New research in the strength and conditioning field has shown a direct correlation between the strength of the hip, specifically the external rotators and abductors, and the risk of NON-CONTACT Anterior Cruciate Ligament (ACL) injury (Khayambashi K, et al. 2016).

Note: the ACL is designed to prevent anterior (forward) movement of the tibia off the femur, excessive medial rotation of the tibia (inward rotation) and hyperextension of the knee. The ACL provides greater stability to the knee joint (Netter F, 2014).

Note: the ACL is designed to prevent anterior (forward) movement of the tibia off the femur, excessive medial rotation of the tibia (inward rotation) and hyperextension of the knee. The ACL provides greater stability to the knee joint (Netter F, 2014).

3% of the 501 athletes tested during the research study were running, walking, jumping, skipping and other activities where there was no blunt force exerted on the knee (Khayambashi K, et al. 2016).

Note: the lateral rotators of the hip include the piriformis, superior and inferior gemelli, obturator externus and quadratus formoris. Gluteus maximus and medius can also externally rotate the hip. The abductors of the hip include gluteus medius, minimus and tensor fasciae latae (Netter F, 2014).

Note: the lateral rotators of the hip include the piriformis, superior and inferior gemelli, obturator externus and quadratus formoris. Gluteus maximus and medius can also externally rotate the hip. The abductors of the hip include gluteus medius, minimus and tensor fasciae latae (Netter F, 2014).

As running, jumping and skipping are all heavily featured throughout the CrossFit program, it seems pertinent to add in exercises to strengthen the external rotators and abductors of the hip in order to prehabilitate from this particular injury.

3 Exercises To Prevent This From Happening To You

1A. Banded Crab Walks

Action: side step - focus on the moving leg - imagine pushing a wall out with the lead leg.

Action: side step - focus on the moving leg - imagine pushing a wall out with the lead leg.

1B. Banded Hip Circles

Action: moving forwards and backwards - go wide stance to close stance - focus should be on lateral hip movement as opposed to moving forwards.  

Action: moving forwards and backwards - go wide stance to close stance - focus should be on lateral hip movement as opposed to moving forwards.
 

2. Banded Hip Bridge

Action: heels down - pressure on band - squeeze glutes to raise hips up - neutral spine position at the top.

Action: heels down - pressure on band - squeeze glutes to raise hips up - neutral spine position at the top.

3. Rear Foot Elevate Split Squats

Action: back toe tucked - focus on front knee - no lateral knee movement - drive through heel to stand. Add weight by holding a weight plate or Dumbbell against the chest.

Action: back toe tucked - focus on front knee - no lateral knee movement - drive through heel to stand. Add weight by holding a weight plate or Dumbbell against the chest.

Programming

For each movement, complete 3x10-20 reps. Add it to your already, ridiculously long, religious CrossFit warm up/cool down to increase strength and avoid potential ACL injury.

Summary


Whilst no current studies exist on ACL injury as related to CrossFit, it is an important take home point that strengthening the external rotators and abductors of the hip has downstream positive implications for the health of the knee.

-Coach Dylan Sorensen
AWF (L-1), CF (L-1), CF (STM) Ex. Prof. (3-4), Current Osteo student (2nd year), Member of the Australian Weightlifting Federation. Member of the Victorian Weightlifting Association. Member of Fitness Australia.


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References & Original Article:
1. http://www.ncbi.nlm.nih.gov/m/pubmed/26646514/
2. Frank H. Netter MD, Netter's Atlas of Human Anatomy, 6th edition, USA 2014

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