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Understanding and Preventing Noncontact ACL Injuries

Understanding and Preventing Noncontact ACL Injuries

$132.95 CAD


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    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.


    A reference for sports medicine physicians, physical therapists, athletic trainers, chiropractors, physiatrists, and coaches.

    An Introduction to Understanding and Preventing ACL Injury
    Timothy Edwin Hewett, PhD, FACSM

    Part I. The Problem of ACL Injuries
    Part Editor: Letha Y. Griffin, MD, PhD

    Chapter 1. Incidence of ACL Injury
    Stephen W. Marshall, PhD; Darin Padua, PhD, ATC; and Melanie McGrath, MS, ATC
    Human Movement and ACL Injury
    What Is Incidence?
    What Is the Average Incidence of ACL Injury in the General Population?
    National Ambulatory Care Surveys
    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
    Recommendations for Future Research

    Chapter 2. Does ACL Reconstruction Prevent Articular Degeneration? The ACL Risk Equation
    Paul H. Marks, MD; Kurt P. Droll, MD; and Michelle Cameron-Donaldson, MD
    Meniscal Pathology
    Osteochondral Pathology
    Impaired Proprioception
    Biochemical Mediators
    Summary and Future Work

    Chapter 3. The Costs Associated With ACL Injury
    Timothy Edwin Hewett, PhD, FACSM; and Bohdanna T. Zazulak, DPT, MS, OCS
    Who Pays for ACL Injury Prevention in the High-Risk Female Athlete?
    Informing the High-Risk Female Athlete

    Part II. ACL Injury Prevention Programs
    Part Editor: Timothy E. Hewett, PhD, FACSM

    Chapter 4. Components of Prevention Programs
    Holly J. Silvers, MPT

    Chapter 5. Theories on How Interventions May Influence ACL Injury Rates:
    The Biomechanical Effects of Plyometric, Balance, Strength, and Feedback Training
    Timothy Edwin Hewett, PhD, FACSM; Gregory D. Myer, MS, CSCS; and Kevin R. Ford, MS
    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 Efficiency
    Sandra J. Shultz, PhD, ATC, CSCS
    Thigh Strength
    Hip Strength
    Core Strength

    Chapter 7. Effect of Prevention Programs on Performance
    Christopher M. Powers, PhD, PT; Christine D. Pollard, PhD, PT; and Susan M. Sigward, PhD, PT, ATC
    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

    Chapter 8. Congruence Between Existing Prevention Programs and Research on Risk Factors and Mechanisms of Noncontact ACL Injury
    William E. Garrett, Jr., MD, PhD; and Bing Yu, PhD
    ACL Loading Mechanisms and Risk Factors of Noncontact ACL Injury
    Current Training Programs
    Future Training Program Development

    Chapter 9. Discussion, Summary, and Future Research Goals
    Lars Engebretsen, MD, PhD

    Part III. Biomechanical and Neuromuscular Mechanisms of ACL Injuries
    Part Editor: Timothy Edwin Hewett, PhD, FACSM

    Chapter 10. Biomechanics Associated with Injury: Athlete Interviews and Review of Injury Tapes
    Tron Krosshaug and Roald Bahr, MD, PhD
    Defining Injury Mechanisms
    Describing the Inciting Event
    Research Approaches to Describe the Injury Mechanisms
    Literature Search
    Athlete Interviews
    Video Analysis

    Chapter 11. Clinical Biomechanical Studies on ACL Injury Risk Factors
    Laura J. Huston, MS
    Kinematic and Kinetic Differences
    Jump Landings
    Sidestep and Cutting Maneuvers
    Muscular Differences
    Altered Muscle Activation Patterns

    Chapter 12. Effects of Neuromuscular Training on Lower Extremity Motion Patterns
    Bing Yu, PhD; and Marlene DeMaio, MD
    Combined Training Programs Including Plyometrics

    Chapter 13. Sport-Specific Injury Mechanisms Associated With Pivoting, Cutting, and Landing
    Mary Lloyd Ireland, MD
    Gender Comparisons
    Definitions of Mechanism of Injury
    Team Handball
    Gender Differences

    Chapter 14. Effects of Muscle Firing on Neuromuscular Control and ACL Injury
    Timothy Edwin Hewett, PhD, FACSM; Bohdanna T. Zazulak, DPT, MS, OCS; and Gregory D. Myer, MS, CSCS
    Differences in EMG Activation Levels Between Males And Females
    Summary and Conclusions

    Chapter 15. Etiology and Mechanisms of ACL Injury in Alpine Skiing
    Bruce D. Beynnon, PhD; Carl F. Ettlinger, MSME; and Robert J. Johnson, MD
    The Epidemiology of Alpine Skiing Injuries
    ACL Injury Mechanisms Associated With Alpine Skiing

    Chapter 16. Noncontact ACL Injuries in Dance and Skating
    Carol D. Teitz, MD
    Muscular Control
    Shoe-Surface Interface
    Center Of Gravity and Proprioception
    What About Gymnasts?

    Chapter 17. The Role of Biofeedback in Preventing Noncontact ACL Injuries
    Julie R. Steele, PhD; Bridget J. Munro, PhD
    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 Injuries
    Part Editor: Sandra J. Shultz, PhD, ATC, CSCS

    Chapter 18. Ligament Biology and Its Relationship to Injury Forces
    James R. Slauterbeck, MD; John R. Hickox, MS; and Daniel M. Hardy, PhD
    Relationships Among ACL Injury Factors
    Effects of Tissue Remodeling
    Sex, Hormones, and ACL Injury

    Chapter 19. Hormonal Influences on Ligament Biology
    Sandra J. Shultz, PhD, ATC, CSCS
    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
    Birth Control Hormones, Ligament Biology and ACL Injury

    Chapter 20. Anatomical Factors in ACL Injury Risk
    Sandra J. Shultz, PhD, ATC, CSCS; Anh-Dung Nguyen, MS Ed, ATC; and Bruce D. Beynnon, PhD
    Notch Size and Width
    Generalized Joint Laxity
    Anterior Knee Laxity
    Anatomical Alignment

    Chapter 21. Intrinsic and Extrinsic Forces Associated With ACL Injury: Can Functional Bracing Reduce the Risk of ACL Injury?
    Bruce D. Beynnon, PhD; and James R. Slauterbeck, MD
    The Biomechanics of Knee Bracing
    The Effectiveness of Braces in Preventing ACL, ACL Graft, and ACL-Deficient Knee Injuries

    About the Editors

    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.