PREVENTION OF ACL TRAUMATIC PATHOLOGIES

Premise

Tactical technical training in basketball occupies approximately 70/75% of the weekly working hours. These exercises affect all the fundamental elements of performance, conditional, coordinative, cognitive.
There are approximately 80,000 anterior cruciate ligament (ACL) injuries, which occur, in most cases during training, in a sporting season in the United States. Most of these injuries can be traced back to non-contact situations and almost always during a "crossover and sidestep cutting maneuver", a classic gesture that is repeated countless times during a race
Statistically ACL injuries in women are reported to be 2 to 8 times greater than men within the same sport. The reasons for this discrepancy are not known. They have been hypothesized in epidemiological studies as possible causative factors, including others alteration of hormonal fluctuations during the menstrual cycle.
The impossibility of putting into action voluntarily or reflexively the active anatomical defense lines, against pathological movements, is partly due to a disturbance of neuromotor coordination, that is to the loss by the athlete to control the complex movements to which the knee is subjected.
Anatomical, biomechanical factors, such as knee or ankle joint instability, become important factors that increase the risk of ACL injury. Furthermore. an "incorrect management of the injured athlete's return to sport, such as protocols that are too aggressive or insufficient in scientific content. all overuse pathologies can represent the first predisposing factor.
Prevention also passes through excellent coordination skills, which, when developed in an optimal way, allow to obtain complex gestural performances of a high level. The "agility training programs" multi-station -proprioceptive training, associated with plyometric training are designed to improve neuromuscular control and allow the patient to adapt, at different speeds, to rapid changes of direction, to acceleration and deceleration, and all activities typical of team sports

Introduction

The voluntary muscular activity of the lower limb and in particular of the muscle groups that "wrap" the knee can be linked to 2 models of contraction:

a co-contraction agonist - antagonist

a reciprocal activation of agonists and antagonists

The quadriceps-hamstring co-contraction stabilizes and maintains the joint in a certain range, and if we want to photograph it in a game situation it would be figured in the "sliding backward" attitude in the defensive position (defensive slide) or in the position of lateral sliding (power shuffle).
The simultaneous contraction of the flexors and extensors is part of an activation pattern which contributes to the stabilization of the knee joint, therefore to the reduction of stress on the ligament capsule system.
Thus, if the muscle activation of the quadriceps and the flexors is simultaneous, the contraction of the latter, which has a role of a brake on the anterior translation, together with the important activity of the gastrocnemius, helps to reduce the load on the acl.
Wojtys et al. Found that female athletes take significantly longer to reach peak hamstring strength when compared to male athletes.
The rapid concentric contraction of the knee flexors, at the moment of their maximum activation, increases the hamstring ability to stabilize the knee and thus reduce the anterior translation which becomes marginal.
However, it is also good to remember that the active lines of defense against the anterior drawer are represented by the hamstring, the gastrocnemius, the popliteal, the sartorius, the gracilis, the semitendinosus and the semimembranous. This active support role decreases as the knee reaches full extension or towards a 180 ° angle.