Knee and ACL injuries commonly occur in sports such as soccer, ultimate, and rugby. Athletes may require months to even more than a year to recover and to be able to return to play. There is a vast amount of literature describing a number of ways on how to prevent knee and ACL injuries. However, the most effective prevention strategies are the ones that are based on scientific evidence, a thorough assessment made by the coach and medical team, and the individual’s input.
Strongly suggested by research, programs most beneficial in preventing injuries consist of flexibility drills, running drills, strength training, core strength, and plyometrics. Each session should last approximately 20 minutes with a goal of exercising a minimum of 30 minutes per week. Programs should be implemented through out the year from preseason to regular season. Although most research studies focused on athletes between the ages of 12 and 25 years, these programs may benefit older individuals.
1) Toe Taps: Standing tall, kick one leg up and touch your toes to the palm of your hand. Alternate legs. Repeat 10 times on each side.
2) Reverse Lunge & Hop: Step back with one leg until you get into a lunge position. Swing the back leg forward until your knee is bent at a right angle by your chest. Maintain an upright body and repeat on the other side. Perform 10 repetitions on each side.
3) Calf Stretch: Standing tall on one leg, extend the other leg forward with only the heel in contact with the floor. Gently bend forward at the hips and feel a stretch along the front leg. Hold for 30 seconds and repeat on other leg. Perform 3 times on each side.
Perform running drills such as forward and backward running or bounding. Watch Physiotherapist Claire lead two athletes through a series of running and other dynamic drills below.
1) Planks: Begin on the floor resting on your forearms and knees. Extend both legs until your whole body forms a straight line from the top of your head to your feet. Engage the core and glute muscles. Begin by holding this position for 30 seconds. Progress to 60 seconds or more to increase difficulty.
2) Glute Bridge: Begin on the floor with your back flat, legs bent at approximately 90 degrees and both feet on the ground. Place both arms to the side then engage your core as you lift your hips up. Hold for a second or two at the top as you squeeze your glute muscles.
1) Box Jumps: Use a box that is around your knee height or higher. Stand in front of the box with your feet shoulder-width apart. Bend slightly downwards, swing your arms back, then swing them forward and explode up off the ground onto the box. Repeat 10 times.
2) Lateral Skater Jumps: Begin by standing on one leg and bend the other leg. Jump sidewards and land on the leg that was bent. Then switch sides. Repeat 10 on each side.
Ever feel pain or swelling on the side of your foot? These symptoms may be due to a condition called Cuboid Syndrome, also known as cuboid subluxation or lateral plantar neuritis. In addition to pain in the lateral mid-foot, redness and a restricted range of motion in the ankle may be present. This syndrome is typically associated with an inversion sprain of the ankle. This is when the foot is forced inwards causing the cuboid bone to sublux, or partially dislocate. The cuboid bone is located near the mid-point of the outer side of the foot and is one of the seven tarsal bones that make up the arch of the foot. It connects the foot and ankle as well as provides stability to the foot.
The peroneus longus muscle is a muscle that runs along the outer side of the lower leg and attaches to the lateral side of the foot. Repetitive strain of this muscle due to activities such as ballet, jumping, or running, may place tension on the cuboid bone. Commonly found in athletes, Cuboid Syndrome may also occur in sports such basketball, football, or soccer. Weight-bearing, uneven pavement, or quick changes in direction that occur in sports may aggravate symptoms. A third cause of this syndrome may be an individual’s altered foot biomechanics. Athletes who have over-pronated feet, also known as flat feet, may be more prone to cuboid subluxation.
Imaging such as x-rays, MRIs, and CT scans can be used to rule out other causes of pain. However, a cuboid subluxation can be difficult to diagnose and therefore, must be carefully assessed by a general physician or other health care professional.
Daily strengthening and mobility exercises should be performed on a pain-free basis to prevent the foot and ankle from becoming weak or stiff. Watch the videos below on how to properly perform strengthening exercises:
Other treatment options include foot support such as padding, taping, or orthotics to help stabilize the bones of the midfoot or correct for over-pronation. Rest from repetitive, weight-bearing actions such as jumping or running may help alleviate pain. Ice affected area for 10 minutes at a time to reduce swelling and inflammation. Consult your family physician, physical therapist, or podiatrist to perform a manipulation if the cuboid bone is suspected to be dislocated.
Insync Physiotherapy’s Michelle Robichaud, RMT, recently returned from her amazing trip to Northern Europe and back in time for the 2018 BMO Vancouver Marathon where she completed an 8-km run! Congrats Michelle!
Check out the photos below of Michelle in Iceland, Scotland, and Denmark: