Anterior Cruciate Ligament (ACL) injuries are among the most common of all sports-related knee injuries. ACL injuries affect the lives of more than 250,000 people in the United States each year.
ACL injuries are often season-ending and require reconstructive surgery and four to six months of rehabilitation, and even longer depending on the player's age. Players who opt to delay an ACL surgery often suffer secondary injuries such as meniscal tears, articular cartilage injury, or medial and lateral collateral ligament injury.
According to research, four risk factors have been studied in order to understand the causes of ACL injury: anatomy, hormones, environmental factors and biomechanics. The studies, including the one conducted at Duke University, indicate that by intervening just within biomechanics, there can be a decrease in the number of significant knee injuries.
The Santa Monica Orthopaedic and Sports Medicine Research Foundation has collaborated with U.S. Soccer, FIFA, University of Southern California and the Centers for Disease Control to better understand the mechanism of injury of non-contact ACL injuries and has worked diligently to develop an effective prevention program named Prevent Injury and Enhance Performance.
A study was conducted for 14 weeks of sixty-one Division I soccer teams over the course of the fall 2002 season. The athletes in the intervention group performed a twenty-minute alternative warm-up called the PEP Program (Prevent Injury and Enhance Performance). This intervention group demonstrated a 100-percent decrease in non-contact ACL injuries during practice and an overall 45-percent decrease in non-contact ACL injury (game and practice) compared to the control group who did not use the PEP program.
Additionally, the rate for ACL injury was reduced even further - a 72-percent reduction, when analyzing the last six weeks of the season. This is because muscle adaptation and neuromuscular training takes approximately four to six weeks to make an effective change in an athlete.
This research indicates that a program that addresses landing technique, core stability, balance and proprioception (joint awareness) can effectively decrease the incidence of ACL injuries in the athlete.
Dr. Timothy E. Hewett of the Cincinnati Children's Hospital and the University of Cincinnati - College of Medicine, and his colleagues initiated a study to examine the effects of a comprehensive training program in order to analyze injury rates, performance and biomechanics in athletes. The athletes trained three days a week for 90 minutes followed by 15 minutes of stretching exercises. The results demonstrated that athletes increased speed during timed sprints after training.
Overall, these studies and the research that was presented show that by focusing on a player's movement patterns, individual performance deficits can be determined. By giving all players a comprehensive intervention or a warm-up program, such as the PEP Program, these deficits can be addressed. Research shows with the use of a program, players are more likely to continue performing at a high level without incurring season ending injuries. PEP will give players the skills to avoid vulnerable positions, increase flexibility and increase strength.The PEP program is a highly specific 15 minute training program.
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