# ACL prevention



## smellycleats (Aug 12, 2016)

Wondering how many of your DD's follow an ACL prevention program either on their own or as a part of training with their club?


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## PossessionSoccer (Aug 12, 2016)

Our team warms up with the FIFA 11 warm up before training and games.


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## timbuck (Aug 13, 2016)

Our team uses this one:  http://www.uwhealth.org/sports-medicine/physical-therapy-athletic-training/soccer-education-acl-injury-prevention-exercises/42908

But 2 or 3 times per week probably isn't enough. 
I also wonder "how many games" do we really need?  12 year old girls (boys too) having ACL surgery is crazy.  But we are seeing more of it.  Are these freak accidents?  Or a result of playing too many games, too close together.


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## galaxydad (Aug 13, 2016)

My understanding about female ACL injuries at  the pre teen- teen level is more about how females develop as puberty sets in. Their Ligaments don't strengthen at the same rate as their bones elongate and as their muscles strengthen which makes them susceptible to ACL tears. I think it's more of a huge increase in female athletic competition rather than over training etc. with that said research is showing that proper warm up and muscle development can lessen the chance but as these ladies develop they are highly susceptible to these injuries during the developmental years. I have seen so many girls team ACLs without contact


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## timbuck (Aug 13, 2016)

ACL is usually a non-contact injury (I think).  My point of them playing too many games is there isn't enough recovery time. 
They are playing multiple games on a weekend. Muscle growth (I know ACL isn't a muscle, but the muscles keep things in place) takes place during recovery.  Which happens 24-48 hours after physical activity. 
If you are a runner (used to run a lot, but not so much anymore), you don't usually run hard 2 days in a row.  You might run long one day and have some sort of active recovery the next (walk, cycle, weights, plyometrics, etc). Or you might run a shorter distance on consecutive days after you have built up to it.  But you don't usually run a balls out 5k mutilple days in a row.  Or 15 miles at race pace multiple days in a row. 
Or lifting weights-  typically you do different muscle groups on consecutive days to let the sore parts recover (i.e.- grow). 
Football teams don't crush it Monday-Friday either and then play a game.  They have easier days and hard days. 
But soccer players are running (probably 3-4 miles for a very active player in a 60 minute youth game), while getting knocked around.  And then coming back and doing it again a few hours later during a tournament.  
Just like we are seeing youth baseball players needing elbow/shoulder surgery, overuse is taxing these bodies more than necessary. Especially for females hitting puberty.   When a male hits puberty, their muscles grow.  They increase testosterone at fast rates.  Their bodies are turning into men (which genetically are made for hunting/survival).  When females hit puberty, they grow breasts. Their hips grow.  They are turning into women.  Their bodies are adding more fat than muscle. (Genetically, their bodies are preparing to be able to be pregnant.).  Girls need to train to grow muscle differently. 
Read the book "Warrior Girls" for some good insight on female soccer injuries.


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## Zoro (Aug 18, 2016)

I've seen/believe 4 areas contribute.  Hip width.  Tendon softness - monthly, muscles and how they turn.
The latter is not so much talked about but at least one trainer says girls tend to plant foot and turn around the planted foot more than guys.   

I have video'd two ACL injury's as they happened.  
Both cases bigger girls, post puberty and heal plants.

One thing we did for DD was in training she had shoes without heal cleats.  That kept her on her forefoot.  For games she wore regular kangaroo skin shoes (banned now in CA).  Some thought at the time that that shoe flexibility and sole that had molded round cleats would give a bit reducing forces in a twist.  Sounded good to me.


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## bruinblue14 (Aug 18, 2016)

Zoro, where did you buy the shoes without the heel cleats? Do they make those?


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## Zoro (Aug 18, 2016)

bruinblue14 said:


> Zoro, where did you buy the shoes without the heel cleats? Do they make those?


Hack saw.  We did this one one set of shoes G12, G13 until she got mad at me and I gave up, but I think it put something in her head.  Her style changed to much more cat like and on her toes.

Reality is they don't need to be cut all the way off.  Just short.  I think a heal plant on a goal kick to send long is required.  The "forward" driving kick does not require a heal plant and can be done more on the whole foot.
By about G15 she was 100% in regular shoes but in PKs (the GK) she'd not even use her heals. 

All in all the idea of an ACL injury panicked me and we did lots of stuff.  Most of it not only improved/reduced acL injury chance but also made her better at playing.
She also did negative training age 14  



and this


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## bruinblue14 (Aug 18, 2016)

I am concerned about ACL injury overall as well; was also thinking the no/low heel cleats might be good for my DD who is flat-footed and does not run on her toes like she probably should.....


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## Zoro (Aug 18, 2016)

Also look into off the shelf forefoot running shoes.  
Nike free being most known but I'd go all in a try a Newton.  I run with those and they have saved my back and let me run when Dr said I shouldn't.  It takes weeks to build the muscles and maybe a month to fix the head.  But the idea of a heal strike feels so barbarian to me now.  I even walk forefoot now which is weird and I goto a heal roll when I think of it.


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## SoccerLife12 (Aug 18, 2016)

smellycleats said:


> Wondering how many of your DD's follow an ACL prevention program either on their own or as a part of training with their club?


I would think all clubs would follow an ACL prevention program as there are approximately 100,000 ACL reconstruction surgeries yearly just in the US, but most don't. Sportsmetrics has trainers that can work with you for recovery and prevention but I haven't found any trainers still doing this in San Diego. You can order CDs that have a 6 week recovery program as well as a prevention program that can be done at home.


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## SoccerLife12 (Aug 18, 2016)

galaxydad said:


> My understanding about female ACL injuries at  the pre teen- teen level is more about how females develop as puberty sets in. Their Ligaments don't strengthen at the same rate as their bones elongate and as their muscles strengthen which makes them susceptible to ACL tears. I think it's more of a huge increase in female athletic competition rather than over training etc. with that said research is showing that proper warm up and muscle development can lessen the chance but as these ladies develop they are highly susceptible to these injuries during the developmental years. I have seen so many girls team ACLs without contact


About 70% of ACL tears are non-contact.  It usually occurs with planting the foot and twisting, specifically when the leg is at full extension is when the knee is most vulnerable.  The high incidence of female athletes and ACL tears is due to muscle imbalances specifically with the VMO. However, when there's contact,  all the training in the world doesn't necessarily help. My daughter tore her ACL when she was 14 when she trapped the ball, leg fully extended,  and a less skilled player just mowed her down taking her out at the knee from the side leaving her in a heap on the ground while a parent on the sideline was yelling how she was just "milking it" because she couldn't get up.  Now post surgery and back playing soccer,  my daughter is continuing the quad strength training on her own as well as an ACL prevention program.  If your club doesn't offer it, then be your own child advocate and find one because an ACL tear is a long recovery!


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## C.A.M. (Aug 22, 2016)

SoccerLife12 said:


> About 70% of ACL tears are non-contact.  It usually occurs with planting the foot and twisting, specifically when the leg is at full extension is when the knee is most vulnerable.  The high incidence of female athletes and ACL tears is due to muscle imbalances specifically with the VMO. However, when there's contact,  all the training in the world doesn't necessarily help. My daughter tore her ACL when she was 14 when she trapped the ball, leg fully extended,  and a less skilled player just mowed her down taking her out at the knee from the side leaving her in a heap on the ground while a parent on the sideline was yelling how she was just "milking it" because she couldn't get up.  Now post surgery and back playing soccer,  my daughter is continuing the quad strength training on her own as well as an ACL prevention program.  If your club doesn't offer it, then be your own child advocate and find one because an ACL tear is a long recovery!


Man my girl and I constantly argue about her trapping while her feet are solid on the ground. Unlike the boys games, refs allow girls to mow down a player with no foul called. She and I argue because I make her work on trapping the ball while either moving (Gareth Bale style) or with the plant foot being on the toes. It allows for more dexterity and agility while being hacked by the nearest bull rushing defender.

The scary part is how many coaches are telling the kids to slide tackle instead of playing proper defensive placement and angling. I'm watching kids hurt themselves doing this mess.


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