Home

18

Sep, 2012

Warm Up Stretches to Prevent Knee Injuries

The Santa Monica Orthopaedic and Sports Medicine ResearchFoundationThe PEP Program: Prevent injury and Enhance PerformanceThis prevention program consists of a warm-up, stretching, strengthening, plyometrics, andsport specific agilities to address potential deficits in the strength and coordination of thestabilizing muscles around the knee joint. It is important to use proper technique during allof the exercises. The coaches and trainers need to emphasize correct posture, straight up anddown jumps without excessive side-to-side movement, and reinforce soft landings. Thisprogram should be completed 3 times a week.The field should be set up 10 minutes prior to the warm-up. This will allow for a smoothtransition between the activities. A sample field set-up has been included in your packet.This program should take approximately 15 – 20 minutes to complete. Along side eachexercise you will notice a box with the approximate amount of time that should be spent oneach activity. This will serve as a guideline to you in order to conduct your warm-up in atime efficient manner.1. Warm-up: Warming up and cooling down are a crucial part of a training program.The purpose of the warm- up section is to allow the athlete to prepare for activity. Bywarming up your muscles first, you greatly reduce the risk of injury.A. Jog line to line (cone to cone):Elapsed Time: 0 - .5 minutePurpose: Allows the athletes to slowly prepare themselves for the training sessionwhile minimizing the risk for injury. Educate athletes on good running technique;keep the hip/knee/ankle in straight alignment without the knee caving in or the feetwhipping out to the side.Instruction: Complete a slow jog from near to far sidelineB. Shuttle Run (side to side)Elapsed Time: .5 to 1 minutePurpose: engage hip muscles (inner and outer thigh). This exercise will promoteincreased speed. Discourage inward caving of the knee joint.Instruction: Start is an athletic stance with a slight bend at the knee. Leading withthe right foot, sidestep pushing off with the left foot (back leg). When you driveoff with the back leg, be sure the hip/knee/ankle are in a straight line. Switch sidesat half field.C. Backward RunningElapsed Time: 1 – 1.5 minutesPurpose: continued warm- up; engage hip extensors/hamstrings. Make sure theathlete lands on her toes. Be sure to watch for locking of the knee joint. As theathlete brings her foot back, make sure she maintains a slight bend to the knee.Instruction: Run backwards from sideline to sideline. Land on your toes withoutsnapping the knee back. Stay on your toes and keep the knees slightly bent at alltimes.2. Stretching: It is important to incorporate a short warm-up prior to stretching. Neverstretch a “cold muscle”. By doing the exercises outlined here, you can improve andmaintain your range of motion, reduce stiffness in your joints, reduce post-exercisesoreness, reduce the risk of injury and improve your overall mobility and performanc e.•Do a large muscle warm- up such as brisk walking for five to 10 minutes beforestretching.• Don't bounce or jerk when you stretch. Gently stretch to a point of tension and hold.• Hold the stretch for 30 seconds. Concentrate on lengthening the muscles when you'restretching.• Breathe normally. Don't hold your breath.A. Calf stretch (30 seconds x 2 reps)Elapsed Time: 1.5 to 2.5 minutesPurpose: stretch the calf muscle of the lower legInstruction: Stand leading with your right leg. Bend forward at the waist and placeyour hands on the ground (V formation). Keep your right knee slightly bent andyour left leg straight. Make sure your left foot is flat on the ground. Do not bounceduring the stretch. Hold for 30 seconds. Switch sides and repeat.B. Quadricep stretch (30 seconds x 2 reps)Elapsed Time: 2.5 to 3.5 minutesPurpose: stretch the quadricep muscle of the front of the thighInstruction: Place your left hand on your partner’s left shoulder. Reach back withyour right hand and grab the front of your right ankle. Bring your heel to buttock.Make sure your knee is pointed down toward the ground. Keep your right leg closeto your left. Don’t allow knee to wing out to the side and do not bend at the waist.Hold for 30 seconds and switch sides.C. Figure Four Hamstring stretch (30 sec x 2 reps)Elapsed Time: 3.5 – 4.5 minPurpose: To stretch the hamstring muscles of the back of the thigh.Instruction: Sit on the ground with your right leg extended out in front of you.Bend your left knee and rest the bottom of your foot on your right inner thigh.With a straight back, try to bring your chest toward your knee. Do not round yourback. If you can, reach down toward your toes and pull them up toward your head.Do not bounce. Hold for 30 seconds and repeat with the other leg.D. Inner Thigh Stretch (20 sec x 3 reps)Elapsed Time: 4.5 – 5.5 minPurpose: Elongate the muscles of the inner thigh (adductor group)Instruction: Remain seated on the ground. Spread you legs evenly apart. Slowlylower yourself to the center with a straight back. You want to feel a stretch in theinner thigh. Now reach toward the right with the right arm. Bring your left armoverhead the stretch over to the right. Hold the stretch and repeat on the oppositeside.E. Hip Flexor Stretch – (30 sec x 2 reps)Elapsed Time: 5.5- 6.5 minPurpose: Elongate the hip flexors of the front of the thigh.Instruction: Lunge forward leading with your right leg. Drop your left knee downto the ground. Placing your hands on top of your right thigh, lean forward with yourhips. The hips should be square with your shoulders. If possible, maintain yourbalance and lift back for the left ankle and pull your heel to your buttocks. Hold for30 seconds and repeat on the other side.3. Strengthening: This portion of the program focuses on increasing leg strength. Thiswill lead to increased leg strength and a more stable knee joint. Technique is everything;close attention must be paid to the performance of these exercises in order to avoidinjury.A. Walking Lunges(3 sets x 10 reps)Elapsed Time: 6.5 – 7.5 minPurpose: Strengthen the thigh (quadriceps) muscle.Instruction. Lunge forward leading with your right leg. Push off with your rightleg and lunge forward with your left leg. Drop the back knee straight down.Make sure that your keep your front knee over your ankle. Control the motionand try to avoid you front knee from caving inward. If you can’t see your toes onyour leading leg, you are doing the exercise incorrectly.B. Russian Hamstring (3 sets x 10 reps)Elapsed Time: 7.5 –8.5 minPurpose: Strengthen hamstrings musclesInstruction: Kneel on the ground with hands at your side. Have a partner holdfirmly at your ankles. With a straight back, lead forward leading with your hips.Your knee, hip and shoulder should be in a straight line as you lean toward theground. Do not bend at the waist. You should feel the hamstrings in the back ofyour thigh working. Repeat the exercise for 3 sets of 10, or a total of 30 reps.C. Single Toe Raises (30 reps x 2 reps)Elapsed Time: 8.5 – 9.5 minPurpose: This exercise strengthens the calf muscle and increases balance.Instruction: Stand up with your arms at your side. Bend the left knee up andmaintain your balance. Slowly rise up on your right toes with good balance. Youmay hold your arms out ahead of you in order to help. Slowly repeat 30 timesand switch to the other side. As you get stronger, you may need to add additionalrepetitions to this exercise to continue the strengthening effect of the exercise.4. Plyometrics – These exercises are explosive and help to build, power, strength andspeed. The most important element when considering performance technique is thelanding. It must be soft! When you land from a jump, you want to softly accept yourweight on the balls of your feet slowly rolling back to the heel with a bent knee and astraight hip. These exercises are basic, however, it is critical to perform them correctly.Please take the time to ensure safe and correct completion of these exercises.A. Lateral Hops over Cone (20 reps)Elapsed Time: 9.5 – 10minPurpose: Increase power/strength emphasizing neuromuscular controlInstruction: Stand with a 6” cone to your left. Hop to the left over the cone softlylanding on the balls of your feet land bending at the knee. Repeat this exercisehopping to the right.B. Forward/Backward Hops over cone (20 reps) Elapsed Time: 10 – 10.5 minPurpose: Increase power/strength emphasizing neuromuscular controlInstruction: Hop over the cone/ball softly landing on the balls of your feet andbending at the knee. Now, hop backwards over the ball using the same landingtechnique. Be careful not to snap your knee back to straighten it. You want tomaintain a slight bend to the knee. Repeat for 20 reps.C. Single Leg hops over cone (20 reps)Elapsed Time: 10.5 – 11 minPurpose: Increase power/strength emphasizing neuromuscular control.Instruction: Hop over the cone/ball landing on the ball of your foot bending at theknee. Now, hop backwards over the ball using the same landing technique. Becareful not to snap your knee back to straighten it. You want to maintain a slightbend to the knee. Repeat for 20 reps. Now, stand on the left leg and repeat theexercise. Increase the number of repetitions as needed.D. Vertical Jumps with headers (20 reps)Elapsed Time: 11 – 11.5 minPurpose: Increase height of vertical jump.Instruction: Stand forward with hands at your side. Slightly bend the knees andpush off jumping straight up. Remember the proper landing technique; accept theweight on the ball of your foot with a slight bend to the knee. Repeat 20 times andswitch sides.E. Scissors Jump (20 reps)Elapsed Time: 11.5 – 12 minPurpose: Increase power and strength of vertical jump.Instruction: Lunge forward leading with your right leg. Keep your knee over yourankle. Now, push off with your right foot and propel your left leg forward into alunge position. Be sure your knee does not cave in or out. It should be stable anddirectly over the ankle. Remember the proper landing technique; accept the weighton the ball of your foot with a slight bend to the knee. Repeat 20 times.5. AgilitiesA. Shuttle run with forward/backward runningElapsed Time 12 – 13 minPurpose: Increase dynamic stability of the ankle/knee/hip complexInstruction: Starting at the first cone, sprint forward to the second cone, runbackward to the third cone, sprint forward to the fourth cone (etc…).B. Diagonal runs (3 passes)Elapsed Time 13 – 14 minPurpose: To encourage proper technique/stabilization of the outside planted foot todeter the position from occurring.Instruction: Face forward and run to the first cone on the left. Pivot off the left footand run to the second cone. Now pivot off the right leg and continue onto the thirdcone. Make sure that the outside leg does not cave in. Keep a slight bend to the kneeand make sure the knee stays over the ankle joint.C. Bounding run (44 yds)Elapsed Time 14 – 15 minPurpose: To increase hip flexion strength/increase power/speedInstruction: Starting on the near sideline, run to the far side with knees up towardchest. Bring your knees up high. Land on the ball of your foot with a slight bend atthe knee and a straight hip. Increase the distance as this exercise gets easier.6. Alternative Exercises – Warm Down and Cool DownWe all know how imperative a cool down is. Please don’t skip it. It allows the musclesthat have been working hard throughout the training session to elongate and deters theonset of muscle soreness. Please emphasize the importance of adequate fluid intake(optimally water). Athletes should have a water bottle by their side during the cool down.The cool down should take approximately 10 minutes. It should begin with a slow jog toallow the heart rate to come down before stretching. This should be followed by somelight strength training exercises. We are recommending two strengthening exercises (seebelow). Finally, stretch the hamstrings, calves, inner thigh, quadriceps, and low back (allof these are explained in the protocol). In addition to those basic stretches, we are offeringsome additional stretches to target 3 muscle groups that are often forgotten.A. Bridging with Alternating Hip Flexion (30 reps)Purpose: Strengthen outer hip muscles (Hip abductors, flexors) and buttocksInstruction: Lie on the ground with your knees bent with feet on the ground. Raiseyour buttocks up off the ground and squeeze. Now, lift your right foot off theground and make sure that your right hip does not dip down. Lower your right footand now lift your left foot making sure your left hip does not dip down. Repeat 30times on each side. As you get stronger, you will place your feet on top of a balland repeat the exercise.B. Abdominal Crunches (30 reps x 2 reps)Purpose: Strengthe n the abdominals (rectus abdominus, obliques)Instruction: Lie on the ground with you knees bent. Place your hands behind yourhead with your elbows out wide. Support your neck lightly with your fingers.Take a deep breath in and slowly contract your abdominal muscles as you exhale.Repeat 30 times. Drop your legs off to the right side. Slowly crunch up with yourelbows out wide. You should feel your oblique muscles working on the side ofyour waist. Repeat 30 times and switch to the other side.C. Single and Double Knee to Chest (supine) (30 sec x 2 reps)Purpose: Elongate the low back musclesInstruction: Lie on your back. Bring your right knee toward your chest and hugfirmly. Keep your left leg out straight in front of you. You should feel a stretchalong your low back and into your buttocks. Hold the stretch for 30 seconds andswitch sides. Now bring both knees to chest. If you feel any pain in the low back,discontinue the stretch and inform your coach/trainer.D. Figure Four Piriformis stretch- supine (30 sec x 2 reps)Purpose: Elongate the rotators of the hip.Instruction: Lie on your back and bend both of your knees. Fold your left ankleover your right knee. Place your hands behind your right thigh and pull your rightknee to chest. You should feel a good stretch in the left gluteals region and the sideof the thigh. Hold for 30 seconds and repeat on the other side. If you experienceand low back pain with this stretch, slowly lower your legs down and let yourcoach/trainer know.E. Seated Butterfly stretch - seated (30 sec x 2 reps)Purpose: Elongate the inner thigh muscles (adductors).Instruction: Sit up bringing your feet in so that the soles of your feet are touching.Gently place your elbows on your knees and slowly push down. You should feel agood stretch of the inner thigh. Hold this for 30 seconds and repeat 2 to 3 times.If you have any questions or concerns regarding this program, pleasecontact Holly Silvers, MPT at (310) 315-0292 ext. 1283 or via email:[email protected].

Website Manager

Section 1: Birthplace of AYSO

News Detail

18

Sep, 2012

Warm Up Stretches to Prevent Knee Injuries

National Partners

Areas of Section 1

Organizational Links

Contact Us

AYSO Section 1