SPORTS MEDICINE
Pay attention: Your knees will thank you
After an ACL injury brought an abrupt end to Cassie Ronda’s first collegiate season, she educated herself on injury prevention and urges you to do the same
an intense rally against a top-ranked team. I was set a ball in the back row and went up to take a big swing. KILL! My teammates rushed together to cheer, but
I
I stayed crumpled on the ground. I had fallen right after landing, and I was unable to move because of the acute pain shooting through my left leg. Instinctively, I knew what the on-site doctor would soon tell me: I had completely ruptured my anterior cruciate ligament, or ACL. My parents were watching the match live
via web-link and saw the injury take place, but they were more than a 1,000 miles away. The same questions immediately flooded their minds and mine: Was my season really over as soon as it had started? Would I be able to fully recover? Why did this happen? The answer to that last question is especially important because pre-college players and those close to them are often unaware of the bad technical habits that can lead to knee injuries. So, listen up, girls! I’ve watched many
young players play, and it’s painful to see how many practice poor jumping and landing form over and over, just like I used to. The last thing I want is for any of you to experience a season- ending knee injury, so I took some time to talk to an expert about how you can reduce the risk.
EXPERT ADVICE Jill Wosmek, the head athletic trainer for
the U.S. Women’s National Team since 2009, has a dozen years of experience working with competitive athletes. Prior to USA Volleyball, she worked with college teams for seven years, including the Penn State men’s and women’s volleyball programs. Wosmek has certainly seen her fair share of knee injuries. To better understand this injury, we first
have to know what the ACL is. Wosmek ex- plains: “ACL provides the majority of stability so our femur (thigh bone) does not translate too far anteriorly (forward) on the tibia (shin bone). It also plays a strong role in limiting rotation through the knee joint.”
32 | VOLLEYBALLUSA • Digital Issue at
usavolleyball.org/mag
t was the first match of my collegiate vol- leyball career at University of Denver, and my teammates and I were in the middle of
The body-weight squat 1. Stance: Feet should be positioned no closer than hip width with toes pointed outward between
roughly 0-20 degrees. As you learn to squat properly, it’s easiest to start with a slightly wider base. Once you become more proficient with the criteria below, you can narrow the base. 2. Weight distribution: Throughout the entire movement, weight should be distributed evenly and the
full sole of the shoe should stay in contact with the floor. 3. Good upright posture: Before initiating the movement, check that your posture is good by making
sure your hips are directly underneath the diaphragm and that you’re not hunched over at the upper back. 4. Sit back: You should initiate the movement by sitting back slightly before lowering your hips. When
you get to a low point that feels comfortable for you, pause briefly and establish a stable bottom position before returning to the top by pushing straight down into the ground through the entire foot. 5. Limit your depth: As you’re learning the squat, it’s important that you don’t go any lower than the
point that allows you to control the following: Knees shouldn’t cave in past the mid-line of the big toe. A good cue for athletes is to punch their knees
out to the corners of the room while keeping their heels and the rest of the sole of their feet on the ground. Pelvis doesn’t tilt and the lower back doesn’t change shape throughout the movement. A good cue for
athletes is to brace their trunk through the entire movement. Bracing is the simultaneous contraction of all the musculature of the lower trunk to maintain the integrity of the spine. Athletes can also hold their hands on their hips to feel how their hips should stay neutral throughout the entire movement. Outside edges of the sole of the athlete’s shoes shouldn’t come off the ground: Cue the athlete to drive
down the outside edges of their feet and keep the entire sole of their shoe flat on the ground throughout the entire movement. Disclaimer: Although this provides some guidance when queuing a body-weight squat, it’s important to
keep in mind that every athlete has differences that need to be addressed. For example, long limb length or poor limb control may necessitate extra focus on specific parts of this sequence.
— Jill Wosmek
WHY ACL INJURIES OCCUR According to Wosmek, an incredible vari-
ety of factors have been proposed as contribut- ing to ACL injuries, and there is still a lot of debate around this issue. One fact that emerges as certain is that “ALL athletes need to take [knee injury prevention] very seriously at a young age,” Wosmek said. She added that one of the main ways we can do this is by asking ourselves, “Are we biomechanically correct?” There is an entire field of study devoted to
sports biomechanics, encompassing both per- formance and injury prevention, but essentially the basis of biomechanics is understanding how muscles, joints and bones work together to properly and efficiently execute a specific skill. What are some signs that a player may not
be practicing proper biomechanics? Wosmek says, “Watch their knee on land- ing – is the knee falling in? That’s something I
see right away.” A player landing with proper biomechanics lands balanced with the knee bent to absorb the impact; the knee should be lined up vertically with the foot and ankle, not falling inward. Wosmek also notices that many hitters
don’t get their feet all the way out to a set before jumping, which causes them to land falling away from the ball, often on a straight leg. That places an incredible amount of stress on the knee. It may seem like players can get away with
these improper mechanics at first, but sooner or later the strain becomes too much for the knee, leading to a high incidence of ACL injuries in girls and women in their mid to late teen years.
SIX YEARS OF BAD FORM After my injury, it took a full reconstructive knee surgery and seven months of rehab before
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