Many soccer coaches and trainers emphasize strength training and plyometrics during their soccer practices and drills. But studies show that proprioceptive training may be the key to reducing the risk for ACL tears in soccer athletes.
A study by Caraffa, et al.* followed 600 soccer athletes after their ACL reconstruction and rehab. One group received traditional training and the other received proprioceptive training. In the end, the group receiving proprioceptive training had less ACL re-tears (10) compared to 70 in the traditional exercise group.
What is proprioceptive training? Simply put, proprioception is the ability to know where your body is without looking. A quick example is to close your eyes and touch your finger to your nose. Your body is able to determine where your finger is in relation to your body and is able to move the finger to the exact location of your nose. This happens when a series of messages are sent between your muscles and your nervous system.
In your legs, proprioception allows you to balance, kick a ball without looking down, or even jump over something. When you injure a muscle or ligament, the pathways from the tissue to the nervous system are disrupted and need to be retrained.
Why are proprioceptive exercises so important following an ACL injury? There is a translation or movement between the femur and the tibia (the two bones that the ACL connects). Neuromuscular training of the quad and hamstring muscles can help control this motion.
How can you test your proprioceptive strength or abilities? There are a few quick tests to test for proprioception in healthy and injured athletes.
- Balance Test – Stand on a stable surface and lift one foot off the ground. Challenge yourself to balance on one foot for 30-60 seconds with your arms at your side. To make this test more difficult, stand on an unstable surface or close your eyes. Test both legs and note any differences in the time you can remain balanced.
- Standing “Y” Test – Stand on one foot on a stable surface (floor). While balancing on one foot, reach your other leg out in front (to the 12 o’clock position) and note how far out you can reach your toe or heel. Then repeat by reaching the leg out to the 4 o’clock position and to the 8 o’clock position. Repeat with the opposite foot and measure for any differences between your right and left sides.
How do you improve proprioception for ACL tear prevention in soccer athletes? While physical therapists and trainers have a wide variety of proprioception exercises to meet your specific needs, here are a few basic exercises that can be done at home.
- Balance Training – Repeat the balance test above but repeat several times. Challenge yourself by closing your eyes, standing on pillows or foam pads, or by reaching out to objects.
- Standing “Clock” Exercise – Similar to the “Y” Test above, reach your leg out to all the numbers on a clock while standing on one foot. Vary the speed to challenge yourself or have someone call out random numbers to vary the order.
- Use BOSU Balls, Foam pads or Tramplolines – These unstable surfaces offer additional challenges to your balance and proprioception.
Landmark Physical Therapy offers free 15 minute proprioception screens. Come in for the challenge and see how you measure up. You will also walk away with some specific exercises to continue at home. Call (480) 661-1124 to schedule your free screen.
*Caraffa A, Cerulli G, Projetti M, et al. Prevention of anterior cruciate ligament injuries in soccer: a prospective controlled study of proprioceptive training. Knee Surg Sports Traumatol Arthrosc. 1996;4:19–21.