and a small waist which will mean less body mass to move, a decreased average Q angle and thus decreased injury risk.

If you're not that shape, and not everyone will be, then it would be wise to plan your training in the long term to focus on a combination of off and on-legs cardio, rather then just running, running, running.

Let's look at more ACL specific implications.

Females can be as high as 8 x more likely to injure an ACL then men.

Females have a far narrower space for the ACL to pass through leaving you extremely vulnerable during twisting motions, even of very short range of motion.

 The Q angle is the angle from the the most lateral part of your hips to the lateral knee and the greater angle this is, the greater potential for "knock knees" you'll have during change of direction and landing movements. This is the twisting/rotational movement discussed above that can put you in the high risk injury category.

Deceleration and landing mechanics are rarely taught to any athlete let alone women, where strength and mechanics can improve your capacity to perform both in a safe manner can be greatly improved.

The posterior chain refers to all the muscles up the back of the body such as the glutes, hamstrings and upper back muscles that can often be neglected in all forms of training, or not trained enough. In regards to ACL injury prevention, the glutes can stabilise the knee from up top and decrease some of the unwanted movement that can occur. During deceleration from sprinting or when changing direction the hamstrings can also assist strongly to decrease the "lag time" mentioned above in reference to looser muscle and connective tissue.

Most ACL tears in women will occur from a 1 step and deceleration movement, cutting movements, change of direction movements and landing from a jump with inadequate knee and hip flexion, essentially landing with straight legs which leaves your muscles unable to take any of the stress of the movement and a lapse in concentration can also result in an unanticipated change of direction.

It's important to know that 70% of female ACL injuries are non-contact and occur with your feet on the ground.


Because of the weakness described above a lot of women will change direction in a more vertical position and will also land with less knee bend which is simply the body taking the path of least resistance to get the job done - strengthening those muscles and actions will change the mechanics of how your body moves and functions, and hopefully take away from the high injury risk category.

The PEP program was designed by Santa Monica Sports Medicine Foundation specifically for women athletes of all sports.

It's a program to be done 3/week and it takes about 20mins each time. I would be wary of fatigue playing a apart in this program essentially rendering it useless as you won't be using the muscles, or the mechanics you're meant to be so I'd suggest at least starting with 10mins x 6/week to spread the stress initially.

WARM UP

Jog with High Knee + Full Hip Extension


Side Shuffle with Straight Torso and Staying Low

Backwards Running Maintaining a Slight Knee Bend At All Times

STRENGTHENING

Walking Lunge

Nordic Curls

Single Leg Calf Raise + Hip Flexion Slow and Controlled

PLYOMETRICS

Line Jumps

Lateral Line Jumps

Line Hops

Lateral Line Hops

Forward Hops

Backwards Hops

Lateral Hops Abduction

Lateral Hop Adduction

Drop Squat  + Stick Landing

Drop Split Squat + Stick Landing

Vertical Jump + Stick Landing

Split Squat Jump + Stick Landing

Hieden Hop + Stick Landing

AGILITY

Run + 3 Step Deceleration

Zig Zag Run + Push Off

Bounding Run

Like I said, I think it's best to start off by cutting this in half choosing half of the exercises and doing them all in go then doing the other half the next day x 6/week in total.

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