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Coaches Blog

Sam's Blog is a bi-weekly addition to the US Youth Soccer Blog. Sam Snow is the Coaching Director for US Youth Soccer.

 

Prevent Soccer ACL Injuries: Quick Tips for Coaches

Sam Snow

Prevent Soccer ACL Injuries: Quick Tips for Coaches

By Dr. Steve Grosserode DPT and Dr. Jared Vagy DPT 

The ACL and Injury

Anterior cruciate ligament (ACL) injury rates are high in youth soccer and have been increasing the past 20 years. These injuries have serious effects on the lives of players, teams and coaches. The ACL connects the thigh bone to the shin bone, helping to prevent twisting and bending of the leg. However, if too much twisting or bending happens at the leg, injury can occur even if there is no contact. In fact, non-contact injuries are responsible for over 70 percent of injuries. 

Trying to figure out what causes these injuries can be confusing. ACL injuries are often blamed on factors that coaches and players cannot control. These factors can be bone structure, hormones or even gender. What is usually neglected is a key reason for injury that we can control: misaligned movement.

 

Misaligned Movement Can Lead to Injury

What is misaligned movement? The human body is like a machine similar to a car. When a car's alignment is off it begins to have wear and tear, perform poorly and then ultimately it will break down. Our bodies are no different. If the body's alignment is off during athletic movement, the body can experience wear and tear, perform poorly and eventually get hurt. Just like we are trained to operate a car skillfully, soccer players need to be trained to move properly. This starts with correcting misaligned movement patterns. 

It is important for coaches to know that just like each player has different skills and abilities, each player has a different way of moving. Certain players may even demonstrate misaligned movement. 

There are many types of misaligned movements. Coaches should watch out for a common misaligned movement that leads to ACL injury: the knee collapsing inward (image 1). Research shows that players who suffered an ACL tear demonstrate a greater amount of knee collapse. The knee can collapse inwards during fundamental movements in soccer. These movements include planting, decelerating and changing directions at high speeds. 

Fortunately, there are exercises that can help to correct misaligned movement. Just as a doctor may prescribe specific medications to treat different illnesses, coaches can let the player know what's going on and give specific exercises for homework to help correct the specific misaligned movement pattern. We will focus on the exercises that help players who demonstrate the misaligned movement called knee collapse (image 1). 

                                                  

5 6

 

(Left) shows the knee collapsing inwards.                 (Right) shows proper knee alignment.

 

 Prevent Knee Collapse with Glute Exercises and Cueing

Glute strengthening and coach's guided instructions (cueing) to move correctly is often overlooked in injury prevention and player development. The glute muscles are the main muscles that control the knee from collapsing inwards. Weakness of these muscles can lead to misaligned movement and injury. It is essential to use the glute muscles to keep the knee in proper alignment especially during planting, decelerating and changing directions (image 2). 

Coaches can help by telling players when they demonstrate this misaligned movement of knee collapse and cue them to keep their knee out while using their glute muscles. Coaches can also assign corrective exercise homework. An excellent way to activate the glute muscles is with a resistance band wrapped above the knees. The glute muscles are used to press the knees against the band to align the knees. 

Perform the three exercises listed below as part of a pre-practice warm-up program to activate hip muscles to stop knee collapse, prevent injury and improve athletic performance. Use a low-resistance band and perform each exercise for 1 minute. The low resistance and long duration will allow hip muscles time to activate but not fatigue.

 Squats – 1 minute

Purpose: Activate specific hip muscles while decreasing stress on the knee.squat

 

A: Put your feet through the exercise band and wrap just above knees. Stand with feet shoulder width apart.

B: Equally bend from your waist/hip and knees. Stop when thighs are parallel to the ground. Make sure to keep knees behind and aligned with the second toe. Squeeze glut muscles upon return.

 

Side Steps – 1 minute 

Purpose: Activate side hip muscles that prevent the knee from collapsing inward.side

 

A: Put your feet through the exercise band and wrap just above knees. Stand with feet shoulder width apart. Equally bend from your waist/hip and knees into a quarter squat position. Make sure to keep knees behind and aligned with the second toe.

B: Use hip muscles to step out to the side with one leg. Slowly step the other leg in while keeping tension in the band.  

 

Monster Walks – 1 minute

Purpose: Activate specific injury prevention hip muscles while keeping proper knee alignment.Monster

 

A: Put your feet through the exercise band and wrap just above knees. Stand with feet shoulder width apart. Equally bend from your waist/hip and knees into a quarter squat position. Make sure to keep knees behind and aligned with the second toe.

B: Bring foot forward and to the side by squeezing the muscle on side of hip. Make sure you maintain tension on the band.

C: Step other foot further forward and to the side while keeping tension on the band.

D, E: Repeat 

Conclusion

Misaligned movement occurs in soccer when players perform athletic movements while the body is not aligned. While there are many different misaligned movement patterns, knee collapse is perhaps the most common and unsafe. If one of your players demonstrates knee collapse, then it is important for the coach to recognize this and tell the player how to correct. In addition, resistance band exercises such as the squat, side step and monster walk can help by activating the gluteal muscles to stop the misaligned movement of knee collapse. This improved movement can prevent injuries and maximize athletic performance. For more information on the various misaligned movements and how to correct visit: yourmovementsolutions.com 

About the Authors

Dr. Grosserode and Dr. Vagy are Doctors of Physical Therapy and co-founders of Movement Solutions. They are co-authoring the upcoming book Prevent Soccer Injury: Lifelong Player Development. Visit yourmovementsolutions.com for more youth sports injury prevention information.

 

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