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Summary
Summary
With more than 200,000 athletes each year suffering noncontact injury to the anterior cruciate ligament (ACL) of the knee, there is finally an up-to-date reference for professionals whose work involves developing and implementing programs to prevent such injuries. Understanding and Preventing Noncontact ACL Injuries provides an authoritative description of the biomechanical, clinical, and injury factors pertinent to the athletes--primarily girls and young women--who experience this problem.
To help readers understand how to incorporate targeted interventions, the book uses a preventive rather than strictly clinical approach to ACL injuries. It provides a thorough description of the current problem on an international scale, the rationale for developing prevention programs, the discrete risk factors for noncontact ACL injuries, and an analysis of current research data on the effects of interventions designed to prevent these injuries.
Understanding and Preventing Noncontact ACL Injuries will help readers
-clearly understand the incidence, cost, and need to quantify risk factors related to the onset of noncontact ACL injuries;
-compare various prevention programs and learn why prevention programs should be implemented--especially among young women--to reduce the potential for injury; and
-understand the interplay between biomechanical and neuromuscular risk factors and become aware of the role hormones, bracing, and biofeedback play.
Understanding and Preventing Noncontact ACL Injuries is based on proceedings from a conference conducted by the American Orthopaedic Society for Sports Medicine and draws on the work of renowned experts in the field. The book logically progresses through four parts to help physicians, professionals, coaches, and other readers better understand the problem and how they may play a part in its prevention. Part I addresses the problem of ACL injuries, including the incidence of injury, risk factors, and costs associated with injuries. Part II examines injury prevention programs, their similarities and differences, and their relative effectiveness. Part III presents the latest information on biomechanical and neuromuscular mechanisms of ACL injuries. Part IV explores hormonal and anatomic risk factors and preventive bracing for ACL injuries.
To illustrate the preventive approaches that may be used, the book contains photographs of individuals actually performing the progressions involved in the programs. Other helpful resources include take-home messages and clinical notes that relate scientific findings to successful preventive efforts. By providing these tools, the authors hope to provide an easy-to-understand reference that appeals to a broad range of individuals, including athletic directors, coaches, parents, and athletes who would like to learn more about how to implement prevention programs in their schools or other organizations.
Understanding and Preventing Noncontact ACL Injuries is a current and unique resource that will be useful for all people affected by this global issue. By combining scientific factors with injury mechanisms, the book will provide readers with valuable knowledge of ACL injuries and help readers implement programs to prevent them.
Author Notes
The American Orthopaedic Society for Sports Medicine (AOSSM) is a national organization of orthopaedic surgeons specializing in sports medicine, including national and international sports medicine leaders. The AOSSM works closely with many other sports medicine specialists and clinicians, including family physicians, emergency physicians, pediatricians, athletic trainers, and physical therapists, to improve the identification, prevention, treatment, and rehabilitation of sports injuries.
Formed in 1972 primarily as a forum for education and research, AOSSM has increased its membership from its modest initial membership of fewer than 100 to over 2,000. There are 67 Accreditation Council for Graduate Medical Education approved fellowships in orthopaedic sports medicine in the United States and Canada.
Members must demonstrate continuing active research and educational activities in the field of sports medicine. Such activities may include service as a team physician at any level of competition; educating persons involved with the health of athletes; service to local, regional, national, and international competitions; and the presentation of scientific research papers at sports medicine meetings. The unifying interest of the membership is their concern with the effects of exercise and the monitoring of its impact on active individuals of all ages, abilities, and levels of fitness.
Table of Contents
An Introduction to Understanding and Preventing ACL InjuryTimothy Edwin Hewett |
Summary |
Part I The Problem of ACL InjuriesLetha Y. Griffin |
Chapter 1 Incidence of ACL InjuryStephen W. Marshall and Darin Padua and Melanie McGrath |
Human Movement and ACL Injury |
What Is Incidence? |
What Is the Average Incidence of ACL Injury in the General Population? |
National Ambulatory Care Surveys |
Summary |
How Does ACL Injury Incidence Vary by Age and Gender? |
How Does the Incidence of ACL Injury Vary By Sport and Gender? |
Literature Review Methods |
Abstraction of Incidence Data |
General Results |
Synthesis and Commentary |
Conclusions |
Recommendations for Future Research |
Chapter 2 Does ACL Reconstruction Prevent Articular Degeneration? The ACL Risk EquationPaul H. Marks and Kurt P. Droll and Michelle Cameron-Donaldson |
Meniscal Pathology |
Osteochondral Pathology |
Impaired Proprioception |
Biochemical Mediators |
Summary and Future Work |
Chapter 3 The Costs Associated With ACL InjuryTimothy Edwin Hewett and Bohdanna T. Zazulak |
Who Pays for ACL Injury Prevention in the High-Risk Female Athlete? |
Informing the High-Risk Female Athlete |
Summary |
Part II ACL Injury Prevention ProgramsTimothy E. Hewett |
Chapter 4 Components of Prevention ProgramsHolly J. Silvers |
Chapter 5 Theories on How Interventions May Influence ACL Injury Rates: The Biomechanical Effects of Plyometric, Balance, Strength, and Feedback TrainingTimothy Edwin Hewett and Gregory D. Myer and Kevin R. Ford |
Single-Component Training |
Multicomponent Training |
Effects of a Comprehensive Program Combined With Either Plyometric or Balance Training Components |
Conclusions and Future Directions |
Chapter 6 Preventive Training Programs: Changing Strength Ratios Versus Positions of Muscular EfficiencySandra J. Shultz |
Thigh Strength |
Hip Strength |
Core Strength |
Summary |
Chapter 7 Effect of Prevention Programs on PerformanceChristopher M. Powers and Christine D. Pollard and Susan M. Sigward |
Performance Measure: Vertical Jump Height |
Performance Measures: Agility, Strength and Lunge Distance |
Performance Measures: Vertical Jump Height, Single-Leg Hop, Speed, and Strength |
Performance Measure: Single-Limb Stability |
Performance Measures: Balance, Strength, Single-Leg Hop, Triple Jump, and Stair Hop |
Summary |
Chapter 8 Congruence Between Existing Prevention Programs and Research on Risk Factors and Mechanisms of Noncontact ACL InjuryWilliam E. Garrett, Jr. and Bing Yu |
ACL Loading Mechanisms and Risk Factors of Noncontact ACL Injury |
Current Training Programs |
Future Training Program Development |
Chapter 9 Discussion, Summary, and Future Research GoalsLars Engebretsen |
Part III Biomechanical and Neuromuscular Mechanisms of ACL InjuriesTimothy Edwin Hewett |
Chapter 10 Biomechanics Associated with Injury: Athlete Interviews and Review of Injury TapesTron Krosshaug and Roald Bahr |
Defining Injury Mechanisms |
Describing the Inciting Event |
Research Approaches to Describe the Injury Mechanisms |
Literature Search |
Athlete Interviews |
Video Analysis |
Conclusions |
Chapter 11 Clinical Biomechanical Studies on ACL Injury Risk FactorsLaura J. Huston |
Background |
Kinematic and Kinetic Differences |
Jump Landings |
Sidestep and Cutting Maneuvers |
Muscular Differences |
Altered Muscle Activation Patterns |
Conclusions |
Chapter 12 Effects of Neuromuscular Training on Lower Extremity Motion PatternsBing Yu and Marlene DeMaio |
Combined Training Programs Including Plyometrics |
Chapter 13 Sport-Specific Injury Mechanisms Associated With Pivoting, Cutting, and LandingMary Lloyd Ireland |
Gender Comparisons |
Definitions of Mechanism of Injury |
Soccer |
Team Handball |
Basketball |
Gender Differences |
Conclusions |
Chapter 14 Effects of Muscle Firing on Neuromuscular Control and ACL InjuryTimothy Edwin Hewett and Bohdanna T. Zazulak and Gregory D. Myer |
Introduction |
Differences in EMG Activation Levels Between Males And Females |
Summary and Conclusions |
Chapter 15 Etiology and Mechanisms of ACL Injury in Alpine SkiingBruce D. Beynnon and Carl F. Ettlinger and Robert J. Johnson |
The Epidemiology of Alpine Skiing Injuries |
ACL Injury Mechanisms Associated With Alpine Skiing |
Summary |
Chapter 16 Noncontact ACL Injuries in Dance and SkatingCarol D. Teitz |
Muscular Control |
Shoe-Surface Interface |
Center Of Gravity and Proprioception |
Choreography |
Miscellaneous |
What About Gymnasts? |
Summary |
Chapter 17 The Role of Biofeedback in Preventing Noncontact ACL InjuriesJulie R. Steele and Bridget J. Munro |
The Role of Biofeedback in ACL Injury Prevention |
Biofeedback, Neuromuscular Activity and ACL Injury Prevention |
Biofeedback, Knee Joint Motion and ACL Injury Prevention |
The Role of Biofeedback in Preventing ACL Reinjury |
Future Directions for Biofeedback and ACL Injury Prevention |
Part IV Hormonal and Anatomic Risk Factors and Preventive Bracing for ACL InjuriesSandra J. Shultz |
Chapter 18 Ligament Biology and Its Relationship to Injury ForcesJames R. Slauterbeck and John R. Hickox and Daniel M. Hardy |
Relationships Among ACL Injury Factors |
Effects of Tissue Remodeling |
Sex, Hormones, and ACL Injury |
Chapter 19 Hormonal Influences on Ligament BiologySandra J. Shultz |
Sex Hormone Profiles: Not all Menstrual Cycles Are Created Equal |
Sex Hormones Effects on Collagen Structure and Metabolism |
Sex Hormones and Knee Joint Laxity and Stiffness |
Menstrual Cycle and ACL Injury |
Summary |
Birth Control Hormones, Ligament Biology and ACL Injury |
Summary |
Chapter 20 Anatomical Factors in ACL Injury RiskSandra J. Shultz and Anh-Dung Nguyen and Bruce D. Beynnon |
Notch Size and Width |
Generalized Joint Laxity |
Anterior Knee Laxity |
Anatomical Alignment |
Conclusions |
Chapter 21 Intrinsic and Extrinsic Forces Associated With ACL Injury: Can Functional Bracing Reduce the Risk of ACL Injury?Bruce D. Beynnon and James R. Slauterbeck |
The Biomechanics of Knee Bracing |
The Effectiveness of Braces in Preventing ACL, ACL Graft, and ACL-Deficient Knee Injuries |
Conclusion |
References |
Index |
About the Editors |