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Prevention of ACL injury and the Tuck Jump Assessment

Prevention of ACL injury and the Tuck Jump Assessment. Alexis Aton, PT, DPT. Importance of preventing ACL injury. On average, ACL repair and post-op rehab will cost between $17,000 and $25,000 1 . Yikes!!! Rupture can mean scholarship loss. Academic performance may decline 2 .

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Prevention of ACL injury and the Tuck Jump Assessment

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  1. Prevention of ACL injury and the Tuck Jump Assessment Alexis Aton, PT, DPT

  2. Importance of preventing ACL injury • On average, ACL repair and post-op rehab will cost between $17,000 and $25,0001. Yikes!!! • Rupture can mean scholarship loss. • Academic performance may decline2. • Early onset of OA3.

  3. Purpose of the TJA4 • Identify those who may be at higher risk for ACL injury. • Assess jumping mechanics. • Identify neuromuscular imbalances. • Results from the TJA can help guide treatment.

  4. Who is this appropriate for? • Athletes, especially those whose sport involves jumping or cutting. • Volleyball, Basketball, Soccer etc.. • Female athletes in particular. • 4-6 times greater risk for non-contact ACL injury compared to males.

  5. How to perform the TJA • Instruct the participant to perform repeated tuck jumps for 10 seconds. • Video tape the participant in both frontal and sagittal planes. • Jumping techniques are then subjectively scored based on the following score sheet…

  6. What do the results mean? • Empirical evidence suggests that participants with 6 or more flaws are at a higher risk for injury and should be targeted for technique training4. • Results can also be used to identify the athlete's “dominance” pattern4,5. • Ligament dominance • Quadriceps dominance • Leg dominance • Trunk dominance

  7. Ligament Dominance (LD) • Decreased use of posterior kinetic chain during landing. • Glutes • Hamstrings • Gastroc • Muscles do not adequately absorb ground reaction forces, so the forces going through bone, ligaments, and cartilage increases. • What to look for: • Valgus collapse at landing. • Foot placement is not shoulder width apart at landing.

  8. How to address LD • Focus on teaching them proper jumping and landing techniques. • Start by teaching them on a shuttle progressing from small hops to larger jumps.

  9. Quadriceps Dominance (QD) • Upon landing, quads activate prior to glutes and hamstrings causing a stiffer landing with less knee flexion. • The hamstrings are synergists to the ACL helping prevent anterior tibial translation. If they don’t activate at the right time, the ACL is placed at a greater strain. • What to look for: • Hard, loud landing • Decreased knee flexion at landing Poor Landing Form Proper Landing Form

  10. How to address QD • Ball bridge with hamstring curl • Unilateral bridge • Single leg dead lift • Russian Hamstrings

  11. Leg Dominance • Individual favors one leg. • What to look for: • Thighs are not equal height during flight. • Foot placement not parallel (front to back) at landing. • Foot contact timing is not equal. Good form Poor form

  12. How to address Leg Dominance • Single leg balance activities • Single leg hopping • Reverse bosu activities

  13. Core Dominance (CD) • Inability to control center of mass. • What to look for: • Thighs do not reach parallel at peak of jump. • Pause between jumps. • Does not land in the same footprint each jump. Thighs not parallel to ground

  14. How to address CD • Plank/Side Plank • Cable chops • Skier crunch • Closed chain hip ER

  15. example • http://www.youtube.com/watch?v=8YOYx1Jl68I

  16. References: • 1. Hewitt TE, Lindenfeld TN, Riccobene JV. The effect of neuromuscular training on the incidence of knee injury in female athletes. A prospective study. Am J Sports Med. 1999;27 (6): 699-706. • 2. Freedman KB, Glasgow MT, Bernstein J. Anterior Cruciate Ligament Injury and Reconstruction Among University Students. ClinOrthop Related Res. 1998; 356:208-212. • 3. Fleming BC, Hulstyn MJ, Oksendahl HL, Fadale PD. Ligament Injury, Reconstruction, and Osteoarthritis. CurrOpinOrthop. 2005; 16(5): 354-362. • 4. Myer GD, Ford KR, Hewett TE. Tuck Jump Assessment for Reducing Anterior Cruciate Ligament Injury Risk. AthlTher Today. 2008; 13(5): 39-44. • 5. Unverzagt C. EIM Sports Competencies Weekend Intensive. 2011.

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