Identification of Athletes at Future
Risk of Anterior Cruciate Ligament Ruptures by Neuromuscular Screening.
Zebis M., Andersen L., Bencke J., Kjær M., Aagaard
P. American Journal of Sports Medicine; 2009, 37, 1967 – 1973.
Literature provides evidence that ACL tears
occur more frequently in females than males. Early osteoarthritis onset seems
to be a major problem for those athletes following ACL injury whether they were
treated surgically or conservatively. Thus, recent research work has been
greatly focused on determining risk factors predisposing athletes to suffer ACL
rupture. Studies suggest that most of the non – contact ACL tears are
associated with situations like side – cutting, landing or rapid deceleration.
Those mechanisms of injuries are linked with great eccentric knee extensors
work and therefore high anterior – directed shear of the tibia. Apart from ACL,
hamstrings also play crucial role in counteracting this movement. Authors
performed neuromuscular screening to predict ACL injuries among 55 elite female
team handball and soccer players. Athletes were screened for the pattern and
magnitude of neuromuscular preactivity in relevant lower extremity muscles
during side – cutting. ACL ruptures were registered in the following 2 match
seasons.
5 players suffered ACL rupture to their preferred
push – off lower limb during following 2 match seasons. Results indicated that
subsequently injured female athletes had significantly lower preactivity of the
semitendinous muscle and higher preactivity of the vastus lateralis muscles
compared to uninjured players. Authors concluded that females with decreased
activity of ST and increased activity of VL during side – cutting might be at
higher risk of sustaining ACL tear. This study suggests the importance of ST
muscle in compressing the medial knee joint and therefore limiting excessive
knee valgus and external rotation of the knee joint and thus reducing the risk of
ACL injury. Moreover, this study has a high clinical relevance highlighting the
importance of preventive exercises focusing on strengthening medial hamstring
and maintaining appropriate quadriceps to hamstrings ratio. Finally, authors believe
that these findings might be relevant in respect to orthopaedic surgery,
because ACL is commonly reconstructed using ST – GR graft. Despite there appears
to be no evidence in the literature that hamstring autograft increases risk of
reinjury, findings of this study suggest that ACL reconstructions with ST graft
should be reconsidered.
All rights reserved to the American Journal of Sports Medicine.
All rights reserved to the American Journal of Sports Medicine.
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