Does an unusually high number of ACL Tears sugggest defective training and medical oversight

[E. Wolf]

For a couple years now, I have adopted the position that the unusual high number of injuries that the Packers suffer from every year strongly suggest that either the medical or training staff are doing something wrong. We have been way out in front of injureis in the leage for about four out of five years now. One or maybe two years could just be coincidence, but any more than that and I refuse to think it is just coincidence. This is bolstered by the fact that the one year we did not suffer an unusually high number of injuries was 2011, the year of the lockout which allowed for only an abbreviated training camp.
Detractors say that ACL tears have nothing to do with either training or medical oversight. Eg this tweet from Jason Wilde:

Jason Wilde ‏@jasonjwilde 1h
I get injury frustration from #Packers fans, but I'm not sure how you blame medical/training staff for @abbrecadabra and @Barclay_64's ACLs.

That's not my understanding, but I do not know enough about it to refute the notion as competently as I would like. So I am starting this poll. Look forward to hearing from everything on this, and hopefully we can all have a better understainding as to why this keeps happening to our team.
GO PACK!

 

[Kitten]

Good question. I think it can or at least it suggests something may be going on in terms of training or conditioning especially when there is a high rate of a specific type of injury. I think it is worth looking into when it's an injury as serious as this. It's not to my understanding either, I too lack the knowledge to refute it, it's just something that would get my attention and make me say, hey, maybe something is going on here that should be checked into.

 

[E. Wolf]

As far as I understanding ACL tears are bound up in over training. Part of it is players are bigger and faster than ever before. They sort of fit into the same family as strains and pulled muscles which definitely DO involve defective training and medical oversight. And we generally get a high number of those as well. Last year we had, I believe, over five pulled hammies alone. That's about ten percent of the team right there.

 

[ivo610]

Im with Wilde. Alot of fans just want someone to blame for everything that isnt perfect with the team.

 

[E. Wolf]

Im with Wilde. Alot of fans just want someone to blame for everything that isnt perfect with the team.

Ok but do you have any knowledge about ACL tears specifically that support that view?

 

[ivo610]

Ok but do you have any knowledge about ACL tears specifically that support that view?

Im not exactly sure what you are asking... do I have any specific knowledge that fans are always looking for someone to blame?

 

[E. Wolf]

Im not exactly sure what you are asking... do I have any specific knowledge that fans are always looking for someone to blame?

What i mean is this: You offered NO insight, facts or rationale about the nature of ACLs that would support or refute the notion that trainind and medical staff are a factor behind this. I am asking if you can offer any.

 

[longtimefan]

Maybe the hamstring issues have something to do with training, warming up etc...But I dont think an acl can be prevented?

The team is already not hitting as much as they have in the past, not sure what else can be done..

That is why they hired a firm to look into the injuries..

 

[weeds]

Maybe the hamstring issues have something to do with training, warming up etc...But I dont think an acl can be prevented?

The team is already not hitting as much as they have in the past, not sure what else can be done..

That is why they hired a firm to look into the injuries..

Damn LT .. he wants insight. INSIGHT MAN!! You offered NO insight. A little cowbell wouldn't hurt neither... so, INSIGHT and COWBELL!! Get right on that, K?

 

[AllouezPackerFan]

As far as I understanding ACL tears are bound up in over training. Part of it is players are bigger and faster than ever before. They sort of fit into the same family as strains and pulled muscles which definitely DO involve defective training and medical oversight. And we generally get a high number of those as well. Last year we had, I believe, over five pulled hammies alone. That's about ten percent of the team right there.

The Packers have had the same medical staff for quite awhile. Dr. McKenzie has been with the Packers since as far as I can remember. I went to school with his kids and he performed surgery on my broken humerus last year. Dr. Pat knows what he's doing.

As far as pulled hammies and injuries like that....perhaps the training regimen has something to do with it....but I'd like to think that the strength and conditioning staff of a professional football team know more about this subject than we do.

 

[jaybadger82]

Yeah. Our medical staff has won awards and stuff.

 

[NorthWestCheeseHead]

What i mean is this: You offered NO insight, facts or rationale about the nature of ACLs that would support or refute the notion that trainind and medical staff are a factor behind this. I am asking if you can offer any.

From the Texas Sports Medicine and Orthopedics Group. Specifically in a FAQ written on ACL injuries written by Tarek O. Souryal, M.D.

Can ACL tears be prevented?

Dr. Souryal: That's the $64,000 question. These injuries are so rampant. There's not a good way to prevent them. We can make some recommendations: Be sure you stretch before, during and after an activity, and get those hamstrings, quadriceps and muscle-tendon units flexible so they can absorb shock. Strength and endurance training is helpful. Most physicians recommend cross-training, because you not only develop the pure strength component but also the endurance component. That will help you in the fourth quarter of a basketball game or the second half of a soccer game. Use common sense: When you get extremely tired and your legs feel like lead pipes, that is not the time to attempt a 360 dunk. Muscles are wonderful shock absorbers. There's split-second timing that's required for a plant and a cut, and a jump and a landing, where the muscles can absorb that shock. When you're fatigued, that split-second timing is lost, and you don't necessarily have the quads strength to absorb the shock when you come down from a rebound.

Really, at this point, that sort of advice is all we have. There are no braces that are preventive. There are proprioceptive exercises that most colleges and pro teams have their players do. At the recreational level, these exercises aren't normally taught.

 

[E. Wolf]

Thanks Northwest. That link pretty much coincides with my understanding==namely that strenght and conditioning are a factor. It may not be THE factor, but I think there is something awry here with either the training and conditioning staff, medical staff, or both.

 

[AllouezPackerFan]

Who are we blaming for Rodgers' broken collarbone last year?

 

[NorthWestCheeseHead]

There are definitely other factors. When you bend at the knees like OL do it puts a lot of your body weight on that joint. It's also multiplicative in effect because of the small area the weight is distributed over. For instance a 250 lbs person walking up stairs is putting 600lbs of pressure on their knees preforming the action. I'd say the size of OL's and the defenders they lineup against and have to forcefully move around play a large role in at least OL ACL injuries.

 

[Carl]

Don't see how training staff can prevent guy from rolling his knee. When a 300 pound plus guy rolls his knee something bad is going to happen.

As far as the overall injury issue last season, here's my take from a physical therapists perspective that I posted on a topic before.

"I know that there are no big muscles on the front of the shin [Regarding Cobb] that would absorb much impact and same with the thumb. [Regarding Matthews]

With Rodgers, he took a lot of force medially almost directly in line with the clavicle, which is a very small bone not meant to handle all that force. It also doesn't have muscles to pull it laterally that would help with that force. More muscle flexibility, which I doubt was even an issue as the vast majority of non athletes even have full shoulder range of motion, would not have helped. The shoulder muscles aren't a like hamstring, which lots of people have tight.

The number one thing to do to prevent bones breaking is to load them like with lifting weights and I'm sure the Packers players have been doing that their entire athletic careers.

As far a hamstring injures, they are the number one most reoccurring soft tissue injury in athletics. This has been known for a long time and despite LOTS of research, there is still no consensus on how to prevent them. First time injuries, yes, second and beyond, not so much.

Finally, can't specifically strengthen an ACL. Can strengthen muscles around it, and I'm sure Buluga has some strong legs. Knee ligaments are more responsible for keeping knee bones stable and they are not meant to handle a 300+ lb guy who moves well.

I'm not saying the staff isn't accountable for some. First time hamstring injuries, for example, are mostly preventable. Just they don't deserve blame for everything."

 

[Carl]

This is basically the same, but with sources I found to back myself up.

Rodgers' Clavicle

"Any severe force on the shoulder, such as falling directly onto the shoulder or falling on an outstretched arm, transfers force to the clavicle. As a result, the collarbone is one of the most commonly broken bones in the body." Johns Hopkins http://www.hopkinsortho.org/claviclefx.html

"The clavicle is easily fractured because of its subcutaneous, relatively anterior location and frequent exposure to transmitted forces. The middle third, or midshaft, is the thinnest, least medullous area of the clavicle, and thus the most easily fractured; the lack of muscular and ligamentous support makes it vulnerable to injury. The usual mechanism of a clavicle fracture is a fall directly on the shoulder with the arm at the side." American Family Physician Journal http://www.aafp.org/journals/afp.html

Without much muscle and ligaments to protect the clavicle, not much Rodgers could have done to prevent it and he fell the exactly same way these describe as a common mechanism of injury (with huge guys landing on top of him too).

Hamstrings

Here's a few hamstring links if you'd like to look through them. In general, you'll find a large prevalence of injuries with many factors being suggested as the reason for the injury, and the injury risk for a reoccurring injury is much higher. There's also a lack on consensus on how to treat them. The best one I found as far as treatment is the top link, but it hasn't got support in the four years it's been out (according to one of my professors who is one of the authors). I think the main point from them is that there are many suggested causes and treatments, but nothing specifically has tons of evidence.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2867336/
http://www.ncbi.nlm.nih.gov/pubmed/22239734
http://www.ncbi.nlm.nih.gov/pubmed/22239734

With Cobb's break, I haven't searched for any articles, but it's safe to say a there's nothing that would have prevented Cobb's injury. He took a helmet straight to the bone. Any loading such as running, squats, jumping, etc. strengthens bones so we can assume Cobb's bones were fine as has had to do a lot of those to get this far. Same with Matthews. If you take a big enough load to the thumb, you're going to break it. Teams aren't going to spend time doing thumb exercises anyway if there are ways to prevent it. When he broke it the second time, there certainly could have been an error in allowing him to return too early though.

ACL

"Several prevention programs have been developed in an attempt to decrease the incidence of noncontact ACL injuries. The focus of current prevention programs is on proper nerve/musclecontrol of the knee. These programs focus on plyometrics, balance, and strengthening/stability exercises." American Orthopaedic Society for Sports Medicine https://www.sportsmed.org/uploadedFiles/Content/Patient/Sports_Tips/ST ACL Injury 08.pdf

Plyometrics, balance, and strengthening/stability exercises are somethings that I would think are normal parts of NFL strength and conditioning programs. If they aren't a part of the Packers system, then there could be some fault for putting players at a higher ACL risk.

But looking at the very high prevalence of ACL injuries across the league, which has been increasing in recent years, there's certainly room for improvement on ACL prevention.http://espn.go.com/blog/nflnation/post/_/id/95723/inside-slant-big-spike-in-acl-injuries_

Hope these help.

 

[weeds]

QUOTE="AllouezPackerFan, post: 563045, member: 2099"]Who are we blaming for Rodgers' broken collarbone last year?[/QUOTE]

I'm still blaming #74. I'm blaming him for the Gulf of Tonkin incident too.

 

[AllouezPackerFan]

Lol, he's probably also hiding Iraq's WMDs.

 

[E. Wolf]

I searched around the web and all the sites indicate that proper strength and conditioning are an important preventive measure. Following are just a handful of online sources I looked through before writing you:

http://www.acefitness.org/acefit/fitness-fact-article/2632/how-to-prevent-and-treat-acl/
http://www.athleticadvisor.com/injuries/le/knee/preventing_acl_tears.htm
http://sportsmedicine.about.com/od/injuryprevention/a/ACL_prevention.htm

These basic tips don't necessarily apply to folks at the professional level and I'd hope the Packers m -amd-t staffs are doing what every one else is doing in the League, but that this is starting to happen yet again makes me think once again that something is seriously wrong with how they are doing things.

One bit I read was also interesting:


" Factors contributing to ACL injuries include ground hardness, grass type and cleat type."


This makes me think maybe there is something about the playing grounds they use that may account for this at least in part.
These unsually high rates of injuries, particularly muscle pulls and strains, but also ACL tears have been going on for five years. THat it keeps happening cannot be mere coincidence.

 

[AllouezPackerFan]

What is the average number of ACL tears per year, per team in the NFL?

 

[Carl]

http://blogs.denverpost.com/broncos...e-day-nfl-records-61-acl-tears-in-2013/24699/

61 last season total last season.

 

[E. Wolf]

Hi Carl,

I don't think anyone attributes the sorts of injuries Rodgers or Cobb suffered last year can be anything but bad luck. ....

 

[Carl]

Hi Carl,

I don't think anyone attributes the sorts of injuries Rodgers or Cobb suffered last year can be anything but bad luck. ....

I've certainly seen people assign blame for those.

 

[Forget Favre]

Who are we blaming for Rodgers' broken collarbone last year?

The ******* Bears, that's who!
I want the Pack and every team to beat those bozo Bears and humiliate them into the ground so much that they will be too afraid to come out and will hibernate for decades to come!