| | ACL Injury Prevention: Anti-Rotation

Author / Christopher McQuilkin

Toes-forward-power-athlete-anti-rotation-chris-mcquilkin-ryan-troupeCommon thinking in strength and conditioning is the stronger the muscle, the safer the joint is from injury.  Focusing on linear force production regardless of the set up or execution, is a fallacy that neglects a monumental component of sport and training: Force Reduction.

In Neuromuscular Reeducation, we discussed training protective knee joint action by creating a default position for jumping, landing, and changing direction.  Muscles can only protect if they are contracted appropriately to control imposed loads (2).

A strength coach applying injury prevention practices should check the Shitty Coaching Trifecta to ensure they truly understand the mechanisms for injury and the proper neuromuscular education techniques.  Without proper identification and correction, the protective muscle reflexes are more or less useless.

ACL-Prevention-Training-NFL-Collin-Mooney-

Once ACL risks are assessed and proper knee alignment/action is mastered through reeducation, the athlete must be challenged further with different ways to prepare for the forces and movements.  This article will present a new training tool to further the force reduction and neuromuscular reeducation process: anti-rotation strategies.  These movements will further eliminate ACL non-contact injury mechanisms and prepare the athlete for all forces and movements they’ll see in their arena.

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Newton and Performance

“For every action, there is an equal and opposite reaction. The statement means that in every interaction, there is a pair of forces acting on the two interacting objects.”

In sports, Newton’s Third Law of equal and opposite reaction forces is omnipresent.  When a running back makes a hard, one-footed cut on the field, or a basketball player lands from a rebound and rotates their shoulders to protect the ball, the surface hits them back with a reaction force greater than their body weight, since their inertia imparts a force to the ground greater than their collective mass (1).

According to Newton’s Laws of overcoming inertia, the mechanisms inside the body must generate an equal and opposite torque to prevent the athlete from continuing in their original direction.  This torque is called an internal flexion moment.  Executed properly, this moment is executed mainly by the posterior chain at that point of cutting or landing.  Deficits in hamstring and glute recruitment may allow for excessive rotational stress on knee joint passive stabilizers, just enough torque to cause injury.  In my experience, this torque is a demand in sport that is almost NEVER acknowledged in athlete training.  In fact, it was not until my training at AXIS that I was aware of the concept of anti-rotation at all.

The goal of force reduction and anti-rotation is load sharing.  If done correctly, muscles simultaneously act not only as force generators, but also dampening springs.  Limiting factors preventing this symbiotic relationship include joint misalignment, ligament dominance, quadricep dominance, and an athlete’s loss of control of their center of mass.  It only takes an instant for an injury to occur.  If one of these injury mechanisms comes into play during this instant, and dampening favors one muscle excessively, there is a dysfunction leading to possible injury.

Anti-rotation training is a key component of effective intervention.

Anti-Rotation

In the sporting arena, lateral flexion, extension or rotation of the trunk needs to be 100% controlled by the athlete as they execute sport tasks through the all planes of motion.  Remember, the four neuromuscular imbalances covered in Injury Mechanisms comprise the formula for an ACL tear, and all are affected by trunk position and uncontrolled movement.  Trunk neuromuscular control is trained through Field Strong movements like the Knee Hug to Horizontal Lunge Twist and Standing Teapot.  Anti-rotation training, however, challenges an athlete to maintain neutral spine as the body moves through the frontal and transverse planes.

Neuromuscular control plays is the most modifiable factor, especially when it comes to the knee and trunk.  On top of the strategies detailed in Neuromuscular Reeducation, we introduce dynamic movements, particularly posterior chain-dominant and trunk-dominant strategies through the frontal and transverse planes which challenge athletes with inertia and rotational forces.

Chelsey-Haardt-Power-Athlete-LFL-ACL-PreventionFrontal Plane – To Stay On The Mission, Use The Athletic Position

As an athlete moves laterally through the frontal plane, a toes forward athletic position is very important.  Proper alignment allows an athlete to use Newton’s Third Law to assist their change of direction by using the opposite force to propel them accordingly.  Misalignment on a lateral step or jump prevents the muscles from acting as force reducers, and the inertia or torque may slow an athlete or worse, cause an overload injury.  Observe the posterior chain activation and sagittal plane loading of the knee as the athlete moves through the frontal plane in the movements below.  Avoid knee tracking outside of the foot, quad dominance or internal/external rotation at the femur.

The trunk dominance strategy for frontal plane training challenges a neutral position with inertia. The athlete must resist lateral flexion and trunk rotation.  This is seems simple in theory, but becomes increasingly difficult in the face of increased forces, trunk fatigue and external resistance.  Observing an athlete head on or from behind will reveal any shoulder tilt or loss of trunk position as they move.

ACL-Injury-Prevention-Volleyball-Power-AthleteTransverse Plane – You Gotta Keep ’em Separated

An athlete’s ability to separate the shoulders from the hips will impact performance.  In volleyball, the blocker must ensure their torso and hands angle towards their opponent’s court.  This is reasonably simple to do for higher, predictable sets, as there is enough time to track, move, plant, and launch.

However, when a lower, faster set is shot towards either sideline, the player must use a swing block.  Essentially, they must turn towards the sideline, approach the incoming ball as if they were hitting, plant, launch, and penetrate the net, again, ensuring their torso and arms face into the opposing court..  Otherwise, the ball could bounce off their hands before landing out of bounds (getting “tooled”).  If the blocker is late, chances are their lower body is still facing the direction in which they approached.  Despite this, if they can separate their shoulders (and arms) from their hips, they can still put up an effective block.  It’s not ideal, but it’s better than losing.

In the video below, this athlete’s performance is not ideal.  Even under a controlled situation (no duress of competition – it’s a demonstration), note her torso position relative to her body.  At best, it faces straight ahead, but mostly, she tends to face the sidelines upon launch.  A smart hitter will line drive it off her hands for the point.  She needs to work on fighting inertia.  She needs to use the opposite reaction to stop her momentum.  She needs to work that shoulder-hip separation so she can face her torso into the court, regardless of her foot position.  She needs Power Athlete.

[youtube]https://www.youtube.com/watch?v=riYXmxBae54[/youtube]

Equally important is prevention of unwanted movement and reduction of forces that pull the athlete through the transverse plane.  Anti-rotation posterior chain dominance strategy challenges the athlete to load the knee posteriorly through the sagittal plane, not only as the body moves through the transverse plane, but also as the trunk rotates.

The purpose of applying trunk dominance to anti-rotation movements through the transverse plane is to fight inertia and torque to maintain a neutral trunk position.  No matter the strength of an athlete, this action is very challenging if the correct stress is applied.

Anti-Rotation Movements:

[vimeo]https://vimeo.com/121062547[/vimeo]

Single DB Asymmetrical Jump
This movement challenges an athlete to produce force out of the athletic position and reduce force in the athletic position with a dumbbell pulling them in an opposing direction.  Look for any favoritism to one side, twisting or bending in the trunk, or rotation in the knees upon landing.

[vimeo]https://vimeo.com/121062482[/vimeo]

Resisted Rotational Squat Hop
This movement assists in the development of the athletic position through the transverse plane and anti-rotation in the trunk by challenging the athlete’s tools to address rotational stresses to solidify effective mechanics for injury prevention.  Maintain straight arms and lock the trunk and shoulders in line with the hips through the movement.

[vimeo]https://vimeo.com/116994178[/vimeo]

Jam Squat w/ Twist
The purpose of the original Jam Squat was to train posterior chain dominance, and this movement takes this purpose one step further.  The action of the hips and knee must load the back through the sagittal plane while the trunk rotates and the athlete separates their shoulders from their hips.  Keep the weight light, and challenge with speed.  If the speed causes the athlete to twist or collapse at the knee, slow them down.

[vimeo]https://vimeo.com/116995770[/vimeo]

Lateral Jump + Front Twist
Here we challenge the athlete through all planes of motion, but primarily the transverse plane.  The expectation is to step out and recover the athletic position and posterior load of the knee, especially during the forward pivot.  In the words of Charlie Francis, “If it don’t look right, it don’t fly right.”  Check for any deviations in the lateral step, jump, landing, and movement through space, and then practice the point in which they falter up to this point.

[vimeo]https://vimeo.com/116997191[/vimeo]

Lateral Jump + Backward Twist
This is an extremely important movement to master, but it must be built into the athlete’s nueromuscular coordination with all previous movements above, and those listed in Preparation.  As the athlete steps laterally, pivots, and swings the trail leg behind, all focus needs to be on the pivot leg.  Without rotation here, the athlete poses a high risk for injury.  Why put them at this risk here? Because it is a low stress, controlled environment for them to practice this backwards rotation and master it before the stress of practice or a game.

[vimeo]https://vimeo.com/121062669[/vimeo]

Single DB Power Clean w/ Open Step
This movement not only challenges an athlete to maintain posture with an off balance pull, but also catch in a balanced athletic position reducing force and resisting any rotation.  The athletes ability to protect positioning with an open step 1/4 turn and their ability to maintain their height and width of athletic position through the transverse plane.  We are constantly finding ways to challenge an athlete’s ability to move seemlessly and effortlessly through space, and this is no exception.

Production Needs Reduction – Empower Your Performance
Unfortunately, strength is only approached from a perspective of force production.  Equally important to an athlete’s training, field sport or otherwise, is the ability to reduce and counteract force. While production is pinnacle for performance, it alone cannot guarantee improved muscular protection.

Educating an athlete to share the load through the posterior chain and resist trunk movements will go a long way in preventing non-contact injuries.  The large range of processes required for musculoskeletal protection illistrates the importance of special strength training in the properly-sequenced, multi-faceted manner.

Mastering force, torque and inertia reduction in the weight room will pay huge dividends when it counts: on the field.

Sources:

1) Hewett, T. E., Ford, K. R., Hoogenboom, B. J., & Myer, G. D. (2010). Understanding And Preventing ACL Injuries: Current Biomechanical And Eepidemiological Cconsiderations – Update 2010. North American Journal of Sports Physical Therapy : NAJSPT, 5(4), 234–251.
2) Verkhoshansky, Y., & Siff, M. (2009, pg. 472). Supertraing: 6th Edition. Rome: Ultimate Athlete Concepts.

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AUTHOR

Christopher McQuilkin

MS, CSCS, SCCC, CHES
Book a consult with me regarding coaching, training, life, education... anything your heart desires. Click below:
calendly.com/pahq-tex

Former collegiate lacrosse defensive midfielder, 4-year letter winner and 3-year team captain. Coached strength and conditioning collegiately with Georgetown University football, Men's and Women's lacrosse and Women's Crew, as well with the University of Texas at Austin's football program. Apprenticed under Raphael Ruiz of 1-FortyFour-1 studying proper implementation of science based, performance driven training systems. Head coached CrossFit Dupont's program for two years in Washington D.C. Received a Master's in Health Promotion Management from Marymount University in 2010, and has been a coach for Power Athlete since October, 2012.

7 Comments

  1. DavidMck on March 3, 2015 at 4:23 am

    Damn @mcquilkin. Awesome stuff. Gonna throw some of this into the mix with my rugby players, curious to see where they’re at in regards to posture and position through these movements. My guess is not where they need to be. This is some top shelf shit right here. Thanks once again.

    • Tex McQuilkin on March 3, 2015 at 5:56 am

      @train608
      Don’t feel a rush to throw these at your girls. This is where you go once the movements in Reeducation are mastered. We then challenge that posterior chain dominance with these dynamic movements. The jam squat is INVALUABLE in teaching female athlete how to load their posterior chain. Once they get that down, throw these at them.

  2. DavidMck on March 3, 2015 at 7:10 am

    Heard. Jam squats.

  3. Ingo B on March 4, 2015 at 8:58 am

    Tex, when is a good time to work these movements in? Pre warm up? Post strength, but pre-conditioning/accessory? Extra Credit?

    • Tex McQuilkin on March 5, 2015 at 4:27 pm

      These are after mastery of sagittal plane posterior loading. The most optimal introduction to them in training is post warm-up and pre strength when the athlete is freshest. Once the athlete is proficient in these, we can add the stress of fatigue. Have them inbetween squat sets, following heavy pulls (post-strength/pre-condo), or following a condo/LATT/sprints.

  4. menacedolan on March 5, 2015 at 4:07 pm

    Excellent work again!!

    While your lower half looks like an old school, sturdy A frame building, with female athletes I would want to bring their feet in a bit to reduce valgus stress due to an increase in Q angle. Thoughts?

    • Tex McQuilkin on March 5, 2015 at 4:24 pm

      @menacedolan
      I concur, Dennis. Each athlete’s set up will vary a few degrees, especially between male and females. With females, we have to fight harder to train posterior chain dominance because they’re at a higher risk for ligament and quad dominance than males. Finding the proper set up that allows females to push their butt back into their hammies is the first step in any prevention/reeducation program. The A-frame shown above is a much better starting point than what is being taught (or not) right now. Start there and work in or out for the safest/most optimal position per female.

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