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Use of plyometric exercise in ACL rehabilitation and injury prevention

Use of plyometric exercise

Anterior Cruciate Ligament injuries (ACL) are usually considered devastating to athletes, with the average recovery taking at least 9 months as well as an associated high number of athletes failing to return to sport (RTS) with high re-injury rates. Just in Aussie rules alone, ACL injuries have been found to be the second most common injury, with almost an injury rate of almost 1 (0.8) player per season each club.

Having one of the highest incidences of ACL injury rates in the world, it is important for Australians taking part in sports such as Aussie rules, rugby league, netball etc use injury prevention programs targeted at reducing the risk of ACL injury.

One key factor that’s often missed when it comes to ACL rehabilitation/Injury prevention programs is the use of plyometric exercises!

The inclusion of plyometric exercises has been shown to massively reduce the risk of ACL injury/re-injury, improving your chances of returning to sport. Studies have shown that by implementing plyometrics into your sessions for 6 weeks you can improve your knee stability and dynamic balance; two factors essential in reducing your risk of ACL injury!

As well as reducing your injury risk, plyometric exercises can help improve your speed, strength and change of direction, enhancing your athletic performance and capabilities.


So what is Plyometrics?

Plyometrics is a specific, unique training method involving jumping, hopping, bounding or skipping movements usually performed in an explosive manner.

They utilise the stretch shortening cycle which involves the rapid lengthening of a muscle tendon unit, followed by a rapid shortening, amplifying power. There are different types of plyometric exercises (both legs or single leg) and they can all be used with various surfaces/environments, e.g. on a trampette/hard surface to accompany different levels of ability.


What are the benefits of plyometrics?

As well as the reduction in risk of injury and re-injury rates that we previously mentioned incorporating plyometric training into your training program can dramatically improve performance
within your sport.

Plyometric exercises have been shown to help improve speed, strength and change of direction ability, all of which are important factors for lots of sports. It’s also likely that you haven’t been doing this type of training meaning there are potential gains to be had!


So how will plyometric training fit into my training?

Plyometric training can generally be split up into four stages. Physiotherapists have expert knowledge in assessing your capabilities and deciding on what stage exercise to begin with. Having
said this, athletes recovering from an ACL injury/surgery will all likely begin with the basics at stage one.

Stage one will focus on bilateral movements at a sub-maximal intensity (both legs), e.g. squat jumps. Exercises in this stage will be done alongside your usual strength training and one of the key aims is to support movement retraining so quality over quantity will be emphasised.

As the stages progress, there will be a bigger focus on single leg movements performed at a more maximal intensity, e.g. single leg drop jumps and hopping. As well as this, the later stages will focus on more lateral and multi-directional movements to enhances change of direction ability. Finally, the last stage will focus on reactive training and adapting the exercises to mimic sport specific tasks, e.g. adding catching a rugby ball to landing from a height on a single leg. Your physiotherapist will utilise factors such as the height or surface you land on to ensure optimal loading of your joints, alongside your appropriate stage of healing post injury.

To summarise, if you are an athlete recovering from an ACL injury or partaking in sports with an associated risk of ACL injury, it is essential you are incorporating plyometric training into your exercise routine. Well planned programs can be used to build strength and explosive power as well as improve quality of movement, each important factors in improving athletic performance.

Intensity of the plyometric task/exercise prescribed can be modified and measured through several factors such as height/vertical or horizonal momentum/effort or type of surface used.

The intensity of the task should align with the ability and recovery stage of an athlete to allow for optimal loading.

Well planned programs should allow for gradual progressions throughout in task intensity and specificity to cater for the athlete’s sport or needs to allow for an effective return to sport.

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