Anterior cruciate ligament (ACL) injuries have been declared “epidemic” among young female athletes by sports medicine specialist Pietro Tonino of Loyola University Medical Center. The problem, he says, is serious enough for parents to begin demanding that coaches spend more time on preventive warm-ups.
The ACL stretches from the thigh bone to the shin bone and helps to stabilize the knee. Female athletes are more prone to injury for a few reasons, including wider hips that turn the knees slightly inward and greater laxity of the ligaments due to hormonal factors. These injuries take a long time to recover from, and may even require surgery. This is frustrating to medical professionals, because they know just how preventable the injuries are.
There are different approaches to prevention that coaches can take, and these approaches are recommended particularly in sports that involve a lot of directional changes and pivots such as soccer. Two promising warm-up programs are PEP and FIFA 11+.
The Prevent Injury and Enhance Performance (PEP) program was designed by physical therapist Holly Silvers specifically for female athletes. The FIFA 11+ (Federation Internationale de Football Association) program incorporates some principles of PEP and resulted from a collaboration of several sports medicine facilities. The two programs are a bit different. First, let’s look at the similarities.
Both programs have been supported by research to be effective ACL injury prevention measures. They both take about 20 minutes to complete and contain the following areas of emphasis: strengthening of stabilizer muscles; neuromuscular coordination; jumping technique; balance.
One of the main differences between the programs is that PEP supports the use of stretching during warm-up, while the FIFA 11+ does not. The PEP program incorporates static stretches, although it does allow for these to be moved to the end of the training session. The FIFA 11+ manual states that static stretches may be harmful to muscle performance, and that research into the effects of dynamic stretches has been inconclusive; it therefore leaves stretching out of the program.
Another difference between the programs is that the PEP program was designed for and studied primarily on female athletes, whereas the FIFA 11+ is designed for both men and women.
Sports injury prevention is important both to ensure that kids can stay in the game and to prevent biomechanical and musculoskeletal problems later on in life. Twenty minutes may seem like a long time to spend in the beginning of practice on a warm-up, but, particularly among young female soccer players, it may be well warranted.
For more on Dr. Tonino’s opinions on preventive warm-up programs, see www.sciencedaily.com.