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ACL (anterior cruciate ligament) Injury Survey

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Inside Shoulder

Nathan Sharpe (72)
I hope the mods think this is the right place.
I want to get some insight into people's experience of ACL injuries.
I am very interested in learning if there are patterns to field type, footwear, weight, height and age.

I will try to publish some findings and the raw data so those better able than me to discern statistical trends can tell me what insights they have into the results.

Personally I have had 2 ACL repairs and now both my teenage sons have ruptured theirs.

Obviously this is unscientific.
If responders could reply with:
Year:
Age:
Weight:
Height:
Leg: (L) or (R)
Surface:
Footwear:
Context: Training, Touch, Rugby, League, AFL, Soccer, Tennis etc.
Treatment: Surgical non-surgical
Outcome (scale 1-10) (1 being the worts outcome):

Hope this is interesting and informative.
This website discussed it but there aren o hard and fast facts: http://www.livestrong.com/article/548782-statistics-on-acl-injuries-in-athletes/
and this one told me something I kind of already knew: CONCLUSION:
The incidence of ACLR increased between 1994 and 2006, particularly in females as well as those younger than 20 years and those 40 years or older. Research efforts as well as cost-saving measures may be best served by targeting prevention and outcomes measures in these groups. Surgeons should be aware that concomitant injury is common.
 

Inside Shoulder

Nathan Sharpe (72)
Year: 1987
Age: 26
Weight: 98kg
Height: 182
Leg: R
Surface: sparse grass with some dirt patches; dry
Footwear: Asics touch football shoes
Context: Touch - side step no contact at all
Treatment: Surgical repair, no meniscus injury
Outcome (scale 1-10) (1 being the worts outcome): 4

Year: 1991
Age: 30
Weight: 102kg
Height:182
Leg: L
Surface: Grass; dry
Footwear: Asics touch shoes
Context: Touch - sidestep no contact at all
Treatment: Surgical; meniscus trim
Outcome (scale 1-10) 7.5
 

Braveheart81

Will Genia (78)
Staff member
The info below relates to when I did my ACL.

Year: 2007
Age: 26
Weight: ~100kg
Height: 6'3
Leg: (L)
Surface: Grass and very soft underfoot
Footwear: Spikes
Context: Touch football, changing directions trying to tip someone. No contact involved.
Treatment: ACL reconstruction w/ hamstring graft
Outcome (scale 1-10) (1 being the worst outcome): 8
 

Braveheart81

Will Genia (78)
Staff member
Year: 2013
Age: 32
Weight: ~110kg
Height: 6'3
Leg: (L)
Surface: Grass
Footwear: Cricket shoes - synthetic surface
Context: Cricket - running between wickets (although was more of a gradual injury that got worse rather than a single incident. Had a tear in the cartilage that would get caught when the knee was fully straightened and would cause my leg to lock painfully.
Treatment: Meniscectomy and chondroplasty surgery.
Outcome (scale 1-10) (1 being the worst outcome): 7
 

D-Box

Ron Walden (29)
Hi Inside Shoulder I did my PhD on ACL injury mechanism. Happy to answer any questions you have either here or via pm

Sent from my HTC_0PJA10 using Tapatalk
 

saulityvi

Syd Malcolm (24)
Not an ACL

Year: 2013

Age: 23

Weight: 94

Height: 177

Leg: L

Surface: dry grass

Footwear: Copa Mundials

Context: 15's rugby, got tackled around the left ankle and the knee got dislocated. Meniscular tear.

Treatment: The meniscus has been since removed almost completely, and i have had two more athroscopies to clean cartilage out

Outcome: 3, I propably had bad knees to start with, but after that I have never felt as good as before it.
 

Inside Shoulder

Nathan Sharpe (72)
Hi Inside Shoulder I did my PhD on ACL injury mechanism. Happy to answer any questions you have either here or via pm

Sent from my HTC_0PJA10 using Tapatalk
You da man.
first question: moulded soles or screw in for hard sydney grounds? (explanations welcome).
second question: many moons ago I read something that suggested that the non-contact ACL injuries (side stepping being the classic) were the result of a breakdown in the communication of proprioceptive information. In discussing this with the family orothopod he didn't seem to embrace it.
To my uneducated mind it perfectly explains the sequence of my own injuries and one of my sons, while it certainly fits with the injury to the other son.
What's the current thinking?
 

D-Box

Ron Walden (29)
First Question

No good answer. There have been some links to harder grounds being associated with more ACL injuries (http://www.johnorchard.com/resources/article-JSMSACL.PDF) and grass types and a little on cleat design (http://ajs.sagepub.com/content/24/2/155.abstract). The papers are all about traction, particularly when turning. If your boot grips hard when twisting on the ball of your foot you increase the load on your knee. The blades style boot with cleats around the edge is what is suggested to be avoided (but good for performance). Screw-ins vs moulded won't make a heap of difference.

The second question is even more complicated. There is not sufficient time from the foot hitting the ground to sense that there is too much stretch and to fire the muscles to compensate prior to the injury occurring. So yes your orthopod is correct. However when you get injured you have high loads and inadequate support. Injuries tend to happen when the body gets in a bad position - wide foot placement, torso leaning over your leg - while also not activating the muscles in your leg enough. The first factor increases load the second decreases the support. This all tends to happen because the sidestep is unplanned - catching the ball and then stepping to avoid being smashed by that defender who just appeared. When this happens you can't activate your muscles in anticipation to the same degree that you can in a planned sidestep. Activating the quads and hamstrings together protects the joint, and we can differentially activate the quads and hammies on the inside of the leg to support the dangerous abduction (pulling the foot to the outside) load.

The good thing is that we know that training can reduce the risk of ACL injuries. What you should be doing is balance training, plyometric based work and focusing on using good technique during sidestepping. Find a good Accredited Exercise Physiologist or Sports Scientist or someone who holds, at least, an ASCA Level 2 coaching certification if you want to tailor the program directly to your sons but the keys are:

1) Increase core stability and you hip abductor strength. This helps control the torso during sidestepping and landing which then reduces the load on the knee. Think of the torso as a huge pendulum swinging side to side. Because it is a long way away from the knee it can produce a large moment (torque) on the knee. The less is moves the smaller the moment. Hip abductor strength also helps to prevent the thigh from collapsing and rolling in which causes effective abduction at the knee joint.

2) Balance training improves co-contraction around the knee increasing the amount of support provided by the muscles. This is particularly important in individuals doing lots of weights training as weights training can reduce co-contraction. Balance training starts a simple as standing on one leg, but you can progress to doing activities where you balance on one leg and pass to each other or kick to each other. You can make it harder by passing to the side, up, down so they have to move around a bit.

3) Plyometric training helps you get dynamic strength and control. It allows you to practice co-contracting and producing force at high speed which is what is occurring when you get injured. The keys to this training is to start slow and focus on technique. Double leg jump and land is a great start. You really need to make sure that the knees bend on contact with the ground and that they track out over the toe. If the knees are going inside of your big toe you have issues. Remember in plyometric training you don't need to appear to be completely knackered to have had a hard session. In the beginning, your should only be starting with about 60-80 ground contacts. As soon as technique starts to go you should definitely stop as you increase the risk of injury.

@Inside Shoulder You may also be interested to know (if you got through this essay) there has been som recent evidence indicating that there may be some sort of family risk factor.

Hope that helps.

Alasdair Dempsey PhD AES ESSAM | Lecturer & Academic Chair – BSc(Sport and Health Science) & BSc(Movement Science)| School of Psychology and Exercise Science | Murdoch University


Room 2.012, Social Sciences, 90 South Street, Murdoch WA 6150 | (Tel +61 8 9360 6526 | (Fax+61 8 9360 7579 | *a.dempsey@murdoch.edu.au| Twitter @ARDempsey @MurdochBiomech | Facebook https://www.facebook.com/DempseyAR
 

Tahspark

Ted Thorn (20)
Thanks for your highly informative post, D-Box. A few preventative lessons there for the young and for those of us who like to think we are:)
 

Inside Shoulder

Nathan Sharpe (72)
Great post D-box.
I find the list of articles in which the second one you mention has been cited daunting - and there is no prospect of me counting it as workload - but I will find out what I can.
 

D-Box

Ron Walden (29)
Great post D-box.
I find the list of articles in which the second one you mention has been cited daunting - and there is no prospect of me counting it as workload - but I will find out what I can.
A tip for chasing articles if you don't have access to a university library try looking for the articles on Research Gate where a lot of authors place a version of an article up for free. You can also try sci-hub.io where many articles have been posted however the legality of this page is questionable

Emailing authors tends to work as well

Sent from my HTC_0PJA10 using Tapatalk
 

Inside Shoulder

Nathan Sharpe (72)
D-Box - you may be interested to know that some of those articles are being referred to "higher authorities" for consideration as to the type of turf being used.
 

GTPIH

Ted Thorn (20)
For my son and very recent (early April) so no outcome yet

Year:2016
Age:20
Weight:80kg
Height:184cm
Leg: L
Surface: Grass (Woollahra No.2)
Footwear: Flashy looking outrageously expensive moulded sole
Context: Rugby. Pushing a player near the sideline and jumping and falling, to avoid spectators sitting on the sideline, in the act of pushing. He doesn't recall any contact though knee may have hit ground
Treatment: ACL reconstruction with hamstring graft scheduled
Outcome (scale 1-10) (1 being the worts outcome): TBA

May be worth adding what position the injured player was playing. My son is an outside back
 
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