ACL & MCL tears

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Alan

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Oct 22, 2013
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I've been thinking about Sam's injury and the ginormous amount of similar injuries in football and here's my fix. Make him wear tennis shoes. QBs don't need to be able to cut like RBs and WRS do. A little less mobility and a lot less rotational traction sounds great to me. Sam was barely touched on his last injury but his foot wouldn't slide and the forces were transferred to his knee IMO.

Read this and let me know what you think.

http://well.blogs.nytimes.com/2013/05/15/when-athletic-shoes-cause-injury/?_r=0
When Athletic Shoes Cause Injury
By GRETCHEN REYNOLDS MAY 15, 2013 12:01 AMMay 15, 2013 12:01 am 47 Comments
15well_physed-tmagArticle.jpg

The right shoes can be important for avoiding injury on the playing field.Credit Brian Harkin for The New York Times
  • PHYS ED
    Gretchen Reynolds on the science of fitness.

    Sometimes innovative science requires innovative machinery, like a moveable, four-legged robotic sled that can wear shoes, a contraption recently developed and deployed by researchers at the University of Calgary to test whether grippy athletic shoes affect injury risk.

    It’s well known, of course, that shoe traction influences athletic performance, especially in sports that involve sprinting or cutting, meaning abrupt rapid shifts in direction. In broad terms, more traction leads to better results.

    In a 2009 study of soccer players and their footwear, for instance, researchers tested the players’ forward sprinting and sideways cutting speed while the players wore their normal soccer shoes, and again after the shoes’ cleats had been shaved down in length by 50 percent and then by 100 percent, meaning they were flat against the outsole. While wearing the shortened cleats, the players had less traction on the field and were significantly slower moving forward or sideways.

    But these and similar studies did not establish whether more shoe traction is always desirable or if there is such a thing as too much stickiness in a shoe.

    Athletic shoes have two primary types of traction. One keeps you sticking to the ground as you move forward. The other, called rotational traction, kicks in when you move sideways or shift direction. The amounts of each type of traction depend on a shoe’s outsole material and on whether it has cleats and, if so, how many, their size and shape, and how they are positioned.

    For some time, most researchers have believed that forward-related traction does not have much effect on injury risk, while rotational traction does.

    But that idea had been difficult to test in real-world situations. For one thing, researchers can’t ethically shave down cleats or otherwise alter shoe traction and ask players to don them and helpfully go out and hurt themselves.

    And logistically, it’s easier to measure shoe traction in a lab than on a playing field.

    But researchers at the Human Performance Lab at the University of Calgary wanted to see whether different degrees of traction would affect whether players got hurt in real playing conditions. So they created their shoe-wearing robotic tester. Mounted on rails, it can move either forward or sideways on a field at whatever speed the researchers choose, while its “feet” stay in contact with the ground and various sensors determine forward and rotational traction.

    With this robot tester at the ready, the researchers recruited hundreds of local high school football players and borrowed their shoes. They fitted each shoe onto the robot tester and determined its unique forward and sideways traction.

    The various shoes varied widely in terms of traction, says John W. Wannop, the University of Calgary kinesiologist who led the study.

    The scientists then returned the shoes to the players and asked each team’s trainer to track all non-contact leg injuries throughout the season. This experiment was repeated for two more years, during which time the playing fields were switched from grass surfaces to artificial turf. At the end of the three seasons, the scientists compared traction levels and injury reports.

    Many of the players had experienced ankle, knee and ligament injuries that didn’t involve contact. This was, after all, football. But the incidence was highest and the severity of the injuries greatest among those players whose shoes provided the most rotational traction. At the same time, the players whose shoes had provided the most forward traction developed fewest injuries.

    This finding was unexpected, Dr. Wannop says, because it had been thought that any shoe with high forward-motion traction would also automatically have high rotational traction, and so would increase injury risk. But this was not the case; some shoes gripped as players ran forward but didn’t stick when they cut sideways.

    Those shoes were the safest.

    Playing surface, meanwhile, had almost no effect on injury risk. Injury rates were similar on grass and artificial turf, whatever shoes the players wore.

    What these findings mean in practical terms, Dr. Wannop says, is that for the ideal mix of athletic performance and reduced injury risk in sports, a shoe should have “high translational traction values and relatively low rotational traction values.”

    Good luck, however, finding precisely that shoe. Companies don’t advertise shoes’ traction values and probably can’t, Dr. Wannop says, since they will vary, depending on your body size and movement patterns and on such ephemera as the muddiness or dryness of a field or trail on any given day.

    Still, there are some broad guidelines to consider when purchasing athletic shoes, especially for team sports like football, soccer or basketball, Dr. Wannop says. Avoid models with multiple large, toothy cleats or rubbery nodules along the outside of the sole, he advises, since they can create too much rotational traction. Look instead for groupings of shorter cleats in the forefoot, which can provide reliable forward-oriented traction.

    Most important, try the shoes before buying, if at all possible. Ask the salesperson if you can go outside while wearing them. Find some grass and sprint, halt, pivot and cut. If your foot slips when you move forward or noticeably sticks when you pivot, Dr. Wannop says, try another pair. You might want to stick to your exercise regimen, but you don’t want to be stuck to the ground.
 

V3

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The way Bradford tore his ACL had nothing to do with the traction on his feet, IMO. I think you have a case for many other tears in the NFL, but not Bradford's. I don't think his injuries were caused because his feet wouldn't slide out from under him or there being an extreme lateral force near the knee.
 

fearsomefour

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The turf I have played on can be very slick with out cleats. It my not be the quality of the turf in NFL stadiums. Pulls and groin strains caused by slipping is better than ACLs. Of course Sam was on a grass field both times he was injured.
Interesting idea, I can't see it happening however.
 

V3

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Just to refresh some bad memories (Sorry, I hate to do it but it's relevant):

http://www.nfl.com/news/story/0ap20...adford-tears-acl-st-louis-rams-to-try-out-qbs

http://www.nfl.com/news/story/0ap3000000382460/article/sam-bradford-out-for-season-with-torn-acl

On the most recent tear, there is some lateral force but I still don't think I'd call it extreme. I think someone that hadn't had their ACL recently repaired would have been fine, or at most, strained. Regardless of the lateral force, I don't think the shoes had anything with the leg not being able to get out from under Bradford as to prevent the injury.
 

Alan

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  • Thread Starter Thread Starter
  • #5
V3 with an alternative theory. Maybe:
I don't think his injuries were caused because his feet wouldn't slide out from under him or there being an extreme lateral force near the knee.
Why do you think that?

BTW, I didn't say the force was near the knee, I said the force was transferred to the knee. But of course I'm talking about the ligaments attached to the knee.

http://bleacherreport.com/articles/...onfusion-leading-up-to-his-torn-acl-diagnosis
The Anatomy and the Injury

Normally, the ACL runs through the center of the knee and prevents the tibia—the shin bone—from moving forward or over-rotating with respect to the thigh. When the joint moves in such a way that the ACL's connection points on the femur—the thigh bone—and tibia move further away from each other, the ligament can tear.

A classic mechanism of injury leading to an ACL tear involves a direct blow to the front or outside of the knee, forcing it to hyperextend or twist inward.

A Vine from Daniel Doelling—via SB Nation's Turf Show Times—shows precisely how Bradford's injury unfolded. Unfortunately, it appears to resemble a combination of the above mechanisms.

As seen, Cleveland Browns lineman Armonty Bryant likely falls into the outside portion of the front of Bradford's knee. The quarterback's knee hyperextends as a result of the hit, likely causing the tear.



f5330da838c3ac0a71ba8c29f2bf885f_crop_exact.jpg


Screenshot of Vine video linked above with edits by the author.
This screenshot shows the moment of impact, highlighted by the yellow circle. The hit appears to push Sam Bradford's knee backward and slightly inward.


In Bradford's case, the injury represents a tear of a ligament graft, not his native ACL. He went down with his first left ACL tear in October 2013 and underwent surgery thereafter.

During the operation, doctors likely used a piece of his patellar tendon—the part of the knee a doctor hits with a reflex hammer—to replace his injured ligament.


Initial Evaluations and Apparent Optimism

Following an injury concerning an ACL tear, an athletic trainer or doctor can employ a few simple physical exam techniques that can strongly hint at or against an ACL tear.

More than likely, Schefter's initial tweet suggested those physical exam maneuvers seemed negative—or reassuring against a tear—following the injury. Two such tests include:

  1. Anterior drawer test: With the athlete lying on his or her back, the examiner bends the knee, plants the foot on the ground and attempts to pull the tibia forward.
  2. Lachman test: With the athlete lying on his or her back, the examiner lifts the injured leg up, grasps above and below the knee and attempts to pull the tibia forward.
If the examiner is able to pull the tibia significantly forward with either the anterior drawer or Lachman tests, an ACL tear becomes a strong possibility. On the other hand, no motion at all suggests an intact ligament.

Both maneuvers do their job very well—especially the Lachman. In fact, positive tests can all but make the ACL tear diagnosis, even without an MRI.

That said, neither test is perfect—even in the best hands practicing the best medicine, as is most definitely the case with the Rams. Sometimes, the MRI simply tells another tale.

Sunday's Follow-up Reports

As mentioned, Rams fans likely went to bed with a bit of reassurance on Saturday. After all, head coach Jeff Fisher mentioned—via NFL Network's Ian Rapoport—Bradford was "walking around fine" following the injury, adding that he would undergo more testing the next day.

Regrettably, the ability to walk in a straight line does not necessarily imply an intact ACL. Pivoting and changing directions becomes quite difficult, but an athlete walking away from a tear is not an uncommon scenario.

From me: (As in rotational movement)

When the concern for Bradford's ACL resurfaced, it likely did so as a result of one of two possible developments:

  • Re-examination by the Lachman or anterior drawer tests demonstrated the development of laxity—or looseness—in the knee, and an MRI confirmed the tear.
  • MRI findings suggested the tear despite reassuring tests.
The exact sequence of events remains a bit unclear.

Bottom Line

Whatever actually transpired, the bottom line is simple: Bradford will miss the entirety of the 2014 season and likely go under the knife fairly soon. The injury represents a brutal and devastating—almost unfair—blow to both the quarterback himself and the up-and-coming Rams, who looked to remain competitive in the otherwise strong NFC West.

The entire NFL and its fans surely send the former Oklahoma Sooner their best wishes as he starts down the road to recovery once again.
 

LACHAMP46

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Jul 21, 2013
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uh oh, Alan's back at it....More squats, lunges, dynamic stretching, YOGA....Increase the functionality & range of motion with power, Sam should be fine....

Great stuff here!
 

RamsOfCastamere

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Making him wear tennis shoes would make him more immobile and prone to hits, sacks and TOs
 

Dr C. Hill

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It would also make him more like us, regular guys. If Bradford was sporting some Chuck Taylor style shoe, while everyone else in the NFL but him was wearing cleats, he becomes one of us. I did not play in high school, but we bucked up and bought shoes for the guys who couldn't afford them back then. I'm not sure I could even root for a team thats QB showed up dressed like Uncle Rico in tennis shoes!
 

Elmgrovegnome

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Jan 23, 2013
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I don't know if tennis shoes is the answer but a less deep cleat may be. However we would have the coolest QB in the league rockin the latest styles. Remember the Air Jordan trend? My kid had Chuck Taylor's this summer. Sam would be getting all kinds of shoe endorsement deals too. Personally I would like him to show up Tom Brady and play in Ugg Boots.