Non-Contact ACL

Prevention
Recommendations
Dr. Thomas Lam
thomaslam@fitstoronto.com
www.fitstoronto.com
THE ACL – end result
ANATOMICAL
CONSIDERATIONS

Ligaments
Meniscus
Muscles
Capsule & Retinaculum
Patella
THE REST OF THE BODY
“5 SITE ANALYSIS”
Physiological
Considerations
 INCIDENCE AND WHY
• Females 2 – 8 times > injury rates vs.
males
• 0.42 – 1 per 1000 athlete exposures
(game or practice)
• Risk Factors:
– Environment – Surface to shoe to foot interface
– Anatomical – Q-angle, histological
– Hormonal – Menstrual cycle, hormone receptor sites
– Neuromuscular
BIOMECHANICAL Mechanism of
Injury
Rate and Magnitude of force to applied tissue
• Exceed tissue tolerance “Joint
Stiffness + Neutral Zone”
Neuromuscular Control Factors
Dynamic Knee Valgus, Arch Collapse, Tibial
Rotation, Straight Knee and collapsed back
• Side-Side differences
• Age “neuromuscular
spurt”
• Quads vs. Hamstring
(eccentric control –
Concontraction –
preactivation)
• GRF (knee flexion)
• Fatigue
• Skill – unanticipated
• “CORE” – lumbopelvic
control – 5 SITE
CONTROL
MOBILITY | MOVEMENT| OUTPUT |
CAPACITY
Attack angles + Explosiveness + Flight is
Jog, Sprint constrained by Force Development
(Strength and Power)
Hop Vertical Power
Landing +
Lateral Power
Jump
Cross-over, Horizontal
Shuffle Power
Energetics
 WHEN | Appropriateness
Pass or Fail
PRIORITY?
Synergistic or Inhibitory
Specificity - Balance

QUALITIES | SPECIFICITY |
DEVELOPMENT (LTAD)
Developme
nt
Road-Map 38”
CP + PEP +
Provincial Teams +
individual ,
Provincial Sport
Organizations...
Know what are your
strengths and what
you need to work on.

Where are you and

where do you need to
be?
* Covered under
extended Health
Care Benefits
DROP JUMP SCREEN
Strength (Maximal Effort)
Squat – leg strength (Chest-Up, Back Arched, Heels on
the ground, “Knee Sleeve”)
Multidirectional Lunge (Co-activation)
Step-Up | Lateral Step-Up or Lunge + Side Shuffle
 
Sportsmetric (Jumping and Landing Mechanics)
  180 jumps
Bounding for Distance
Bounding in Place
Cone Jumps
Hop, Hop Stick
Jump into Bounding
Jump, Jump, Jump, Vertical
Mattress Jumps
Scissors Jump
Single-Legged Jumps, distance
Squat Jumps
Step, Jump up, Down, Vertical
Tuck Jumps
Wall Jumps

Agility + Acceleration + COD

Screen and look
Teach proper landing mechanics
Teach coactivation
Develop strength and power qualities
Improve strength endurance of muscles crossing the knee
Implement the Sportsmetric ACL prevention protocol

DR. THOMAS LAM

WWW.FITSTORONTO.COM
THOMASLAM@FITSTORONTO
.COM