ACL injuries are more common in female athletes than in male athletes, at a ratio of around 8-to-1. That may seem discouraging for women athletes, but there is good news! There are specific sets of ACL-protective exercises that can be incorporated into practices to reduce the number of injuries. The Affinity Orthopedics & Sports Medicine departments have videos that demonstrate these exercises to reduce injury risk, and most school athletic trainers are well versed in describing these exercises. Other common injuries in basketball include kneecap dislocations, meniscus tears, hamstring/groin pulls and tendinitis. The plan below will outline how to best avoid these problems.
First, I’ll discuss a few facts about knee injuries and basketball, then a few warm-up exercises important for most running, cutting and jumping sports, followed by a number of dynamic exercises to prevent injuries to the knee. Finally, I’ll end with a summary of lower extremity exercises to avoid. Keep in mind that basketball practices should begin with light cardio and dynamic stretching before heavy competitive maneuvers are added. Static stretching is, in general, best added at the end of a practice to keep muscle fibers as responsive as possible during play.
Warm-up should be dynamic in nature, such as straight leg marches, power skips, walking quad stretches, elephant walk, hip cradle and hip rotator walks. These are each completed for the length of the gym floor or so. A good further progression would carry into plyometric exercises such as standing tuck jumps, 180-degree jumps, squat jumps and split leg jumps. Correct positions include bringing knees up (not head/neck down), trying to land quietly and with both legs in a balanced position. Always avoid single-leg landings and work on discouraging inward knee positions on landings. Correct alignment would generally call for the chest to be aligned from a side view with the knees and the balls of the feet. Also, strict avoidance of straight-legged landings is key.
Strengthening exercises for the lower extremities include core strengthening as a key component. This includes abdominal crunches, reverse crunches, planks and side bends. Resistance bands can be used to complete forward, reverse and lateral steps. Advance plyometrics include cone hops side-to-side and front-to-back, quick feet hopping drills in X patterns and figure-eight running drills with cones set 30 feet apart.
In addition, there are a generalized number of knee exercises to be avoided as they can be detrimental to knee biomechanics and can increase injury risk. These include full-arc knee extensions, deep squats, hurdler’s stretches and in some cases even lunges. As the knee bends beyond 90 degrees there is very little benefit to the lower extremity muscles in terms of strength, and the kneecap is placed at additional risk for injury in this compromised position. Much of lower extremity strengthening that will enhance performance can be achieved with knees closer to full extension or with a shorter arc than a 90-degree bend.
Good luck and never stop playing!