Proper muscular alignment begins with your hips over your knees, and your knees over your feet. Making sure that these stay consistent during movements is integral. There are three general positions of the knee in standing posture which include varus and valgus posture.
Aside from normal, the valgus knee posture is most common because it puts the knee into a defaulted stable position skeletally, but compromises the soft tissues like your medial meniscus, your medial collateral ligament, and your ACL.
Structurally, women are more predisposed than men to knee injuries and osteoarthritis because of their default to a valgus position. There are plenty of studies that emphasize this, which also show the prevention of injury by improving alignment and muscle strength.2, 3, 4.5
When you land from a jump on both feet, you should be landing as if to keep your joints in line. This decreases any lateral force on soft tissue or hard tissue. Landing on both feet should look like the bottom of a squat (which will be discussed later). Improvement of these mechanics will help improve the outcomes and help prevent recurring injury.6
2. Muscular Strength
Your muscles control the movement of the skeletal system through two types of contractions: concentric and eccentric. Concentric contractions are what you feel every day — when you contract a muscle by shortening it. An example? Your biceps flex your elbow. When you bend your elbow in an elbow curl, that is a concentric contraction for the biceps. The eccentric contraction happens when you resist the original pull of the muscle. After curling the dumbbell, you decide to slowly uncurl your arm instead of letting your elbow straighten without resistance. Eccentric contractions are important in controlling your body’s motion against gravity, especially during landing.
When you land, your body uses its muscles’ eccentric strength to control movement against gravity. Without that movement, it will default to using the bones’ structural integrity to stabilize itself.
The muscles that you should be focused on control the knees from the hip. Several studies show that improvement of muscle strength and mechanics may decrease the incidence of injury. These three muscles include your hip abductors, external rotators, and your gluteus maximus.
Your hip abductors and external rotators control valgus movement at the knees, while your glutes control your global downward movement. Like I discussed before, valgus stress on the knee puts you at a high risk for ligament damage. Here are some examples of exercises you can implement into your training to help strengthen these muscles.
Hip External Rotation: Clamshells
Focusing on alignment of the hips, knees, and ankles is important in strengthening these muscles in their proper ranges of motion. Making sure that you feel these exercises in the right place ensures proper muscle activation instead of compensation.
It’s important to focus on practicing these motions with exercises that are similar to jumping. Making sure that you are able to do the exercises discussed earlier is important in retraining your brain to maintain these alignments, which will be the new normal. Squatting and lunging are the most applicable exercises to basketball.
Plyometrics will help emphasize a proper alignment pattern. They should be done with players under supervision. Practicing single and double leg jumps with proper alignment is also important. The more consistent you are at performing these motions with proper alignment in training and game-practice situations, the more innate it becomes during a game situation.
Injury prevention should start with coaches in conjunction with a physical therapist. Athletes and coaches should be aware of accessory movement to help prevent injury by beginning to implement these concepts.
- Aerts I, Cumps E, Verhagen E, Wuyts B, Van De Gucht S, Meeusen R. The importance of a 3 month prevention program on the jump-landing technique in Basketball. Journal of Sport Rehabilitation. 2004
- Beynnon BD, Vacek PM, Newell MK, Tourville TW, Smith HC, Schultz SJ, Slauterbeck JR, Johnson RJ. The effects of level of competition, sport, and sex on the incidence of first-time noncontact anterior cruciate ligament injury. Am J Sports Med. 2014 Jul.
- Acevedo RJ, Rivera-Vega A, Miranda G, Micheo W. Anterior Cruciate Ligament Injury: identification of risk factors and prevention strategies. Curr Sports Med Rep. 2014; 13(3): 186-91.
- Butler RJ, Willson JD, Fowler D, Queen RM. Gender Differences in landing mechanics vary depending on type of landing. Clin J Sport Med. 2013; 23(1): 52-7.
- Willson JD, Davis IS. Lower Extremity strength and mechanics during jumping in women with patellofemoral pain. J Sport Rehabil. 2009; 18(1: 76-90.
- Willson JD, Binder-Macleod S, Davis IS. Lower extremity jumping mechanics of female athletes with and without patellofemoral pain before and after exertion. Am J Sports Med. 2008; 36(8).
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