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4th Annual Marino Lecture
and Symposium
ACL/ Injury Prevention Program
Phases
Sports and Physical Therapy
Associates
Cincinnati Sports Medicine
1999 Using a combination of Jump
Training/ Plyometrics
Strength Training and Flexibility
6 week...
PEP Program
USC, Santa Monica California,
from 2000 to 2002 completed 3
studies
Highly specific Training session
Used to r...
Training To Reduce ACL
Injuries
Cincinnati Children’ Hospital
Timothy Hewett, Ph.D.
Jump Training
www.cincinnatichildrens....
ACL/General Injury
Prevention Program Phases
Dynamic Warm-
up/Cool down
Plyometrics/ Neuro
Muscular Re-ed
Proprioception/
...
Dynamic Warm up
Prepares the Body for the
demands of the work out or
practice
Increases heart and respiratory
rate and blo...
Dynamic Warm Up
Progress from low to high
intensity
Include all planes of motion, Multi
directional and Diagonal Patterns
...
Dynamic Warm Up
Many Of the Components of The Injury
Prevention Program can be worked on
during this phase
DukeHealth.org:...
Cool Down
Following Sport or Activity
Cool down consists of moving in same
movement patterns as warm up with
decreasing In...
Plyometrics/Strength
Progressive Leaping and
bounding exercises
This gives Muscle pre stretch
which enhances muscle
contra...
ACL Injury
Prior to starting Plyos
Instruct Athlete on the
stability/power position
Knees bent 25-30 degrees
Hip and Knee in Neutral
...
Reps and Sets
Foot Contacts per workout:
Level Low intensity Med Intensity High Intensity
Beginner 40 60 80
Intermediate 6...
Criteria for Advancing
Once Athlete has
mastered each jump
for at least 2
consecutive practice
sessions , this means
good ...
Plyometrics/Jump
Training
Higgins/Duke
Proprioception
The ability to maintain
stability and orientation
during static and dynamic
activities.
Mechano Receptors a...
Proprioception
A proprioception
program should
stimulate these
mechano receptors.
The ability to know
where you are in
spa...
Strengthening
Strengthening
To increase a muscles
tolerance to physical
stress. This in turn
will increase its
cross secti...
Isolation Exercises
Isolates Muscle groups to address
Imbalance
post injury or surgery
+Less chance of injury during train...
Multi Muscle Group
Training
Sports Specific
Training
– Training muscle
groups to work
together in concert.
Training the bo...
Multi Muscle Group
Examples
Field exercises
Squats
Diagonal Patterns
NATA
Open Chain Exercises
Open Chain : Foot is
free to move
– SLR, SAQ, LAQ
– Leg Extension machines
– Leg Curl machines
Hamstr...
Closed Chain Exercises
Closed chain: Foot is Fixed
– Wall slides, squats, lunges
– Leg Press Machine
– Hack Squat Machine
...
Which is Better??
Open Chain vs. Closed Chain
Studies show long term no
greater results in strengthening
and no greater re...
Repetitions How Many?
Science of Repetitions
– Physiologically higher
repetitions give the joints and
tendons better blood...
Frequency of Training?
How often to train the
same
movements/muscles?
– It depends on similar
variables
In-season, pre-sea...
Periodization
The science of cycling
reps and intensities
during different
parts of the
training cycle.
NSCA
Flexibility:Improving a
Joints Range of Motion
Types of Stretching
– Active- Hold 2-3 sec
repeat 20 times
– Static – hold ...
ACL Injuries/
Patellofemoral Pain
The age group that
ACL injuries occur 13-
17:
Also age group
marked decrease in
flexibil...
Stretches to decrease
Patella Tendinitis Witvrouw AJSM 2001
Stretches
– Rectus/Quadriceps
- Hamstring
Time to stretch?
Optimal time to stretch
– After warm-up
– At end of Cool
Down
Ian Jeffreys, MS CSCS
NSCA
Agilities
Most Sports are in
themselves agility
movements
However practicing
cutting movements that
tend to cause stress t...
Pick Agilities to Fit Sport
Agility Patterns that
mimic sports
movements
– Grapevines
Side to side
– Run ,plant and cut
NS...
ACL Prevention Today
Although the Pep program and
Cincinnati prevention
programs reduced ACL
injuries significantly.
Both ...
ACL Project Prevent
USC ACL Project
Prevent
A 3 year Study
Funded By the NIH
Identify Gender
Specific Movement
Patterns
Th...
As Athletic Trainers and
Physical Therapists
Utilize evidence based
Medicine as the backbone of
your rehab!
Develop a prog...
FIELD DRILL FOR Injury
PREVENTION
Run Back Peddle Run Back Peddle
Cut
and
Run
Plyometrics,
Squats, Side
to Side, etc.
Rais...
If Budget is really Bad
1 piece of Chalk
1 pebble
4 single Leg Jumps
2 Double leg Jumps
1 180 Degree Jump
1 Single Leg Squ...
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ACL Injury Prevention Program

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Sports and Physical Therapy Associates share a presentation on the ACL Injury Prevention Program.

Veröffentlicht in: Gesundheit & Medizin, Sport
  • hi. i want this ppt. file. please send me: hadiakbari62@gmail.com thanks
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ACL Injury Prevention Program

  1. 1. 4th Annual Marino Lecture and Symposium ACL/ Injury Prevention Program Phases Sports and Physical Therapy Associates
  2. 2. Cincinnati Sports Medicine 1999 Using a combination of Jump Training/ Plyometrics Strength Training and Flexibility 6 week preseason program Reduced ACL injuries in the Trained Women vs. Untrained women Hewett 1999 AJSM
  3. 3. PEP Program USC, Santa Monica California, from 2000 to 2002 completed 3 studies Highly specific Training session Used to replace the conventional warm up Dramatic reduction in ACL injuries from 72% to 88% compared to the control groups Mandelbaum AMJS 2005
  4. 4. Training To Reduce ACL Injuries Cincinnati Children’ Hospital Timothy Hewett, Ph.D. Jump Training www.cincinnatichildrens.org/sportsmed Pep Program Dr. Bert Mandelbaum, MD www.aclprevent.com
  5. 5. ACL/General Injury Prevention Program Phases Dynamic Warm- up/Cool down Plyometrics/ Neuro Muscular Re-ed Proprioception/ Balance Strengthening Lower Extremities/Core Flexibility Agility PEP/Cincinnati Sports Medicine
  6. 6. Dynamic Warm up Prepares the Body for the demands of the work out or practice Increases heart and respiratory rate and blood flow to muscles Increases core body Temperature Enhances Muscles elasticity Athlete Should break a sweat w/o excessive fatigue Usually 10-20 minutes NSCA
  7. 7. Dynamic Warm Up Progress from low to high intensity Include all planes of motion, Multi directional and Diagonal Patterns Warm up should include exercises for both upper and lower extremities Warning: May induce fatigue in deconditioned athlete NSCA
  8. 8. Dynamic Warm Up Many Of the Components of The Injury Prevention Program can be worked on during this phase DukeHealth.org: Mike Huff and Verne Gambetta have taken Low intensity agilities, Plyos and dynamic stretches to act as warm up
  9. 9. Cool Down Following Sport or Activity Cool down consists of moving in same movement patterns as warm up with decreasing Intensity Static Stretching Optimal Time Rehydrate/ Refuel Carbs Relax Ian Jeffreys MS CSCS NSCA
  10. 10. Plyometrics/Strength Progressive Leaping and bounding exercises This gives Muscle pre stretch which enhances muscle contraction Allerheigen 1994 Jump Training/ Neuro Muscular Control Develop stability during the movement patterns that seems to put knee in most vulnerable landing or cutting positions Valgus landing with rotation Co contraction of Muscles to Stabilize Joint Mandelbaum 2000
  11. 11. ACL Injury
  12. 12. Prior to starting Plyos Instruct Athlete on the stability/power position Knees bent 25-30 degrees Hip and Knee in Neutral alignment Control valgus Greatest level of Ham to quad co contraction NSCA
  13. 13. Reps and Sets Foot Contacts per workout: Level Low intensity Med Intensity High Intensity Beginner 40 60 80 Intermediate 60 80 100 Advanced 100 120 140 McNeely NSCA 2008
  14. 14. Criteria for Advancing Once Athlete has mastered each jump for at least 2 consecutive practice sessions , this means good form and DOMS has subsided you may progress to greater level of difficulty. If athlete is in middle of high volume jumping season, basketball, volley ball etc. watch for signs of overtraining NSCA
  15. 15. Plyometrics/Jump Training Higgins/Duke
  16. 16. Proprioception The ability to maintain stability and orientation during static and dynamic activities. Mechano Receptors are neuro sensory cells that are responsible for monitoring joint position and movement. 6 exteroceptive senses 1 interoceptive sense Kinetics
  17. 17. Proprioception A proprioception program should stimulate these mechano receptors. The ability to know where you are in space NSCA
  18. 18. Strengthening Strengthening To increase a muscles tolerance to physical stress. This in turn will increase its cross sectional area. Progressive Resistive means move up!!! NSCA
  19. 19. Isolation Exercises Isolates Muscle groups to address Imbalance post injury or surgery +Less chance of injury during training - Costly - Doesn’t strengthen stabilizing muscles NATA
  20. 20. Multi Muscle Group Training Sports Specific Training – Training muscle groups to work together in concert. Training the body to work per the required needs to the specific demands of a sport. NATA
  21. 21. Multi Muscle Group Examples Field exercises Squats Diagonal Patterns NATA
  22. 22. Open Chain Exercises Open Chain : Foot is free to move – SLR, SAQ, LAQ – Leg Extension machines – Leg Curl machines Hamstring /Quad Ratio +great for isolating muscle groups
  23. 23. Closed Chain Exercises Closed chain: Foot is Fixed – Wall slides, squats, lunges – Leg Press Machine – Hack Squat Machine + co-contraction of leg and hip muscles - don’t isolate muscles as well
  24. 24. Which is Better?? Open Chain vs. Closed Chain Studies show long term no greater results in strengthening and no greater result in injury. PFS or ACL – Use them appropriately Erik Witrvrouw, AJSM 2004 Hooper & Morrisey AJSM 2001
  25. 25. Repetitions How Many? Science of Repetitions – Physiologically higher repetitions give the joints and tendons better blood flow – Used better for post-season or rehabilitating an injury 15-20 reps – Lower reps better for strength/power, used better during power cycles and pre- season Grimsby
  26. 26. Frequency of Training? How often to train the same movements/muscles? – It depends on similar variables In-season, pre-season, off-season, age and sport of the athlete – Typically the same muscle group no more than 2 x/week NSCA
  27. 27. Periodization The science of cycling reps and intensities during different parts of the training cycle. NSCA
  28. 28. Flexibility:Improving a Joints Range of Motion Types of Stretching – Active- Hold 2-3 sec repeat 20 times – Static – hold 30 seconds repeat 2 times – Dynamic -Active Movements through exaggerated ranges NSCA
  29. 29. ACL Injuries/ Patellofemoral Pain The age group that ACL injuries occur 13- 17: Also age group marked decrease in flexibility which can lead to Patellar Tendinitis and or PFS Witvrouw AJSM 2001
  30. 30. Stretches to decrease Patella Tendinitis Witvrouw AJSM 2001 Stretches – Rectus/Quadriceps - Hamstring
  31. 31. Time to stretch? Optimal time to stretch – After warm-up – At end of Cool Down Ian Jeffreys, MS CSCS NSCA
  32. 32. Agilities Most Sports are in themselves agility movements However practicing cutting movements that tend to cause stress to the athlete’s knee can create improved coordination and strength through sports specific movements NSCA
  33. 33. Pick Agilities to Fit Sport Agility Patterns that mimic sports movements – Grapevines Side to side – Run ,plant and cut NSCA
  34. 34. ACL Prevention Today Although the Pep program and Cincinnati prevention programs reduced ACL injuries significantly. Both groups readily admit it is unclear which aspect of their programs were responsible for the reduction in injuries USC/Cincinnati Sports Medicine
  35. 35. ACL Project Prevent USC ACL Project Prevent A 3 year Study Funded By the NIH Identify Gender Specific Movement Patterns That may predispose Female Athletes to ACL Injuries
  36. 36. As Athletic Trainers and Physical Therapists Utilize evidence based Medicine as the backbone of your rehab! Develop a program that works for your coaches, teams and patients ! Achieve participation with resources and time available ! One Size doesn’t Fit All
  37. 37. FIELD DRILL FOR Injury PREVENTION Run Back Peddle Run Back Peddle Cut and Run Plyometrics, Squats, Side to Side, etc. Raise level of difficulty as season progresses Side to Side, Carioca, etc 30 yards x 30 yards
  38. 38. If Budget is really Bad 1 piece of Chalk 1 pebble 4 single Leg Jumps 2 Double leg Jumps 1 180 Degree Jump 1 Single Leg Squat Make the Squares Bigger Start Again

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