ACL: Three dreaded letters no athlete ever wants to hear.

The ACL, or the Anterior Cruciate Ligament, is an important ligament that functions as a knee stabilizer. When torn in athletes, ACL injuries often lead to surgery, an ended season, and up to a year spent in rehabilitation in order to achieve a successful return to sport. Even then successful return to sport and/or return to prior level of sport function is not guaranteed. A study by Benedict Nwachukwu, MD and colleagues at HSS demonstrated that successful return to sport after ACL reconstruction occurs in 88% of cases. 

Given the difficulties associated with ACL rehabilitation and recovery the goal is to avoid these injuries in the first place. Unfortunately, ACL injuries are very common, with between 100,000 to 200,000 occurring each year. In fact ACL tears are non-discriminant and can occur in all ages and sport function types – from the professional athlete to the occasional weekend warrior. 

Top players like Klay Thompson, Derrick Rose, Kristaps Porzingis and many other NBA basketball players have sustained ACL injuries in their careers. While there are many promising stories of recovery, the road to get there is not easy!

Everyone is vulnerable, including youth athletes and especially female athletes. In fact, females are two to ten times more likely to suffer an ACL injury than their male counterparts (HSS). The available literature suggests that a number of factors may influence this increased risk in women. Factors include lower extremity alignment, hormonal regulation, intrinsic ACL anatomy and neuromuscular differences. 

Luckily, there are ways athletes can help minimize their risk of injury. 

Many injury prevention exercises share a common focus: improving strength (especially quads, hamstrings & core), flexibility, balance, proprioception, jumping and landing properly and having good alignment to protect your knees.

To diminish the risk of ACL injury, here are 5 ACL injury Prevention Tips brought to you by HSS & the NBPA Sports Medicine Team.

These exercises should be done routinely, ideally three times per week to help significantly reduce chances of injury. 

5 ACL Injury Prevention Tips 

1. Calf Raises | 30 Reps 

Instructions:

• Stand upright with your feet hip-width apart and your toes pointing forward.

• Raise your heels off the floor and squeeze your calves.

• Return to starting position, by slowly lowering your heels, and repeat. 

Targeted Muscle: Calves 

2. Glute Bridge | 12 Reps

Instructions:

• Begin on your back with your knees bent, arms straight beside you, feet flat on the ground.

• Engage your core, press your heels to lift your hips until your body is a straight line between your knees and your shoulders. For a more challenging version, lift up with only leg

• Hold for two seconds and slowly return to starting position. 

Target Muscles: Glutes, Hamstrings, Abdominals

3. Lunges (Forward & Reverse) | 8 Reps each leg

Instructions:

• Stand tall with feet hip-width apart. Engage your core. Do two forward lunges followed by two reverse lunges.

• Forward Lunge - Take a big step forward with right leg. Lower your body so that your right thigh (front leg) is parallel to the floor and your right knee is positioned directly over your ankle. Your left knee should be bent at a 90-degree angle and pointing toward the floor with your left heel lifted. Return to standing by pressing your right heel into the floor and bring left leg forward. Alternate legs.

           Target muscles: Quads and Core

• Reverse Lunge - Take a big step backwards with your left foot. Lower your body so that your right thigh (front leg) is parallel to the floor with your right knee is positioned directly over your ankle. Your left knee should be bent at a 90-degree angle and pointing toward the floor with your left heel lifted. Return to standing by pressing your right heel into the floor and bring left leg forward. Alternate legs, step back with right leg. 

           Target muscles: Glutes and Hamstrings

4. Jump Squat | 10 Reps

Instructions:

• Starting with feet hip-width apart, do a regular squat, engage your core, and jump up explosively.
• When you land, push your butt back and lower down into a 45 degree squat position to complete one rep. 
• Once landing properly, repeat the same motion.

Target muscles: Glutes, Hamstrings, Quads, Lower Abs, and Calves

5. Skater Jumps | 6 Each Side

Instructions:

• Standing feet shoulder width apart, lift your left knee in the air and get into quarter squat. 

• Using the momentum from your left leg, jump horizontally to about 2-3 ft, landing on your left leg. Absorb impact for 1-2 secs and repeat the motion with your right leg as lead to complete one rep. Be sure to pump your arms to increase the momentum.

Target muscles: Glutes, Hips, Quads

Injuries aren’t always preventable, but the more time you put into pre-rehabilitation, the less time you will have to work on coming back.

For more information on how to treat and recover from injuries, visit the Hospital for Special Surgery, the #1 Hospital for Orthopedics and Official Hospital of the NBPA.

Dr Benedict Nwachukwu is a contributing author and is a Sports Medicine Surgeon at Hospital for Special Surgery and Medical Consultant for the NBPA. For more information about his surgical practice visit www.manhattansportsdoc.com