I had a reader email me the question "What are the top three things that should be in every program to prevent knee injuries?"
While I think this is an incomplete question I want to try to respond with something satisfactory. Injuries mechanisms are multifactorial and complicated so trying to pin down only three things to prevent the occurrence of something like an ACL tear or ankle sprain is impossible. Additionally, we can't actually "prevent" anything but I am confident that you can significantly reduce occurrences with intelligent training.
While I think this is an incomplete question I want to try to respond with something satisfactory. Injuries mechanisms are multifactorial and complicated so trying to pin down only three things to prevent the occurrence of something like an ACL tear or ankle sprain is impossible. Additionally, we can't actually "prevent" anything but I am confident that you can significantly reduce occurrences with intelligent training.
So here would be my "Top 3"
1). Multidirectional Agility & Movement Drills
The reason many people end up with knee injuries is due to their inability to effectively plant, decelerate and change direction. Progressively challenging the athlete in multiple planes first with rehearsed and scripted drills and eventually with reactive and competitive drills can establish the movement skills necessary to change directions successfully on the field.
2). Stability Focused Plyometric Drills
Many performance programs include plyometrics but far too many place a huge emphasis on force production and very little focus on deceleration. Rehabilitation and reduction strategies should focus on educating the athlete to land properly and accept force from the ground before explosively producing force.
3). Progressively Challenging Strength Training (Primarily Unilateral Lower Body)
None of the aforementioned training techniques will be effective if the athlete enters them with too little strength. Strength training is the foundation for any reactive and dynamic drills that come later on down the line. Progressively moving from isometric to eccentric and finally traditional concentric strength work is a technique I use in rehab that works well in a regular training environment as well. The fundamental strength to decelerate and stabilize the joint should be a primary objective in any training program. Additionally, performance programs should focus primarily on unilateral lower body strength exercise to promote multi-planar stabilization of the hip, knee and ankle.
1). Multidirectional Agility & Movement Drills
The reason many people end up with knee injuries is due to their inability to effectively plant, decelerate and change direction. Progressively challenging the athlete in multiple planes first with rehearsed and scripted drills and eventually with reactive and competitive drills can establish the movement skills necessary to change directions successfully on the field.
2). Stability Focused Plyometric Drills
Many performance programs include plyometrics but far too many place a huge emphasis on force production and very little focus on deceleration. Rehabilitation and reduction strategies should focus on educating the athlete to land properly and accept force from the ground before explosively producing force.
3). Progressively Challenging Strength Training (Primarily Unilateral Lower Body)
None of the aforementioned training techniques will be effective if the athlete enters them with too little strength. Strength training is the foundation for any reactive and dynamic drills that come later on down the line. Progressively moving from isometric to eccentric and finally traditional concentric strength work is a technique I use in rehab that works well in a regular training environment as well. The fundamental strength to decelerate and stabilize the joint should be a primary objective in any training program. Additionally, performance programs should focus primarily on unilateral lower body strength exercise to promote multi-planar stabilization of the hip, knee and ankle.
4). Sagittal Plane Core Stability. Often I find athletes who can't control the relationship between their ribs and pelvis will suffer injuries distally due to lack of control proximally. Teaching an athlete to create stiffness from the center out can go a long way to preventing injuries.
5). Energy System/Mode Specific Conditioning. Conditioning the athlete via their specific energy systems in modes similar to their sport will ready them to resist fatigue and faulty mechanics at the joint during sustained competition.
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