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The Doctor Writes
 Falling Part 2
I promised you a discussion of fall prevention and how it relates to sports injuries. Falling doesn’t usually come to mind when we think of sports injuries. We picture the injured athlete as someone who takes or delivers a hit, thereby sustaining the damage. But a large number of sports injuries are non-contact injuries, the result of knee hyperextension after a jump, torqueing the knee in a turn, twisting the ankle on a slight irregularity in the playing surface.
What do these injuries have in common with our grandmother’s slip in the bathroom? They all have something to do with balance and biomechanics. And if they have something to do with balance then there may be something you can do to prevent injury. I say may because there is nothing we can do to alleviate the risk altogether. Sometimes bubble wrap comes to mind. Let’s get back to our single leg standing exercise. If you haven’t read that then go to my archives and check it out. The rest of you have been doing your exercises and should already be fairly proficient at the single leg stand. So now let’s apply it to the athlete and sports injury prevention. Again, it’s all about balance. Although balancing acts for you and me might be recovering from a trip over a slightly uneven sidewalk, for an athlete it involves high speed, with more weight, more force. The hit a running back takes from a two hundred seventy-five pound defensive end may not be what causes his ACL to tear. It might be the off-balance landing, with the knee hyperextended. Sure, we’ve all seen footage of football and soccer players sustaining direct hits to the side of their knees, blowing out the ligaments. There’s no question this kind of trauma is going to cause damage no matter how long you can stand on one leg. The non-contact injuries are the ones we can prevent. The idea is to train the lower extremities to more naturally land in a flexed position and to more quickly recover from an off balance position. We do this through a series of single leg exercises in which the athlete jumps and lands on one leg. There are many programs which have been employed by college teams for this purpose. I haven’t seen too much of it in high school, but I’m sure it’s coming. The “Prevent Injury, Enhance Performance Program” from the Santa Monica Orthopaedic and Sports Medicine Group is one of more complete programs available on the internet. You can find it at www.aclprevent.com. I think these exercises are every bit as important as weight lifting and cutting time off your 40-yard dash. I tore my ACL in a non-contact, hyperextension injury over a year ago. This is a very common injury pattern in women. I can verify that it was my habit to extend my knee rather than flex it in an unstable situation such as slipping or jumping. It had happened to me before. Since my surgery I have been faithfully doing my single leg standing and other single legged exercises to diminish my predisposition to having this happen again. I believe it is working and a flexed knee position when reacting to a slip or fall is becoming more second nature to me. I have slipped and tripped at least thirteen times (it’s amazing how having the injury makes me pay more attention to this ridiculous kind of detail) since then and have recovered easily and without straining my knee. Of course I freak out every time it happens. Oh, my knee, my knee! Where’s the bubble wrap when you need it? I also had my son on this program for several years and although I realize there is no way to completely prevent this type of injury in a contact athlete, I think it was important to know he was following the concepts currently accepted by most orthopedic surgeons…and his mom. . Read past articles and memoirs from this section
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