Athletes and Knee Injuries

Posted by The Soccer Doctor on June 18, 2018
Posted in: Recovery & Regeneration, Uncategorized. Tagged: , , , , , , . Leave a comment

The knee is the largest joint in the body, and is subjected to an enormous workload during many sports. That is why the knee is the most frequently injured joint in the human body. The most commonly known knee injuries in sports are the ACL and Meniscus tears.


The main causes of these injuries are sports related, such as a violent twisting of the knee while the foot is fixed or excessive knee twisting. Most often ACL injuries occur when pivoting, cutting or landing from a jump. Majority of sports- related ACL injuries are non- contact injuries like soccer and basketball. Female athletes are known to have a higher risk of ACL injury while competing in competitive sports. IMG_8180Why woman are more prone to ACL injuries is unclear, some experts say it’s due to a combination of theories such as Anatomic differences between men and woman the Q-(quadriceps) Angle the angle at which the femur (upper leg bone) meets the tibia (lower leg bone) this angle is greater in woman then in men it is thought this increased angle places more stress on the knee joint. Muscular imbalances may be another cause, Hamstring/Quadriceps strength imbalances. Most athletes tend to have strong quadriceps and tight hamstrings. A good strength training program along with a stretching program will help to correct these hamstring/quadriceps strength imbalances. A proper training program on jumping and landing technique can reduce the likelihood of an ACL injury.
Meniscus tears occur with a twisting turning or violent bend of the knee while the foot is planted. Basketball, Football and Soccer have high rates of meniscal injuries. fullsizeoutput_4ddInjuries to the medial meniscus are about five times more likely then lateral meniscus tears. An athlete with a meniscus injury who wants to continue sports activities will have to undergo surgery. An injury to the meniscus will almost never heal by itself, due to lack of blood to that area. If you feel you have an ACL or Meniscus tear seek medical attention for further evaluation and treatment.

 

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Do you have clicking or popping in your hip?

Posted by The Soccer Doctor on June 4, 2018
Posted in: Injury Prevention, Recovery & Regeneration, strength training, Uncategorized. Tagged: , , , , , , , , . Leave a comment

What causes a snapping hip syndrome?

Snapping hip commonly occurs in runners, triathletes, and occasionally in recreational athletes. The snapping is a result from the iliotibial band moving over the greater trochanter. Extending the hip from a flexed position might provoke the snapping. The motion will create a audible or palpable snap or click.  If the athlete is complaining of significant pain or difficulty with weight bearing they should have diagnostic imaging performed to rule out any labrum tears.

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Initial treatment for the client/patient should be rest and avoid activities associated with the snapping. Once pain has subsided, treatment should focus on stretching and strengthening of the hip abductors, adductors, hip flexors, and iliotibial band. Continued hip problems may require diagnostic imaging and a visit to a physician.

Typically return to action is 2-3 weeks when a consistent stretching and strengthening program is performed. Failure to improve may require some physical therapy.

This video shows this athlete performing some mini-band exercises that are ideal for recovery from Snapping Hip Syndrome

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Part 2 “Post-PT for ACL Reconstruction”

Posted by The Soccer Doctor on May 29, 2018
Posted in: Injury Prevention, Recovery & Regeneration. Tagged: , , , , , , , , , , , , , . Leave a comment

Functional Integration
Functional integration may begin with basic activity as early as 12 weeks post-surgery and can be progressed toward athletic activity between four and six months. The goal during this time (i.e., 12 weeks to six months) is to safely load the knee in all planes of motion without compromising the graft site.

IMG_7311

Flexibility
Stretching the muscles around the knee is a priority for the client. Specifically targeting the quadriceps, hamstrings, and calves should maintain adequate flexibility around the knee.

Hamstring stretch
Ankle mobility
Groin/Hip/Thoracic
Calf stretch

 

Balance
Balance activity should have been implemented in
the early stages of rehabilitation. At the time of fitness activity, the client should have good balance with basic single-leg activities. Progressively challenging the knee in multiple planes will help prepare the joint for higher- level activity.

 

Strength training
Training should focus on developing symmetrical strength between the quadriceps, hamstrings, and hip muscles. Strengthening of the hip muscles helps restore stability in the lower limbs and decreases strain on the reconstructed ligament. The hamstrings and quadriceps are particularly important because they add stability to the injured knee and are critical in long-term knee function and prevention of further injury.

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Month 6 – 9

  • Sport specific training and preparation to play phase.
  • Improve fitness, Improve strength, Improve proprioception, and Return to sports training.
  • Plan to return to sport when confidence has returned – usually 9 months

Month 9 – 15

  • Return to sport phase
  • At 9 months the knee will start to free up and feel less tight
  • Full proprioception to where the knee feels normal usually takes about 15 months. 

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What’s Your Summer Off-Season Soccer Plan?

Posted by The Soccer Doctor on May 28, 2018
Posted in: Core Training, strength training, Uncategorized. Tagged: , , , , , . Leave a comment

Phase 1: The Off-Season

Focus: Functional Strength

The off season is the foundation of your overall soccer training routine, and as a result, it is the most important component of your training. It creates the base on which all other strength and power are built. In the off-season, you will prepare your joints, muscles, ligaments and tendons for greater training intensity during other phases of training and improve overall muscular stability. fullsizeoutput_533

During the off-season, much of your training should focus on the muscle groups that make up your core. This includes your abs, back and trunk. Having a strong core allows your upper and lower body to work together fluidly.

The off-season is also a prime time to balance out your body and its strength. Every soccer player, like most other athletes, has a dominant side. Since you perform the same skills over and over again (for example, kicking with your dominant foot), your muscles develop unevenly. The off-season is the perfect opportunity to balance overuse and underuse of various muscle groups (for example, quads versus hamstrings).

Phase 2: Off-Season/Early Pre-Season

Focus: Maximal Strength

During this phase, you will be working toward becoming as powerful as possible. To do this, you will be lifting the most weight during this phase to increase your strength as much as possible. It is best to complete the maximal strength phase before your soccer season begins so that the remainder of your strength training phases can focus on power and strength endurance, which are both extremely important during on-field play. IMG_7622.JPG

Phase 3: Late Pre-Season

Focus: Muscular Power and Strength Endurance

Now that you have built up your muscles in phases 1 and 2, phase 3 will help your turn all of that strength into soccer-specific power and muscular endurance. This is extremely important for soccer players, as they play one of the few sports that requires equal amounts of muscle endurance and explosive force.

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To build soccer-specific power and endurance, your weight training routine will be replaced by plyometrics during this phase. Plyometrics, originally developed in eastern Europe, are specifically-designed jumping and upper body exercises that develop and increase speed, power and agility. Plan on having this phase last about 4-6 weeks.

Get Your Soccer Players Guide to Performance Training E-book:

This 43 page E-book Includes: – Proper Foam Rolling Technique – Sample Acceleration Drills – Full Strength Training Workout Plan – 14 Week Off-Season Workout Plan – Over 20 Recovery Nutrition Ideas – 52 Week Breakdown for Training ***Bonus*** ACL Injury Reduction Program*** ***Access to Videos that coincide with training program***

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Part 3 “Treatment options for ACL tears”

Posted by The Soccer Doctor on May 22, 2018
Posted in: Injury Prevention, Recovery & Regeneration, Uncategorized. Tagged: , , , , , , , , . Leave a comment

Surgical Considerations
There are several procedures currently used by surgeons to repair the ACL. Surgery involving the medial third of the patellar tendon and the medial hamstring (i.e., semitendinosus) are the two most common procedures.

The Patellar Tendon Graft
This procedure involves taking the middle third of the patellar tendon (autograft) to replace the damaged ACL. The procedure has consistently demonstrated excellent surgical outcomes with a 90 to 95% success rate in individuals returning to pre-injury levels of activity. patellar-tendon-graft

This procedure may not be indicated for people with a history of patellofemoral pain, arthritis, or patellar tendinitis, or for smaller individuals with a narrow patellar tendon. Reported problems with the procedure include post-operative pain behind the kneecap, pain with squatting, and a low risk of patellar fractures.

The healing patellar graft has been linked to anterior knee pain.The prevalence ranges from 15 to 25%, with reported incidences as high as 55%.

The Hamstring Tendon Graft
With this procedure, the surgeon typically harvests strands of tendons from the medial semitendinosus to reconstruct the ACL. This procedure has fewer problems with pain behind the knee-cap, better cosmesis (no anterior incision), decreased post-operative stiffness, and faster recovery. Reported problems with the procedure include increased laxity of the new ligament due to graft elongation (stretching), slower healing of the tendon graft, and loosening of the graft at the anchoring site in the bone. knee_acl_hamstring_tendon_intro02

The Allograft
Surgeons also use cadaveric or allograft grafts from the Achilles tendon, tibialis anterior, and patellar tendon to replace the torn ACL. The allograft procedure may be beneficial for patients who have failed prior ACL reconstruction or who have multiple ligaments that need repair. Problems with the allograft procedure include risk of infection and graft elongation.

Non-operative Management
Non-operative treatment may be beneficial for older, sedentary individuals, but it may be problematic for younger, active individuals. The ACL-deficient knee may still cause instability with activity and may lead to further injury to knee structures such as the menisci or articular cartilage. The focus of treatment is to maintain adequate ROM, gait, proprioception, and strength of the muscles around the knee specifically, strengthening the hamstrings.

Post-operative Precautions
During the first six to 12 weeks after surgery, the fixation of the graft into the bone is the weakest point. It is common for clients who return to higher-level activity to develop anterior knee pain.

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“Most common causes for ACL tears”

Posted by The Soccer Doctor on May 10, 2018
Posted in: Injury Prevention, Recovery & Regeneration. Tagged: , , , , , , . Leave a comment

Three part series on ACL tears…

ACL injuries are the most common sports-related injury of the knee. Seventy to 80% of ACL injuries are non-contact, with only 20 to 30% resulting from direct contact.
Pivoting and cutting sports such as soccer and basketball are the most common scenarios, whereas most direct contact ACL injuries occur in American football. Injuries often occur in relatively young athletic individuals 15 to 45 years of age. Females are two to eight times more likely to injure their ACL than males. Also, female basketball players are 7.8 times more likely to injure their ACL than male basketball players. img_7787.jpg

Mechanism of injury
The mechanism of injury often involves a maneuver of deceleration combined with twisting, pivoting, or side-stepping.

Signs/Symptoms
Most often a client will report hearing or feeling a “pop” during the activity, followed by immediate swelling, insta- bility, decreased ROM, and tenderness often occurs at the lateral line. This typically requires immediate medical care to immobilize and protect the joint, followed by a visit to the orthopedic doctor for further diagnosis and intervention.

Early Intervention
Postsurgery clients typically will be in physical therapy for the first three to four months, depending on the physician’s preferences and the client’s insurance constraints. The client
is generally able to perform full weightbearing with crutches and a brace for the first two to six weeks. Physical therapy and a strengthening program continue until the injured knee has 90% of the strength of the other knee.

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Common among protocols is a return to functional activity between 12 and 16 weeks after surgery and a return to sporting activities around six months. Clinical results of the ACL reconstruction are quite good, with very low reinjury rates. The most common complication is residual anterior knee pain.

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Ankle Sprains

Posted by The Soccer Doctor on April 12, 2018
Posted in: Injury Prevention, Uncategorized. Tagged: , , , , , , . Leave a comment

Ankle sprains account for 1 out of every 10 visits to the emergency room.

Ankle sprains are classified into three grades: mild sprain (grade 1), moderate (grade 2), and severe (grade 3).

Mild Sprains-Typically take 1-2 weeksdegrees-of-ankle-sprains-rs

Moderate Sprains-Typically take 2-4 weeks

Severe Sprains_Typically take 4-6 weeks

The goal as healing progresses is to restore motion, strength, balance, and function to the ankle.

Treatment for most acute injuries begins with PRICE (protection, rest, ice, compression, elevation) and usually improves after a few days. However, difficulty to bear weight on the ankle could be a sign that a physician should take a look.

A common cause of recurrent problems with ankle sprains is incomplete rehabilitation and not correcting ankle weakness, in particular weak peroneal tendons. These are tendons that go along the outside of the ankle and prevent the ankle from rolling.

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