By Mike Mejia, CSCS
Last month, in part one of my series on injury prevention, I went over the importance of improving the strength and mobility of
all the muscles that surround the ankle joint. This time around, we'll start working our way up the body and focus our attention on the knees and hips. Although these are two extremely important joints that each warrants an article all to themselves, I'm covering them together because many of the drills I'll be featuring here involve action across both joints. Not to mention the fact that knee injuries can often be attributed to strength and/or flexibility imbalances that start in the hips.
Speaking of knee injuries, although there are many types which differ in severity, anything involving the ACL (anterior cruciate ligament) automatically garners a lot of the attention. In fact, the mere mention of those three dreaded letters is enough to give any athlete cold sweats. And that's because tearing your ACL will not only put an end to your season, but you can bank on doing at least 6-9 months of rehab before you can even think about returning to competition. Perhaps even more troubling, though, is the fact that this is an injury that's on the rise; especially amongst female athletes, who are up to 4-6 times more likely to tear their ACL than males. While it's true that both anatomical and hormonal factors play a role here, a lack of proper conditioning also contributes heavily to this increased injury rate. More specifically, failure to engage in a proper warm-up prior to physical activity, (such as the one's you'll find right here- please link to video warm-up page) as well as not targeting strengthening efforts on the posterior chain (the hamstrings, glutes and lower back working together as a unit) have been identified as primary causes.
There are also a number of other less severe injuries that affect soccer players of all ages and genders. These include everything from acute injuries like a torn meniscus, to ligament sprains and strains and even overuse problems such as patellar tendinitis. As far as the hips are concerned, though somewhat less publicized, injuries such as labral tears and hip impingement are becoming more and more common amongst young athletes. In both instances, although genetic factors may sometimes play a role, much of the reason for the increased injury rates currently being seen in youth sports can be attributed to overuse of specific muscles and movement patterns. Combine this with a failure to regularly engage in the appropriate kinds of stretching and strengthening exercises and it's no wonder why this problem is reaching near epidemic proportions.
While it’s true that injuries are an inevitable part of competitive sports, there are definitely steps you can take from a training standpoint to help swing the odds more in your favor. The drills featured below will give you an excellent starting point, as they're specifically designed to help improve both strength and range of motion around these two important joints. The first four are more geared towards those with limited training experience, but are still highly recommended for athletes of all ages and genders, because they target areas that tend to be neglected in most traditional strength training programs. Most can also be done either with, or without additional weight- making them perfect for younger kids that are just starting out. In the continuation of this article, I'll feature four more advanced drills that require a bit more in the way of balance, stability and coordination.
The Drills:
1. VMO leg raise: This simple leg/ core strengthening drill targets the VMO (vastus medialis obliquis), a crucial muscle in terms of helping provide knee stability.
Begin by lying on your back with your left leg bent at about 45 degrees and your foot flat on the floor, while your right leg is lying on the ground completely extended. Next, brace your core to keep it tight and with your right foot flexed (toes pulled towards you) rotate your leg out about five degrees or so (in this position your toes will point slightly to the right, instead of straight up). Keeping your core tight and right knee completely straight, maintain the five degree turnout of your right leg as you raise it up off the ground until it forms a diagonal line to the rest of your body. At this point your knees should be right in line with each other. Hold this top position for at least 1-2 seconds before lowering back down and repeating until you've completed 10-12 repetitions, then switch sides. To increase the difficulty, try adding some ankle weights.
Coaching Tip: Be sure to keep your knee straight with a slight turnout to target the VMO and avoid arching your lower back away from the ground. Use a slow, controlled speed.
2. Supine Bridge: Targets the often under-used glutes and hamstrings, while also working the core.
Start out by lying on your back with both knees bent about 45 degrees and your feet flat on the floor. With your core braced tight, drive with your heels and push into the ground, as you lift your hips and lower torso up until you form a diagonal line from your knees to your shoulders. Hold there for a second of two before lowering back down. Continue until you've completed 10-12 repetitions. To increase the difficulty, try doing one leg at a time by holding the other one directly up above your hips.
Coaching Tip: Make sure you're driving through your heels to work your glutes and hamstrings (back of the legs) and not pushing through the balls of your feet which will involve the quads (front thighs) more. Also be sure to keep your core braced tight to keep strain off of your lower back.
3. Side lying clamshells: Strengthens the outer glutes to help with proper knee tracking.
Lie on your side with your knees bent about 45 degrees and your shoulders, hips and knees stacked over each other. Begin by placing your top hand on your top hip to make sure it doesn't move and keep your feet together as you lift your top knee up until it forms a 45 degree angle to the rest of your body. Hold there for 1-2 seconds and then continue until you've done 10-12 repetitions and then switch sides. To increase the difficulty, try holding the top position for 5 seconds per repetition.
Coaching Tip: Be sure not to let the top hip "roll" backwards and keep your feet touching throughout the entire exercise.
4. Sumo Squat: Builds strength while also improving dynamic flexibility in the groin area.
Stand with your feet slightly wider than shoulder's width apart with your toes turned out to the ten and two positions on a clock. Place your hands behind your head with your elbows out wide and begin by keeping your chest up tall as you sit back into a squat. As you descend make sure your knees track over your toes and avoid "pinching" inwards. Once you've reached the point where your thighs are parallel to the ground, pause for a second and then press back up to the starting position. Continue until you've completed 10-12 repetitions. To increase the difficulty, bring your arms down and hold a medicine ball, or dumbbell at arms length between your legs.
Coaching Tip: Knee tracking is your biggest concern here; as tightness in the groin can really tug those knees inward. Make sure your knees follow directly over where your toes are pointed. Also make sure your back is straight throughout with no rounding of the spine.
For more great injury prevention tips, keep an eye out for my new DVD "BASE Training: Injury Prevention for Young Athletes" which will be released in the middle of October!