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Format: 04/23/2014
Format: 04/23/2014

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Allegheny General Hospital Study Explores Training Regimen to Prevent Knee Injuries in Student Athletes

Wednesday, March 10th, 2010

Sports medicine specialists from Allegheny General Hospital are experienced with training serious athletes and weekend warriors alike to improve performance while decreasing the likelihood that they will sustain a painful knee injury. Now, physicians and athletic trainers are leading a research study that brings their expertise to student athletes—one of the most vulnerable populations for knee injuries.

“ACL injuries are one of the most common orthopaedic injuries with more than 100,000 occurring each year across the nation,” said Sam Akhavan, MD, director of the Human Motion Training Academy. “Most of the injuries are in younger, active people.”

The hospital’s Human Motion Training Academy has completed an initial clinical research study with two local high schools to help determine whether a catalog of specific exercises can be effective in preventing ACL tears.

The anterior cruciate ligament (ACL) attaches to the femur in the upper leg and the tibia in the lower leg to stabilize the knee. Most tears and strains of the ACL occur due to stopping, starting, or pivoting motions. Eighty-five percent of ACL injuries are non-contact injuries, according to Dr. Akhavan, a sports medicine physician who also serves as a team physician for the Pittsburgh Riverhounds and Pittsburgh Pirates.

The first phase of the trial involved the girls’ basketball teams from Avonworth and Northgate high schools. Over time, Allegheny General plans to expand the program to offer training to students in all 14 high schools within its service area.

“Allegheny General Hospital’s Sports Medicine Program prides itself on offering injury prevention programs to the community,” said Craig Castor, supervisor, Sports Medicine. “We’re happy to bring this enhanced training regimen to students at their own practice facilities.”

Participants in the AGH study were evaluated as they performed a simple test, jumping into the air 10 times. Certified athletic trainers examined their landings, the position of their feet while they were airborne and other factors to come up with a score for each athlete. Prior research suggests that the higher the score, the more likely the player is to sustain an ACL injury in the future.

Over 12 sessions, athletic trainers worked to correct detected performance deficits in a portion of the athletes by retraining students in proper landing skills and teaching them exercises designed to improve balance and increase jump strength.

Fifteen of 20 students received an “at-risk” score during pre-season testing. At the conclusion of the season, all at-risk athletes who participated in training sessions had improved post-test scores and were no longer considered to be in an increased risk bracket. The at-risk athletes who did not receive specialized training remained in the at-risk range at post-testing.

“Our goal with this program is to reduce the incidence of ACL tears, but, what we are also seeing is a significant improvement in sports performance measures, such as vertical jump, quickness and explosiveness," Dr. Akhavan said.

For the team from Avonworth High School, the training helped increase players’ vertical jump by anywhere from two to five inches, said girls’ varsity coach Bob Schulz.

During his coaching career, Coach Schulz has seen many athletes succumb to ACL injuries. The last time his team headed to the playoffs, he lost his best player to one. This season, the Lady Antelopes entered the playoffs having sustained just two ankle sprains.

“Over my 28-year varsity coaching career, the results I’ve seen from this particular program are incredible,” Coach Schulz said. “The girls learned to run better, had better balance, increased speed and vertical jump, and had fewer injuries.”

Preventive training regimens that increase strength are important not only because of the decreased mobility ACL injuries cause, but also because individuals who suffer ACL tears are likely to experience repeat injuries.

“A child who tears an ACL is four to five times more likely to tear the other ACL than a child who has not,” said Eric Cardwell a certified athletic trainer in Allegheny General’s Human Motion Center who also serves as an athletic trainer for North Hills High School.

Mr. Cardwell’s sports medicine background prompted him to develop a rehabilitation program to help athletes with torn ACLs return to play more quickly. But, striving to prevent the injuries from occurring in the first place while improving athletic performance is preferable, he said.

The jump training trial also will closely examine the gender disparity involved with ACL injury. Anatomical differences such as hip width and varying core muscle strength mean that young women are more than nine times as likely to injure their ACL as their male counterparts. These physical differences, coupled with a participation boom in scholastic girls’ sports could cause youth ACL injuries to continue to surge.

As female athletes run a higher risk of suffering an ACL tear, investigators opted to focus their initial research on girls’ teams. As the study expands, male athletes will be invited to participate and athletes involved in other non-contact sports such as soccer and volleyball may also be enrolled.
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