Motion Stability talks Football
Post by Beth Collier, PT, DPT, OCS
With the baseball all-star break complete, No. 2 pencils in abundance on the shelves of stores everywhere, and crisp mornings in July complete with the smell of autumn, an avid sports fan, such as myself, cannot help but anticipate the arrival of football season! Year after year, hopes are set to the highest as pre-season hype takes over the radio, television, newspaper and social media. Our yearly mantra seems to be, “this is sure to be our year…. if we can keep everyone healthy.” Our ultimate downfall, year after year, seems to be injury after injury.
Most recently in the world of college and professional football, ACL injuries seem to be in abundance more than ever before. Last year in the NFL, there were 27 preseason ACL injuries and over 50 for the entire season, marking one of the highest incidences to date. Last year the University of Georgia was exceptionally disheartening with the amount of ACL injuries. The Georgia Bulldogs suffered the loss of six players last year from ACL tears, including the senior quarterback Aaron Murray, receiver Malcolm Mitchell, Keith Marshall, and receiver Justin Scott-Wesley. Many of these injuries occurred from non-contact mechanisms, such as Malcolm Mitchell’s chest bump with a teammate in the end zone.
So, why the sudden surge of injuries? Let’s explore more on the ACL and possible contributing factors to the injuries that are running rampant.
The ACL (anterior cruciate ligament) is a structure deep inside of the knee that is responsible for providing stability between the 2 larger bones, the femur and tibia. When the knee is forced into excessive extension (too straight), the ACL becomes very tense leaving it at risk for a sprain or tear injury. An injury to the ACL can leave the knee very unstable and impair balance and agility function.
When most people think of ACL injuries in football, there is the common picture of a player’s foot planted on the ground while an opponent hits the player in the lower leg, which causes the knee to hyperextend. However, many of the ACL injuries of recent date are non-contact injury, meaning the ACL was injured without multiple players colliding. So what are other causes of such injuries when there is no contact mechanism? Here are some things to think about
1. Shoe wear
Shoes are constantly changing and every shoe is built for specific functional goals. Many players and teams are turning to performance shoes which may enhance speed or agility but are more minimal in the way of support or stability. However, this shoe structure could also transmit more extension force through the knee due to the increased time the foot is in the ground which could lead to excessive tension to the ACL. The hip flexor or hamstring muscles may also be affected due to the increased muscle load required to pull the shoe out of the ground as an athlete is sprinting. Also, with shoe technology changing so rapidly, a player may use a new type of shoe on any given game, essentially having to learn how to run each time in the new shoes.
2. Playing surface
Based on the considerations of shoe wear, we also have to consider the running surface. Cleats will interact differently with artificial turf, grass that is dry, wet, long, short, etc. In this way, the grounds maintenance crew can play a large role in the safety of athletes. In general, artificial turf is much less forgiving and stiff, which may provide a better traction for sprinters running in a straight line, but it does not allow for rapid direction changes. Imagine a cleat sticking into the turf as the upper body rotates to change direction causing a torsion force at the knee which can lead to ACL or meniscus injuries.
3. Training and Conditioning
Many people make the mistake of training their lower body using only squats, lunges, burpees, and running. Most of these exercises target quads, calves and gluts, which are important in power moves and running, yet they are not the only important parts. Hamstrings are the most commonly overlooked muscles in lower body training, typically because most people have tight hamstrings and they think that tight means strong. However, this is very inaccurate thinking! Hamstrings have to contract at the same time as the quads to stabilize the knee. And, as it relates to the ACL, hamstrings have to work eccentrically (slowing down momentum) to counteract any excessive knee extension motion. So, not only do you need mobility in your hamstrings, you also need good strength and control of these muscles for stability at the knee.
4. Taping and bracing
Many athletes preventatively tape or brace their ankles to avoid ankle sprains before beginning a game or workout. However, too much stability or rigidity at the ankle can cause other joints in the leg, especially the knee, to compensate by utilizing more range of motion. Imagine landing on the ball of your foot on another player’s leg with a rigidly taped ankle. Because your ankle is so stiff, it cannot bend and flex, so instead, your knee extends back, which stretches your ACL.
5. Movement patterns
Your body will generally adapt to movements and positions after prolonged and repeated exposure. However, the way your body adapts may not necessarily be the most efficient or safe way to perform. Especially as a high level athlete who can coax their body to perform most anything their brain asks of it. However, inefficient or abnormal movement can cause a breakdown to body parts that are not intended to take certain levels of stress. This can lead to direct injury or can cause a slow breakdown of your body over time. A functional movement screen, such as FMS or Fusionetics, can identify abnormal movement patterns which the athlete can address in training/practice or during the off-season to prevent injury in the future.
While this is not an exhaustive list, I think these are important factors that need to be further researched and considered. If you have any questions regarding injury prevention or return to activity after an injury, be sure to contact the expert physical therapists at Motion Stability.