According to the Centers for Disease Control and Prevention (CDC), high school athletes account for about 2 million injuries and around a half-million doctor visits each year. But few of these injuries, says Madras physical therapist Brock Monger, are as costly to a student-athlete and his or her family that a torn ACL.

“An ACL tear in the knee will often lead to surgery and months of rehabilitation,” said Monger, co-owner of Apex Physical Therapy in Madras. “Often, I’ll see many of these student-athletes during post-surgery rehabilitation, but I’d much rather see them before that – when our goal is preventing this all-too common injury from happening in the first place.”

One of four major ligaments in the knee, the anterior cruciate ligament (ACL) is a band of tissue that connects the thigh bone to the shin bone and provides a great deal of knee stability during deceleration and direction changes.  An estimated 200,000 ACL injuries are reported in the U.S. each year, most commonly among athletes.

According to studies, women and girls are most susceptible to an ACL injury playing soccer, while men and boys are more likely to experience an ACL injury while playing football. Despite occurring so often within aggressive contact sports, most ACL tears are non-contact injuries.

“You have a student athlete plant their foot to quickly change direction, then bam, the ACL tears,” said Monger. “Basically, if their knee buckles inward and their body weight is going outside their base of support, injuries can happen.  Jumping and landing awkwardly upon a straight or hyper-extended knee can also lead to ACL injuries.  You’ll see these non-contact injuries in soccer and football, but also sports like basketball, gymnastics, skiing, and so on.”

Over the years, Monger and the physical therapy team at Apex Physical Therapy have worked with countless athletes post-surgery whose rehabilitation has led to successful outcomes. There are so many variables with ACL injuries, and there is constant research updates on how to prevent these devastating injuries.  Here are some steps that can help prevent ACL injuries that include:

Strength: Having strong and balanced muscle integrity, especially in the hips (glutes), hamstrings, calf muscles, and core muscles.  Front thigh muscles (quadriceps) need to be balanced with back thigh muscles (hamstrings) in terms of strength.  Exercises such as: single leg balance, single leg step downs, wall squats, single leg bridges, lunge steps, and broad jumps are some of many exercises that can work toward preventing injuries to the knees.

A Good Warm-Up: It’s well-known that the lack of a good warmup can lead to injury, and this is certainly the case with ACL injuries. The muscles, tendons, ligaments, vascular, nervous and balance systems all need to get on the same page prior to high level practices and games.  Coaches are excellent teachers.  If in a team sport, take the time to really put forth a good effort with the warm-ups the coaches provide.

Exercise Balance, Agility, and Jumping:  Learn and practice sport-relevant strategies for balance, agility, and jumping.  This is also considered neuromuscular training, or training all the movement systems together.  Research suggests starting in early teenage years if possible and change any movement strategies that are risky such as landing from jumps without proper absorption or knees drifting inward. In terms of neuromuscular training, the more practice, the better results are for injury prevention.

Work with a Movement Specialist:  There are many experts in the community to consider working with to optimize body mechanics, strength, neuromuscular training and injury prevention.  These experts can include:  coaches, physical therapists, athletic trainers, sports medicine physicians and others.  The research for injury prevention is ever growing and working with someone that keeps updated in current findings is very practical.

According to Monger, physical therapists are specifically trained to identify weaknesses and imbalances in the body, then correct them with an eye toward both injury prevention and optimal athletic performance. The team at Apex Physical Therapy is able to provide athletes with a full movement analysis, then create them individualized training regimens meant to promote optimal health and performance.