WISSENSCHAFTLICHER BEITRAG: Prävention von Rupturen des vorderen Kreuzbandes im Ballsport: eine Literaturübersicht

Abstract

Summary A number of epidemiological studies has shown that the rate of ACL ruptures in female athletes is 2.4 to 9.5 times higher than in male athletes. Approximately 70% of these injuires occur without direct contact to another player (noncontact situations). Various studies have shown that the most frequent situations are landing a jump, stopping and plant and cut maneuvers. However, there is evidence that gender specific differences in coordination and neuromuscular control may be an explanation for the high incidence of ACL injuries in female athletes. Female athletes tend to be more upright with a slightly flexed valgus knee when cutting and landing. The muscle mechanics in this position favors the qua-driceps while denying a favourable position for the hamstrings to conteract the quadriceps. Additionally, women also have greater quadriceps activation. Therefore, when cutting, women place their knee in a position that favor a quadriceps-induced anterior drawer maneuver, placing the knee in a position of increased risk for ACL injury. Various studies have shown that specific training programs can reduce the incidence of ACL injuries significantly: 1. The Henning prevention strategies stressed: – changing the plant and cut to an accelerated round turn, – landing with a bent knee rather than a straight knee, – changing a one step stop on a straight knee to a stopping with a multiple-step with a knee bent. 2. The Caraffa Program showed that incorporation of proprioceptive drills such as balance board exercises into pre-season conditioning program is able to reduce the ACL injury rate significantly. 3. The Cincinnati Sportsmetric Program includes a temporal staggered jump training. 4. The Kiel Team Handball Injury Prevention Program includes elements of all three former programs.