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GCJ    What Does Research Say?

In 1996, Huston and Wojtys reported that female athletes tend to fire their quadriceps in response to anterior tibial translation, which can overload the ACL when the knee is at or near extension (men's hamstrings fire instead).
Jump Training

Plyometrics is the science of jumping. Before any female embarks on a jump-training program, she must learn correct technique.

Question - What happens when you practice bad jump technique?

Answer - A small vertical jump, but worse than that, the possibility of a serious knee injury.

The Training section of the August 2002 edition of Women's Basketball Magazine, featured an article by Laura Ramus demonstrating Jump Training Techniques. Click here to see a summary. It can help you understand how to improve your jump technique, and learn how to prevent a knee injury.

good jumping technique compared with incorrect technique - click here for more information
Click here or on the photo above,
for more Jump Training Techniques !


Summary of Correct Jumping Techniques

•Land on the ball of your foot and sink into your heel.
•Flex at the hips, knees and ankles.
•Maintain a straight back-neutral spine position.
•Maintain chest over knees and knees over second toe.


Laura Ramus, P.T., A.T.C. is Head Athletic Trainer and Strength and Conditioning Coach for the WNBA's Detroit Shock. Since 1994, she has also served as the Manager of Sports Medicine at St. John Hospital and Medical Center in Detroit, Michigan. Her articles have been syndicated in newspapers throughout the USA, and can be found in each edition of Women's Basketball Magazine, and weekly in the Detroit News.
Check out Laura's recent columns, published by the Detroit News, -click here!


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Here is one basic exercise called Star Jumps that is used by Detroit Shock trainer Laura Ramus.

Find a point on the ground. Then run eight pieces of masking tape out from the center point so that they form a starburst. Stand in the center, then jump forward to the end of the first piece of masking tape. Jump back. Going clockwise, work your way around the star. Remember to jump with knees coming up to the front. And move your whole body side to side, with no wiggly Suzie Chapstick maneuvers, says Ramus !

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Protect your daughter's knees
Ways to reduce the high rate of injury among female athletes
By Ellen Creager
Something tore in Laura Farhat's right knee during a volleyball game 3 years ago. Now she has given up basketball and soccer. Tennis, which she loves, hurts. Volleyball is a strain. Even kneeling is painful.

Laura is 15.

``The girls in sports these days are extremely competitive, and they push and push and play even when they're hurt,'' says Laura's mother, Patricia Farhat of Royal Oak, Mich. ``I wish they would train the coaches better in preventive exercises.''

If you are a female who plays sports or you have a daughter who does, you should do one thing: Learn to protect the knees.
GCJ    What Does Research Say?

10 WAYS TO PROTECT YOUR KNEES IF YOU PLAY SPORTS:

1. Encourage your school, coach, trainer or school district to learn and use new programs to train female athletes for pivot sports. Ask questions at back-to-school night or players meetings.

2. Maintain proper weight. Each extra pound you have puts four extra pounds of pressure on your knee when you walk.

3. Have your posture evaluated. If you tend toward a swayback or flat feet, get proper shoes. Both conditions can put more inward pressure on knees.

4. Strengthen your core muscles-back, abdominals, hips - not just your legs. That's where your strength comes from to play in a more crouched -and knee-protecting- position.

5. Start training 6-8 weeks before a sport or new activity begins. "A lot of this can be done at home" says Dr. Edward Wojtys, head of sports medicine at the University of Michigan in Ann Arbor. "Sending girls to the gym and having them just lift weights and run is not enough. You have to do the plyometrics and reflex training."

6. When you move during sports or just during everyday events, think: "Jump straight as an arrow" and land "light as a feather," toes to heels.

7. Be vigilant about using proper jumping and playing techniques near ovulation. New research at U-M shows ACL injuries tend to cluster on days 9-14 of women's cycle as the estrogen peak relaxes ligaments.

8. Aim for functional training: that is , do things that mimic the movements you actually would use in a sport or activity. "Correct strength training for girls is when you can control your own body weight against gravity," says Detroit Shock trainer Laura Ramus, who uses only light dumbbells in her program.

"When you go to shoot a basket, you need to control your own body weight as you jump, it's the best resistance. It does not make sense for a girl to sit on a leg extension machine. When in sports, do you kick your leg up like that?"

9. Work on improving reaction times. "When we test muscle strength, women contract their muscles slower than men," says Ramus. "Women take longer to generate maximum force than men do. If they have to stop quickly and turn, then it's more likely they're injured". Improve reaction times, and you can cut injuries. Ask coaches or trainers for assistance with this skill.

10. Work your hamstrings, not just your quadriceps. The hamstrings (back of thigh) help to stabilize the ACL and can also help improve your jump. In men, hamstrings are 60 percent to 70 percent as strong as the quadriceps (front of thigh). In women, they're only 45 percent to 55 percent as strong.


5 THINGS YOU SHOULDN'T DO:

1. Full squats

2. Running downhill

3. Climbing stairs two at a time.

4. Exercising on hard surfaces

5. Wearing high heels regularly.

Sources for tips: Detroit Shock athletic trainer Laura Ramus; Dr. Edward Wojtys, University of Michigan; Cincinnati Sportsmetrics; American Acadamy of Orthopaedic Surgeons.

``Some of the things we are doing with our female athletes are making them even more prone to injury,'' warns Dr. Edward Wojtys (VOY-tis), director of sports medicine at the University of Michigan and professor of orthopedic surgery. ``If you ask trainers why they use a particular exercise, they usually can't give you a reason.''

For the past decade, athletic trainers and sports medicine experts have watched in horror and scrambled to find solutions to knee injuries among female athletes, particularly tears of the anterior cruciate ligament (ACL). The ropy ACL connects the thigh bone to the shin bone behind the kneecap.

Female athletes who play pivot sports -- basketball, soccer and volleyball -- have a rate of ACL injuries 2 to 8 times higher than male athletes, depending on the sport. A sudden twist can rip the ACL, destabilize the knee, require surgery or lead to cartilage damage, arthritis and other lifelong problems.

That risk is unacceptably high, says Wojtys. Players and parents must demand changes.

``For years, we have trained girls just like boys. We thought if leg curls and leg extensions are good for boys, they're good for girls,'' he says. ``That's not true.''

New research at the University of Michigan shows that Division 1 college female athletes who play pivot sports have weaker knee muscles than women who don't play pivot sports. Wojtys suspects something in their training is at fault.

Laura Farhat may need knee surgery this fall if physical therapy does not help the pain. Her mother, who sees Laura's sports career fading at the tender age of 15, never considered that athletics could actually be a threat. Now she wonders about the sports training the girls got -- or did not get.

``Now I even wonder about all those suicides (running relays) the coach had them doing,'' she says. ``It seems like the best athletes are the ones most likely to get hurt.''

An estimated 20,000 high school girls and 10,000 college-age women have serious knee injuries each year. But that number can be lower. How? Although they bicker over training details, experts have known for a few years that a combination of functional weight training, plyometrics (jump training) and reflex training can cut the risk to female athletes.

The trick is getting out the word -- and getting it down to the middle school and high school level, where it is needed most.

``Not enough people know these things or know how to train with them,'' says Laura Ramus, head athletic trainer for the WNBA's Detroit Shock and an authority on knee injuries. ``We need to get this information out to coaches to teach girls to play sports in a lower position. You need to reach the girls when they are 11, 12 and 13 because that's when they are developing those neural pathways. I get Olympic and professional athletes who are demonstrating the same incorrect biomechanics as high school players.''

Ramus adds, "If you play straight up and down, which is how a lot of girls play, you will risk your ACL. But you need to be strong to play low."

They leap to the side. They pivot. They jump.

The Detroit Shock is tops in one category: For the past two seasons, not one player has torn her ACL.

Luck? Hardly. The Shock uses a training program Ramus designed to reduce knee injuries.

GCJ    What Does Research Say?

Anatomy and biology can't be changed. But Wojtys and Ramus urge players and parents to demand specific training geared to girls and women, based on the latest research. They urge players to find out if they are at risk, then work on improving jumps, reflexes and control. Get the right shoes. Have your jump evaluated. Start now! Don't wait until you're hurt to take care of your knees.
It employs weight training that involves nothing more than dumbbells adn players' own body weight and plyometrics (jump training). Ramus teaches proper jump technique adn retrains the brain in jump mechanics to build power and improve performance.

In Ramus' first year with the Shock, 1998, star Korie Hlede tore an ACL. In 1999, player Rachel Sporn was injured. Last year, Ramus put players on her program. No Shopck player has had an ACL injury since. That's contrary to the experience of other WNBA teams like the New York Liberty, which lost Rebecca Lobo most of two seasons to ACL tears, and the Houston Comets, which this year lost the WNBA's biggest star, Sheryl Swoopes, after she tore an ACL in preseason.

What's Ramus' biggest success with the Shock?

"I've been able to change Dominick Canty's jump; she was an ACL waiting to happen, " Ramus says. "She came up with a 34-inch vertical jump, but her biomechanics needed changing. Over a year's time, she is now jumping higher and jumping correctly."

The pros, scared by the devastation of fellow players, are willing to take drastic steps to change their playing style. ``But for the junior high or high school kids, sometimes they feel invincible,'' Ramus says. ``If I can't get them to buy into the injury aspect, I tell them I'll make them jump higher, 1 or 2 inches. That works.''

Ramus' Girls Can Jump™ program is a streamlined variation of a pioneering program developed by Cinncinnati Sportsmedicine called Sportsmetrics. Detroit County Day, Grosse Pointe North, East Detroit and Marian high schools plan to employ Ramus' program this fall."

But changing decades of ingrained training techniques by coaches and trainers is a slow process. All the experts' knowledge has not trickled down to the school gyms of the the United States.

  • High school girls playing basketball are 4 times as likely as boys to have an ACL injury. In college, women ar 8 times as likely as men.
  • High school girls playing soccer are 6 times as likely as boys to have an ACL injury. In college, women are 3 times as likely.
  • After they hit puberty, girls have an overall ACL injury risk of 1 in 50. But the risk rises as a girl moves up in sports. A woman who plays Division 1 basketball for 4 years of college has a 1 in 10 chance of ACL damage. Of the top 18 players on the 1996 U.S. Olympic basketball team, 12 had ACL problems.

    Just because ACL injuries are common does not mean they're harmless, Wojtys says. It takes 3 months to a year to recover from an ACL injury, surgery or not. Some tears never heal properly. An undiagonsed problem can cause cartilage damage. Any kind of knee injury can lead to later arthritis."

    "People think: 'OK, you tear your ACL, have surgery, and you get back to normal.' But many women are signficantly affected the rest of their lives, " Wojtys says. "We may be creating a whole generation with very significant impairments as adults."

    Older U.S. women already have a higher rate of knee problems than men. A 1999 study of John Hopkins University found that 24 percent of women ( and 18 percent of men) over age 60 have consistent knee pain that interferes with daily activities.
    Genu valgum vs Genu varum
    Because women have wider hips, they tend to be more knock-kneed (Genu valgum) than men, and the interior space for their ACL to pass through is smaller. Men tend to have a more relative bow legged (Genu varum) anatomy.

    Experts debate the factors that cause women and teen girls to have a greater ACL risk, but they boil down to anatomy, biology and biomechanics.

    Women have wider hips and a naturally more knock-kneed stance. They have looser ligaments because of hormone fluctuations. Their muscles are smaller and weaker than men's, particularly their hamstrings(back of thighs), and certain muscle reflexes are slower or fire differently. To compensate, women tend to play sports in a more erect stance than men, causing more force on the knee with every landing."

    ACL injuries usually come not from running into another player, but in frighteningly simple ways: landing on a straight knee, suddenly stopping or planting the foot to change direction. It happens in sports, but it also can happen just tripping on a stair.

    Anatomy and biology can't be changed. But Wojtys and Ramus urge players and parents to demand specific training geared to girls and women, based on the latest research.They urge players to find out if they are at risk, then work on improving jumps, reflexes and control. Get the right shoes. Have your jump evaluated. Start now! Don't wait until you're hurt to take care of your knees.


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