Ligaments help to protect our joints.  Unlike muscles, they do not contract or expand.  Instead, they offer passive support and limit the range of movement in a joint.  Unfortunately, if the joint is forced beyond the normal range of motion, ligaments can be torn, often resulting in surgery and time away from activity.

The anterior cruciate ligament is located in the knee and prevents the tibia (shin bone) from sliding forward on the femur (thigh bone).  Injury to this ligament is common in sports that require rapid deceleration, landing or pivoting (like soccer or basketball). 

One way to help protect ligaments and passive joint structures is to simultaneously contract the surrounding muscles.  This helps to stiffen the area and prevent excessive movement beyond the normal range of motion.  A study published in The American Journal of Sports Medicine found that those athletes who changed direction in an upright posture had less co-contraction of the muscles around the knee.  Due to this, the joint was less protected.  In comparison, those athletes who changed direction with a deeper bend in the knee showed a greater level of muscular contraction in the quadriceps and hamstring.  This offered more protection to the ligaments and the joint.

Although it is commonly understood that adopting a low, athletic position during sports will have a positive impact on performance, it also helps to prevent injury.  It is important that young athletes are encouraged to change direction with a deep bend in the knee so that the chances of injury to the anterior cruciate ligament are lessened.

References

Myer GD, Ford KR, Paterno MV, Nick TG, Hewett TE. The effects of generalized joint laxity on risk of anterior cruciate ligament injury in young female athletes. The American Journal of Sports Medicine 2008; 36(6): 1073 - 1080.

Gilchrist J, Mandelbaum B, Melancon H et al. A randomized controlled trial to prevent noncontact anterior cruciate ligament injury in female collegiate soccer players. The American Journal of Sports Medicine 2008: 36(8); 1476-1483.

Disclaimer
The purpose of this blog is to educate our patients and those interested in improving their health and wellbeing. We recommend that you always consult with a qualified health care professional before applying any of the topics or suggestions mentioned on this website. This information is not intended to diagnose or treat your condition. Burlington Sports Therapy, Dr. McIntyre or Dr. McDowall accept no responsibility for any complications arising from the use of any suggestions, exercises or topics of discussion on this site.

Recently we spoke with a number of soccer coaches about exercises that are suitable for a pre-game warm-up.  Below you will find a warm-up routine for young soccer players that we believe is an appropriate blend of evidence based principles and faithful practices that have been used for years.  Should you have any questions or concerns please do not hesitate to contact us or post your comments right on this site.

1. Light jog - 2 widths of the pitch.

2. Static stretching (5 minutes) - quadriceps, hamstrings, hip flexors, gluteals, calves, neck and shoulders.

3. Dynamic stretching of the upper and lower limbs (5 - 10 minutes).

4. “Cross Country Skiing” - (number 4 from the FIFA 11) - 30 seconds each leg.
“Single Leg Chest Passing” - (number 5 from the FIFA 11) - 30 seconds each leg.
“Jumps over a Line” - (number 8 from the FIFA 11) - 30 seconds.

5. Light jog - 2 widths of the pitch with a few 10 yard sprints.

6.  Repeat number 4.

7. Small possession games (4 vs. 4) in an area measuring approximately 30 X 30 feet.

For more information about the FIFA 11, please visit www.fifa.com. 

Disclaimer
The purpose of this blog is to educate our patients and those interested in improving their health and wellbeing. We recommend that you always consult with a qualified health care professional before applying any of the topics or suggestions mentioned on this website. This information is not intended to diagnose or treat your condition. Burlington Sports Therapy, Dr. McIntyre or Dr. McDowall accept no responsibility for any complications arising from the use of any suggestions, exercises or topics of discussion on this site.

Muscular strains are very common injuries affecting athletic and active people.  Unfortunately, there are many misconceptions and misunderstandings as to why these injuries occur and how we can prevent them.  As always, we’re going to use the published, peer reviewed literature to help dispel some of the myths…

In order to understand how hamstring muscles function during activity, it’s essential that you understand the different types of muscular contraction that occur.  

When we run, the hamstring is responsible for both a concentric and an eccentric contraction.  The eccentric contraction occurs as the hamstring slows our leg during the swing phase.  The concentric contraction occurs after our foot contacts the ground, helping to propel us forward.  Injury to the hamstring muscle usually occurs during the late swing phase of the running stride and / or during footstrike, when the hamstring muscle is switching from an eccentric to a concentric contraction.

An interesting study published in the Scandinavian Journal of Medicine and Science in Sports spent 4 years looking at elite soccer teams in Iceland and Norway.  What they found was that those athletes who followed a stretching program saw no reduction in the incidence of hamstring strain.  Those teams using an eccentric hamstring strengthening program showed a significant reduction in hamstring strain.  In fact, numerous studies have now shown us that hamstring strain injuries are not usually caused by muscular tightness but are more attributed to weakness.  Specifically, hamstring muscles that are weak during eccentric contraction (the swing phase of running) are more prone to strains.  You can then understand why stretching the hamstrings will only help to make them longer or “looser” but will not necessarily help to prevent injury.  To give the hamstrings more eccentric strength, the athlete needs to train them eccentrically.  Several studies have examined the usefulness of the “nordic lower” exercise (pictured below).  Repeatedly, it has been found to be helpful in reducing hamstring strains in athletes and is why it is included in the “FIFA-11″ program.  This exercise eccentrically trains the hamstring muscle so that it can withstand aggressive lengthening and deceleration of the leg during the swing phase of running. 

As always, these recommendations are to educate the reader.  Before implementing new exercise we suggest that you consult with a suitable practitioner who can decipher your risk of injury and the suitability of this exercise for you.  This exercise is primarily used for the prevention of hamstring strains.  If you have a strained hamstring you likely require treatment before thinking about prevention of re-injury.  Call or email our clinic so that you can be examined by one of our doctors and fix that hamstring injury once and for all!

References

Sangnier S, Tourny-Chollet C. Comparison of the decrease in strength between hamstrings and quadriceps during isokinetic fatigue testing in semiprofessional soccer players. Int J Sports Med 2007: 28; 952-957.

Arnason A, Andersen TE, Holme I, Engebretsen L, Bahr R. Prevention of hamstring strains in elite soccer: an intervention study. Scandinavian Journal of Medicine & Science in Sports. 2008: 18; 40-48.

Croisier JL, Ganteaume S, Binet J, Genty M, Ferret JM. Strength imbalances and prevention of hamstring injury in professional soccer players. The American Journal of Sports Medicine 2008: 36(8); 1469-1475.

Gioftsidou A, Ispirlidis I, Pafis G, Malliou P, Bikos C, Godolias G. Isokinetic strength training program for muscular imbalances in professional soccer players. Sport Sci Health 2008: 2; 101-105.

Greig M, Siegler J. Soccer specific fatigue and eccentric hamstrings muscle strength. Journal of Athletic Training 2009: 44(2); 180-184.

Nordic Lower exercise - as seen at www.fifa.com; “The 11″.  

Disclaimer
The purpose of this blog is to educate patients and those interested in improving their health and wellbeing. We recommend that you always consult with a qualified health care professional before applying any of the topics or suggestions mentioned on this website. This information is not intended to diagnose or treat your condition. Our chiropractic clinic in Burlington, Dr. McIntyre or Dr. McDowall accept no responsibility for any complications arising from the use of any suggestions, exercises or topics of discussion on this site. Should you have any further questions about these topics please contact our chiropractic clinic in Burlington.

As mentioned in previous posts, certain sports are associated with certain injuries.  As baseball season is upon us, it may be a good time to introduce you to some of the newer concepts associated with dysfunction in the throwing shoulder.  Repeatedly throwing (as with baseball) places an enormous demand on the different tissues of the shoulder.  Ask any competitive baseball player if their shoulder has ever been sore and you’ll soon understand why much of the research on athletic shoulder injuries is performed on pitchers.  Over the last few years there have been some interesting articles and studies published in sports medicine journals that have changed the way that many practitioners assess, diagnose and treat these injuries.

Many baseball players come to our clinic complaining of pain in the shoulder while throwing that makes them unable to throw at their usual velocity and accuracy.  Often referred to as the “dead arm” in throwing athletes, clinicians now have some useful ways to detect changes in the shoulder that may be causing the problem.  Although not the actual clinical tests we would use, the following may give you an idea as to whether you have a shoulder at risk…

Is there a difference from left to right in how far you can bring your arm backwards?

Is there a difference from left to right in how far you can reach up your back?

Do the contours of your shoulder blades look different when you’re at rest?

Do the contours of your shoulder blades look different when you move your arms?

Although some of the above findings may help detect the shoulder at risk of injury, it’s important that you have your condition properly diagnosed by your chiropractor or sports medicine doctor.  If you experience pain, stiffness, the dreaded “dead arm”, or if you simply plan on throwing a lot this summer, give us a call!

References

Burkhart SS, Morgan CD, Kibler B. The disabled throwing shoulder: spectrum of pathology part 1: pathoanatomy and biomechanics. The Journal of Arthroscopic and Related Surgery 2003; 19(4): 404-420.

Burkhart SS, Morgan CD, Kibler B. The disabled throwing shoulder: spectrum of pathology part 3: the SICK scapula, scapular dyskinesis, the kinetic chain and rehabilitation. The Journal of Arthroscopic and Related Surgery 2003; 19(6): 641-661.

McClure P, Tate A, Kareha S et al. A clinical method for identifying scapular dyskinesis, part 1: reliability. Journal of Athletic Training 2009; 44(2): 160-164.

Tate A, McClure P, Kareha S et al. A clinical method for identifying scapular dyskinesis, part 2: validity. Journal of Athletic Training 2009; 44(2): 165-173.

Disclaimer
The purpose of this blog is to educate our patients and those interested in improving their health and wellbeing. We recommend that you always consult with a qualified health care professional before applying any of the topics or suggestions mentioned on this website. This information is not intended to diagnose or treat your condition. Burlington Sports Therapy, Dr. McIntyre or Dr. McDowall accept no responsibility for any complications arising from the use of any suggestions, exercises or topics of discussion on this site.

Last week we dispelled the myth that certain types of soccer cleats predispose you to ligament injuries in the knee.  Given the time of year (and the fact that we have a certain passion for the game) we’re going to continue looking at injuries in soccer.

According to the literature, the incidence of injuries in soccer players is as high as 1.3 injuries per player each year.  It is also worth noting that 22-42% of soccer injuries are re-injuries and 58% of injuries are non-contact.  So how can we reduce those numbers?

FIFA (the governing body of soccer) has recognized this problem and taken a step toward changing it.  The “FIFA 11″ is an exercise and warm-up program designed to prevent and reduce injuries in soccer.  The program was developed by experts using current published literature and was designed to be easily implemented with players of all ability.  In keeping with newer trends in musculoskeletal medicine and training principles, there is little to no focus on static stretching of muscles.  Rather, the program emphasizes core strength, eccentric muscular contraction, proprioception, dynamic stabilization and plyometrics.  (You’ll find a link to the FIFA 11 at the bottom of this blog).

As practitioners, we often see athletes in our clinic with injuries that may have been prevented with the appropriate guidance.  For some players, certain exercises need to be prescribed while for others certain exercises need to be discontinued.  Whatever the case may be, it’s important that players consult with a knowledgeable practitioner who is able to diagnose and identify predispositions to certain injuries and who is able to provide the appropriate preventative recommendations.

If you’re a soccer player or coach who is interested in preventing injuries this summer, we encourage you to review the FIFA 11 and consider it as part of your training and warm-up program.  We also recommend that you check this area of our website over the course of the summer as we’ll be posting a few more articles relating to the prevention of soccer injuries.  Feel free to contact us if you’re interested in coming to the clinic for an assessment that will help identify those factors that predispose you to common soccer injuries.

As always, feel free to post your comments and questions.  Good luck this summer, and go Arsenal!

http://www.fifa.com/aboutfifa/developing/medical/the11/index.html

References

Nielsen AB, Yde J. Epidemiology and traumatology of injuries in soccer. American Journal of Sports Medicine 1989: 17; 803-807.

Engstrom B, Forssblad M, Johansson C, Tornkvist H. Does a major knee injury definitely sideline an elite soccer player? American Journal of Sports Medicine 1990: 18; 101-105.

Hawkins RD, Fuller CW. An examination of the frequency and severity of injuries and incidents at three levels of professional football. British Journal of Sports Medicine 1996: 32; 326-332.

Disclaimer
The purpose of this blog is to educate patients and those interested in improving their health and wellbeing. We recommend that you always consult with a qualified health care professional before applying any of the topics or suggestions mentioned on this website. This information is not intended to diagnose or treat your condition. Our chiropractic clinics in Burlington, Dr. McIntyre or Dr. McDowall accept no responsibility for any complications arising from the use of any suggestions, exercises or topics of discussion on this site. Should you have any further questions about these topics please contact our chiropractics clinic in Burlington.