Vail Health Magazine 2013 - page 31

skiing, and thus, skiers are some of
Olson’s primary clients — especial-
ly ski racers.
“With ski racing in general you’re
putting some of the ligaments in
the knee at greater risk than you
are in a lot of other sports. Ski
racers are going to be at greater
risk than a basketball player, for
example,” he says. “But there are
steps that can be taken to mini-
mize that risk.”
Howard Head works with a
number of professional ski racers.
Before they have the chance to in-
jure their knees, physical therapists
use the research from Cincinnati
to condition individuals on how to
move their bodies and strengthen
muscles to prevent ACL tears —
and not in expected ways.
At one point when doctors and
physical therapists wanted to help
build strong knees, they focused
on strengthening the quadriceps
and hamstrings. These seem
like the obvious areas to isolate
around the knee, right? The new
research, however, indicates that
for women, it’s actually the hip
muscles that are directly related
to noncontact ACL injuries so,
as far as what happens in the
PT room, therapists focus on
strengthening those muscles
around the hip joint — the rota-
tors and gluteal muscles.
“As far as what it looks like here,
some of the later work done has
shown strengthening of the prox-
imal hip muscles — gluteals and
small rotators — can stabilize the
knee and improve motor control
when landing,” Olson says. “We
do a lot of patterning. When you
perform a movement, it needs to
become second nature. If we have
you jump and land right 10 times
with us, then it’s that motor train-
ing that will help, so every time
you perform that movement, the
hip muscles fire properly and you
increase the amount of hip and
knee flexion to decrease the stress
to the ligaments.
For professional and amateur
athletes alike, this kind of pattern-
ing conditions them to make the
kind of movements that will help
them avoid ACL injuries. Olson
points out that a common miscon-
ception about the role of physical
therapists is that they only treat
individuals following an injury. As
this ACL study and application
demonstrate, people can benefit
from the guidance of a thera-
pist in order to identify possible
weaknesses and stay healthy while
pursuing their sport.
“This kind of treatment is going
to be beneficial across the board
if there is an identified weakness,”
he says. “Overall, people think
about PTs only when they’re hurt.
But there is a growing demand
for wellness checkups. Any female
athlete recovering from a knee
injury or looking to limit their
exposure to a knee injury could
certainly benefit.”
In terms of evidence, Olson
mentions a recent review article
published involving training fe-
male soccer players with strength-
ening and motor patterning drills
that led to a lower incidence of
ACL injuries.
“The systematic review was
done just last year,” he says. “They
try to collect all the relevant
research articles out there to an-
swer a given question. This article
looked at nine different studies
and there was moderate evidence
showing that strength, agility,
plyometric and proper landing
technique training can decrease
ACL injuries in female athletes.”
When it comes to research,
there is a constant stream of new
information in physical therapy.
Making sure there is enough
evidence and support to substan-
tiate the claims made by each
discovery, however, is a constant
hurdle. After all, therapists can’t
simply run with every fresh piece
of information and totally trans-
form their treatments.
Then there are the big waves of
discovery — like female hip mus-
cles’ connection to non-contact
ACL injuries.
“You’re constantly getting in new
ideas and evidence-based practice,”
Olson says. “But this is a really
good summary. There is enough
evidence that points to the things
we’re now practicing and they’re
being adopted on a global scale.”
Photos by Dominique Taylor and Dan Coffee
A female athlete
is 2 to 6 times
more likely to
experience a
non-contact ACL
tear than her
male counterpart
Opposite Page:
Research has shown
that strengthening the muscles
around the hip joint helps prevent
non-contact ACL injuries for female
skiers such as Vail native and U.S. Ski
Team member Mikaela Shiffrin.
Howard Head therapist Philip
Galloway helps clients prevent injuries
with exercises.
Thomas Olson, DPT
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