According to a new research study published in the June issue of The American Journal of Sports Medicine, there are consistent characteristics for the mechanisms for anterior cruciate ligament (ACL) injuries. The study was done as a systematic analysis of video tapes from actual ACL injury situations in Norwegian and international female team handball. It shows that ACL injuries mainly occurred in a plant and cut moves or one-leg landings, resulting in a forceful valgus collapse with the knee close to full extension combined with external or internal rotation of lower leg, without direct contact with other players.
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| ACL injuries are most often associated with cutting maneouvers or one-legged landings |
In light of the high number of ACL injuries in female team handball players during the previous 10-15 years, the Oslo Sports Trauma Research Center wanted to describe the mechanisms for ACL injuries in female team handball. Twenty videotapes of ACL injuries from Norwegian or international competition were collected from 12 seasons (1988-2000). Three medical doctors and three national team coaches systematically analyzed these videos in order to describe the injury mechanisms and playing situations. In addition, 32 ACL injured players in the three upper divisions in Norwegian team handball were interviewed during the 1998-99 season to compare the injury characteristics between player recall and the video analysis.
The main observation of this study was that ACL injuries in female team handball mainly occurred in two situations, a plant and cut faking movement (to change direction to pass an opponent) or a one-leg landing from a jump shot. In both cases the injury mechanism appeared to be the same. A consistent pattern with a forceful valgus collapse from a position with the knee close to full extension combined with slight rotation of the tibia (external or internal) was observed. The foot was firmly planted on the floor, and in nearly all cases outside the knee.
To prevent non-contact ACL injuries in team handball and other ball games, the data available seem to indicate that athletes could benefit from not letting their knee sag medially during cutting movements or when suddenly changing speed. Since the injuries in every situation occurred when the foot was planted and firmly fixed to the floor, it can be assumed that the friction between shoe and the floor surface may also play a role.
The principal investigator for this study was physical therapist Odd-Egil Olsen from the Oslo Sports Trauma Research Center, with physical therapist Grethe Myklebust, professor Roald Bahr and professor Lars Engebretsen.
Read the article here.