ROCHESTER, New York—A program aimed at decreasing non-contact anterior cruciate ligament (ACL) tears among female high school athletes works so well that the effort is now being expanded to over 11,180 student athletes on nearly 700 school sports teams in the Rochester, NY, area. The PEP (Prevent injury, Enhance Performance) program being rolled out to 119 high schools is a 2-year program that teaches coaches, trainers, and students how to prevent ACL injuries.

"PEP works by retraining the nervous and muscle system in female athletes to be more efficient, and as a result, reduce the potential for non-contact ACL tears."—Andy Duncan, PT, ATC
PEP comprises a specialized warm-up program, and exercises and training to increase muscle strength, plyometrics, agility, balance and flexibility. The program takes about 20-25 minutes to complete and should be done two to three times a week. Sample PEP exercises include:
  • Warm-ups: Jog, slides, backpedals
  • Strengthening: Lunge walk, ball bridge, calf raise
  • Plyometrics: Lateral, front/back and single leg hops, rebound jumps, scissor jumps
  • Agility: Shuttle and pivot runs
  • Stretching Hamstrings, quads, calves, groin and hip flexors

“PEP works by retraining the nervous and muscle system in female athletes to be more efficient, and as a result, reduce the potential for non-contact ACL tears," Andy Duncan, PT, ATC, director of sports rehabilitation at the University Sports Medicine (USM) of the University of Rochester Medical Center in Rochester, New York, said in a press release. "In effect, we are re-teaching the muscles how to fire and respond to signals from the nervous system. At the end of six weeks, if the program is done correctly and consistently, these athletes will have a much better chance at preventing an ACL tear."

PEP cut ACL injury rate by 80%

The pilot data are impressive. "We would typically expect to see about two ACL tears per 100 participants, or about 58 non-contact ACL tears for the 2,900 athletes we have been working with," said Michael Maloney, MD, director of USM. "To date, we've seen only 10 non-contact ACL tears, so this data is very promising.”

More than 30,000 high school and college age females will rupture their ACL every year. Exactly why female athletes are more prone to these tears is not fully understood, but some theories point toward hormones, biomechanics and environment.

The roll-out of the PEP program is funded by a $161,000 grant from the Greater Rochester Health Foundation (GRHF).  

Beginning in the summer of 2009 USM athletic trainers will use a "train-the-trainer" approach to educate team coaches/representatives on the benefits and components of the PEP program. The sessions will be interactive, including demonstration and participation. Videos detailing each exercise will be given to each team to help guide the athletes through the program.

References

1. University of Rochester Medical Center. ACL Injury Prevention Program Successfully Tackling Growing Problem. Press release issued on Feb. 9, 2009.