Dynamic warm-ups are the norm for teams getting ready to play, but they’re not enough to address the high risk for ACL injuries that exists for female high school athletes today. To do that, we need to include ACL injury prevention exercises.
There is strong evidence that well-structured ACL injury prevention warm- ups work. They reduce the overall risk of non-contact and indirect-contact ACL injury by 51-62% and 64-73% in young females (13-24 years of age) who are active in sports. None of us wants to see a young athlete sustain this injury, but we’re not doing enough. The number of ACL injuries is still climbing rapidly.
In conversations I had at the United Soccer Coaches convention just held in Baltimore, it is clear that although coaches have good intentions they are often not sure whether their warm up fits the criteria to reduce injuries. Plus, they are concerned about the time it will take away from their practice.
Here, according to a position statement from the National Athletic Trainers Association, is what an effective injury prevention training program looks like:
- Warm up program 15-20 minutes (replaces traditional warm-up)
- Multi-component include at least 3 types of training: strength, plyometrics, sport-specific agility, balance, flexibility (*see FIFA and PEP links at end of article)
- Gradual, simple progression of intensity
- Performed at least 2x/week
- Pre-season and in-season
- With a qualified instructor (coach, assistant coach, physio or trainer) providing feedback on movement quality and exercise technique
For most teams there are a few key adjustments needed to turn the dynamic warm up into ACL injury prevention.
- Add a few exercises from at least 3 kinds of the training types. Choose from strength, plyometrics, sport-specific agility, and balance (*sample exercises shown in FIFA 11+ and PEP links below) Flexibility in the form of static stretching should come at the end of all training and games.
- Be sure and progress your warm up. Once athletes can complete reps with good form, add a challenge. (ie. vertical jumps in place –> jumps side to side over ball or cone –> leap and land one footed –> leap and volley the ball)
- Start this during pre-season and continue in season. Training begins when warm up begins. Establish this from the beginning with your team.
- Provide feedback on form as they perform the warm-up. Warm-ups with careless movement are not only a waste of time; they are actually reinforcing the poor movement habits that players already have ingrained. Be sure knees hinge forward and not inward, knees, hips and ankles are aligned in landing and cutting, and posture is strong, not collapsing forward and sideways.
How do you know whether your injury prevention warm-up is taking hold? See if the sound movement habits you’re teaching are put into play.
- When players jump and land, are they bending their knees to absorb the shock of landing? (or do they land straight-legged?)
- When players cut and change direction, is the cut over a strong and well-aligned plant foot, bent knee and firmly supported torso?
- Can players remain strong against a shoulder challenge while holding possession or playing the ball?
- Can players perform all of these equally well on both left and right sides?
Start today by adding a couple of these training ideas to your everyday dynamic warm up and let’s help our players avoid an ACL injury.