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The ACL and its friends

It’s seven o’clock in the morning and Anna is already awake. Today is an important day. If they win todays basketball game they will go to the finals.

She is nervous and she can’t sit still and it feels like her muscles, ligaments and joints are living their own life, like they are talking to each other and she is right…

The brain, also called the coach, sends out signals to the muscles and joints to wake up.

“It is important that you help each other out today and work together as a team.”

The muscles start to wake up slowly. They are well prepared for the game today. They have improved their strength by training on the new machines at the gym.

“I will do my best”, says the tired and pronated foot, “but I can’t promise anything.”

“What do you mean by you can’t promise anything”?” says Tibialis posterior muscle in an angry voice. “The team and I always have to compensate when you collapse as soon as you hit the ground.”

The game is now playing at full power. The muscles and ligaments are working hard. Even the tired foot is doing its best.

They are four under and it is two minutes to go. Anna has nothing to loose and is working very hard. She is running with the ball and suddenly something happens. Anna gets pushed from the side. She falls and her right knee starts to pivot.

The proprioceptors of the anterior cruciate ligament, ACL, send out signals to the muscles and the coach, the brain. 

“You have to help me to decelerate the tibia that is coming forward and the pivoting of the knee. You have to work together as a team or this will not go well!”

Even the medial collateral ligament sends out signals for help. 

“We can help you”, shout the quadriceps muscles. 

They realize soon that this is much harder than they thought it would be. They have built up their strength on the machine where Anna has been sitting on her butt kicking her legs. When in basketball do you do that?

“We need help”, screams the Quadriceps. “The foot what are you doing down there?”

“I can’t take it any more, says the foot. “I’m so tired. Don’t forget that I’m born this way. That’s not my fault. This is so different from training pronation and supination with a rubberband. Soleus and Tibialis posterior can you pull the tibia back while the Tibialis posterior also decelerates pronation of the foot?”

“I’m doing my best”, says the soleus. “I’m holding on to the tibia and fibula but tibia is falling forward and rotating internally too much and too fast.”

The gastrocnemius tries to decelerate the internal rotation of femur and the eversion of the subtalar joint. They realize soon that this is so different from the heavy heel lifts that they have been doing at the gym.

“Piriformis we need help to decelerate the internal rotation of the femur!” shouts the gastrocnemius”

Piriformis is struggling hard and asks the hamstrings to decelerate the internal rotation and flexion of the knee, and also help to decelerate the valgus position of the knee.

“We are doing our best but don’t forget that we also have to decelerate the flexion of the hip. We are so confused. We have only been trained to bend the knee in an open chain position lying on the stomach. Standing up in a closed chain position we seem work totally different.”

Gluteus medius is also trying to help out by holding on to the trochanter major, trying to decelerate the adduction and internal rotation of the femur. The muscle has to work very hard because this is much harder then lying on the side lifting the leg.

“You have to work harder screams the ACL. I can’t take it much longer!!!”

BANG!!!

It gets quite. All of them understand what just had happened and they feel very sad. They had lost their friend, the ACL. The Semimembranosis and the ACL were best friends. Together they decelerated the rotation and forward motion of the tibia. They decelerated the pivoting of the knee.

“What will happen now?” asked the sad and worried Semimembranosis.

How will I be able to compensate for this? Is it true that they might even use me as a graft?

“They can take the graft from us instead” said the quadriceps muscles.

– “What happened? What went wrong?” asked the tired pronated foot.

The coach, the brain, tries to support everyone in the team.

“You did your best and you can’t blame yourself. We need to learn from this now. We need to be more prepared. We need to find out why this happened, treat the cause and than train more functionally. That way we will know how to react when we get in to situations like this.”

Anna had an ACL surgery and the quadriceps shared of its tendon. Anna and her team had learned a big lesson.

All of the players in the team went through individual testing for mobility, stability, force speed and power.

Functional movement patterns and local motion at the foot/knee, hip, trunk and shoulder girdle complex were tested in an upright position with the help of the testing system 1080 Movement Assessment Plan (1080MAP).  

The foundation of any physical performance is to have good mobility and stability. If not, the body will find ways to compensate for it. To prevent future injuries it is really important to have good functional mobility and strength.

The 1080MAP showed that many of the players were lacking extension and rotation of the hips. Good mobility in extension and rotation of the hips is really important when it comes to change of direction and sprinting while playing basketball.

To prevent the knee from going through excessive valgus and internal rotation, putting the ACL at risk, the players who needed it, were given exercises to increase the extension and the ability to open up, external rotate, the hips.

To increase mobility and stability each player got an individual home program.

To test and train force, speed and power with the same functional movement patterns they used the 1080 Quantum.

The result showed the relationship between force and speed, which is another informative key to improve any physical performance.

By combining test results of mobility, stability, force and speed it was easy to see what each player should focus on, mobility or strength, and in what body part.

Now they trained more functional.

They trained the muscles and joints to work together, not is isolation and in three planes of motion.

They also trained with 1080 Quantum to safely and independently control resistance and speed in the concentric and eccentric phase while measuring force, speed and power throughout the movement.

To really make sure that the training improved their ability to sprint and change direction they used the 1080 Sprint to test and train.

1080 Sprint has the same robotic technology as the 1080 Quantum and has a 90 m long line that could easily be used on the basketball court. It was used for variable resistant over the course of a sprint and for overspeed training to allow for neuromuscular adaption to high speeds in a fully controlled environment.

When Anna started to play again she was quicker and better than ever before. The muscles were well prepared and knew how to react in the different positions. Anna got nominated “the best player of the year”.

The coach, the brain, was very proud. The muscles, joints and the ligaments were very happy. Now they were finally a real team. It was a lot of laughter in the team and they lived happily ever after…

Written by

Jessica Parnevik-Muth

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“Visible results from the first appointment with 1080MAP™” – Eirik Andreassen, DRIV, Oslo

 
Eirik Andreassen from DRIV Trening in Oslo, Norway, was one of the trainers who attended the very first 1080MAP™ ANALYSIS course in Stockholm, as early as March 2014.

 
“I immediately understood that 1080MAP was great, and a tool that would help my clients to improve their performance”, says Eirik.

 
At the time of the course, Eirik was a student at the Norwegian School of Sport Sciences and a fresh graduate from the GIFT Institute. Today he works at DRIV Trening as a trainer.

 
At DRIV, there are 5 trainers who use the 1080MAP system daily for athletes who want to perform better. The system is also used for those with injuries and pain.

 
“We use 1080MAP at the first appointment with our clients who are experiencing pain. It has proven to be a great tool to help us set a program to help them become pain free.”

 
Eirik says that when using 1080MAP, clients are open and willing to get more help, maybe because they better understand their weaknesses themselves when looking at their results.

 
“The clients better understand their limitations from looking at their 1080MAP profiles, and are extra motivated to put in that extra effort now that they can follow their progress and see their improvements.”

 
Clients typically buy a package consisting of a test, a retest and 10 PT-training sessions that will help them reach their goals.

 
“As a trainer, using 1080MAP, I am now able to be very specific in my work, which leads to improvements for my clients in less time than before. Not to mention the feedback from the clients; they think it’s both fun and relevant to learn more about how their bodies are functioning.”

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Why a mobile midfoot is important in golf

Playing golf requires good mobility and stability in your feet, especially the midfoot. To be able to load well during a backswing you need to be able to keep the big toe and the medial part of the heel on the ground. Players with a stiff midfoot have a tendency to put too much weight on the lateral part of the foot, or to straighten the same-side knee.

 
The direction of the ground reaction force is different if the weight is put on the lateral part of the foot during the end of a backswing. The balance and the loading of the hips will also be affected.

 
Compensating by trying to straighten out the knee can be compared to jumping with straight knees – no load, no explode.

 

Here is an easy way to mobilize a hypomobile midfoot with the help of 1080Wedge:

In the example below, one of our clients was analyzed with the help of our web-based testing system, 1080MAP (Movement Assessment Profile). In one of the tests, he is standing on his right foot, toe-touching with his left. His hands are on top of each other at shoulder height with straight elbows. 90 % of his weight is on the right foot.

 
We then measure how many degrees he is able to rotate his whole body to the right without lifting his big toe or the medial part of the heel. This is a pure rotation test and he is not allowed to compensate by flexing his hip, knee, elbows, or trunk. The trunk needs to be straight.

 
The average score of this test (3 949 tests) is 113 degrees rotation to the right. His 1080MAP test result showed a decreased supination pattern in his right foot, and decreased internal rotation in his right hip. He was able to rotate 62 degrees to the right.

 

1080map

 

After only mobilizing his midfoot with 1080Wedge he increased his rotation with 23 degrees from 62 to 85 degrees. That was after only 8 repetitions using 1080Wedge, see below

 
How to use 1080Wedge: Stand in a stride standing position with the involved foot in the back. Put 1080wedge (with a 4 degree angle) under the midfoot with the higher part of the wedge under the lateral part of the midfoot. Angle the wedge 10 degrees towards the big toe. Keep the hands on the pelvis. Turn the pelvis towards the involved side, keeping the knee straight. It is important that the motion is driven all the way down to the foot. Repeat 8 times.
 
1080map_test_golf

 
Never increase mobility without giving a stability exercise. Stand on the involved side.  Bring up the opposite knee to hip height. Rotate side to side 20 times. Make sure the pelvis is rotating.

 
This is how happy you become when both the mobility and balance is increased in just 8 repetitions!

1080map_test_knee

 
If you are interested in measurable results don’t hesitate to sign up for our upcoming courses – check out our calendar. To order 1080Wedge and instructions on how to use it, email info@athletic1080.com with your name and post address.

 
>>Read more about 1080Wedge here.