Train the Brain to Prevent ACL Injuries

Everyone involved with women’s basketball knows the prevalence of ACL injuries in the sport. However, few people agree on the best approach to prevent these injuries, and many believe there is no possible prevention. A recent University of Michigan study, “Fatigue Induced ACL Injury Risk Stems from a Degradation in Central Control,” from August 2009 Medicine and Science in Sports and Exercise suggests that training the brain to handle the different movements and actions involved in basketball is as important as training the leg muscles.

University of Michigan researchers studying ACL injuries had subjects perform one-legged squats to fatigue, then tested the reactions to various jumping and movement commands. Researchers found that both legs, not just the fatigued leg, showed equally dangerous and potentially injurious responses, said Scott McLean, assistant professor with the U-M School of Kinesiology. The fatigued subjects showed significant potentially harmful changes in lower body movements that, when preformed improperly, can cause ACL tears.

“These findings suggest that training the central control process of the brain and reflexive responses may be necessary to counter the fatigue induced ACL injury risk,” said McLean.

A second study by McLean, “Difference between Sexes and Limbs in Hip and Knee Kinematics and Kinetics During Anticipated and Unanticipated Jump Landings: Implications for ACL Injury,” from the British Journal of Sports Medicine tested males and females:

In a related paper, McLean’s group again tested the single leg landings of 13 men and 13 women after working the legs to fatigue. While both men and women suffer an epidemic of ACL injuries, women are two to eight times likelier to tear this ligament than men while playing the same sport. However, the study showed that men and women showed significant changes in lower limb mechanics during unanticipated single leg landings. Again, the findings point to the brain, McLean says.

During testing, a flashing light cued the subjects to jump in a certain direction, and the more fatigued the subjects became, the less likely they were able to react quickly and safely to the unexpected command.

The studies suggest that training players’ anticipatory skills and ability to react to unexpected stimuli – like suddenly avoiding a defender – may impact the prevention of ACL injuries.