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Making Football Safer | Muscle & Body Magazine

Professional football players have taken the field and the 2013 NFL season is upon us, so I’d like to revisit a topic I touched on back in August profiling the ACL injury. As I wrote, every year, between 250,000 and 300,000 athletes suffer injuries involving the ACL (anterior cruciate ligament, found in the knee), injuries that could potentially end professional seasons and even careers. As we all accept, football is a human demolition derby, where athletes crash into each other, then violently hit the ground. While most players are able to get back up, it’s not unusual to see an athlete rolling on the turf, clutching his knee.

Consider the severe knee injury of Miami Dolphins tight end Dustin Keller, which he suffered during a preseason game against the Houston Texans. Keller, who was tackled by safety D.J. Swearinger, endured ruptures to his anterior cruciate, posterior cruciate and medial collateral ligaments in his right knee, and also dislocated his kneecap—a truly devastating multiple injury for any individual. While coaches and staff members hope Keller will be ready to resume play by the 2014 NFL season, I would suspect that his recovery process might take longer.

The Triple Whammy Of Knee Injuries

“On the scale of ligamentous injuries to the knee of multi-ligamentous injury tears that Keller sustained, it is the most severe and often associated with long-term instability,” explains orthopedic surgeon William Sherman, MD, team physician for the New Orleans Zephyrs (a triple-A baseball team affiliated with the Florida Marlins). Sherman adds that surgery for this injury “is extensive and requires a protracted rehabilitation course of up to a year.”

In what I refer to as the “triple whammy,” tearing three ligaments of the knee, much like Keller has done, is on a level of severity all its own. Here’s a brief look at the anatomy of the knee.

  • The posterior cruciate ligament (PCL), according to the American Academy of Orthopedic Surgeons, “is located in the back of the knee. It is one of several ligaments that connect the femur (thighbone) to the tibia (shinbone). The PCL keeps the tibia from moving backward too far.” An injury to the PCL requires a powerful force. For example, a common cause of this type of injury is a bent knee hitting a dashboard in a car accident, or a football player falling on a knee that is bent.
  • The medial collateral ligament (MCL) is located on the inner part of the knee. This ligament keeps your shinbone (tibia) in place.
  • The anterior cruciate ligament (ACL) allows for rotation of the tibia to the femur.

Regarding non-surgical and surgical treatment of multiple ligament tears along with a dislocation, “acute surgery in patients with combined ligament injuries of the knee can lead to stiffness, primarily with medial-side (inner) injuries,” according to the U.S. National Library of Medicine. Moreover, “knee dislocations with lateral-side injuries require acute repair to achieve a good long-term result.”

Therein lies the problem with precipitating an athlete’s return to the field. Not only do athletes who suffer triple-whammy knee injuries have to concern themselves with time off and recovery, but they also need to evaluate their situation and how this injury could change the mechanics of how they play ball.

Sherman says, “With any multiligamentous injury, there is always a certain degree of instability and change in mechanics that may lead to the premature development of arthritis.”

Making Prevention A Priority

Hip extensors (butt muscles) are of the upmost importance when it comes to an athlete’s ability to decelerate the center of his mass during a landing. An athlete will benefit from a bend in the knee when landing, as opposed to absorbing the force with a straight leg. If an athlete can expect stiffness postsurgery, as research has suggested, then it is safe to assume that said athlete might experience less of a bend and more of a straight leg—a level of rigidness in the trunk, which is problematic for a previously injured knee.

Of course, professional athletes are supervised by team physicians and physical therapists, who can administer plyometric and neuromuscular training to overcome the injury during the recovery process; however, it’s likely that extra measures are taken when dealing with three complete ligament tears.

When I was a wide receiver at Tulane University in the mid-’70s, padding for the thighs, hips and knees was standard issue for all players. Since the knee is one of the most injured areas on an NFL player’s body, it is hard for me to comprehend that it has taken the league this long to mandate that players wear protective thigh and knee pads during this season—still not a great solution to the sustained impacts to the knee, but at least NFL players now have some type of protection.

With the new NFL padding rule, players will be policed during warm-ups and games to make sure the pads stay in place. Let’s hope and pray that injured players like Keller make a safe and speedy recovery from what many medical experts consider a career-threatening injury.

Regarding preventative measures for a nonprofessional athlete who does not have the same rehabilitation options as a professional would, I suggest strengthening your lower trunk in order to prevent such injuries from occurring (see my August column for exercises), as well as practicing proper form in all pivots and landing drills.

It is my hope that after reading both of my articles on the severity of knee injuries, you will recognize how truly important it is to maintain core stability and lower-trunk strength. Don’t think of it as protecting your knees; understand that you are protecting your entire body. When the knees go, life changes—just ask any retired NFL player with a triple-whammy knee injury.

Link: Making Football Safer | Muscle & Body Magazine.