ACL injuries are a hard, grueling injury both physically and mentally. One of the tough questions is WHY? Why did my ACL tear? Especially when you are part of the 70% of non-contact ACL tears, it can be unnerving to say the least. We will do our best to attack the complexity of that question.
INJURIES ARE COMPLEX
It is worth noting that all injuries are incredibly complex processes. If anyone tells you that "you got injured due to X" (insert a singular reason like weak quads or poor balance) then
they likely have a very simplistic and uniformed viewpoint on the topic. The reason you got injured is likely very multifactorial, many of them are listed on the right. Genetics, strength, control, environmental factors are all more commonly held and important factors.
A commonly neglected and more recently emphasized factor is the role the brain plays in ACL tears.
MISSING PIECE OF THE PIE
We have to be missing something. Why every year do NFL players like Saquon Barkley, Kyler Murray, Nick Bosa tear their ACL? You can not seriously tell me they are lacking in coordination, strength, stability or athleticism. These are the best of the best. The missing piece of the pie is the brain.
The brain is incredibly complex but we can simplify it better understand injuries. The body provides sensory information through vision, somatosensory (skin, joints, receptors, etc) and vestibular (inner ear).Your brain takes that sensory information, process's it, filters it, then comes up with a unique motor (muscle) program. This "motor program" includes when to fire muscles, how much to fire, how long, etc.
This process is incredible but sometimes the brain messes it up. A good example is when you are running up the stairs, your toe catches a step and you trip. You have ran up the stairs thousands of times without tripping, why did you just trip? The brain made a sensory error. You were distracted thinking about something else and your brain made a miscalculation leading to a motor error (tripping). Now apply that same thought process to the chaos of the sporting environment. The brain is taking in huge amounts of sensory information (defense position, angles, decisions, etc) and then basing the next move, pass, jump, play off that information.
If our brain is unable to filter all of the sensory information it can become overloaded and make motor/sensory errors. These errors lead to poor stability, poor muscle tension or firing and increase the risk for ACL tears. The picture to the right highlights that. The top player can filter LARGE amounts of sensory information and excels with few motor errors. The bottom athlete can filter SMALL amounts of sensory information and make many motor errors leading to injury.
SLOW THE GAME DOWN
So what do we do about that?
First, don't forget the other pieces of the pie. We need to be strength training and playing multiple sports at an early age. We need to be engaged in play and risk activities at an early age. This helps build a robust sensory and motor movement system.
Second, we need to and can improve our ability to process information. This is called visual processing speed. Visual processing speed is the amount of time needed to make a correct decision about a visual stimulus.This is the biggest differentiator between amateur and elite athletes. One way to do this is dual task. This just means doing two tasks at once. Even better would be if the stimulus you provide dictates the action. Here are some examples.
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To sum it up injuries are complex. ACL injuries have left experts scratching their heads for decades due to the seeming unpredictability of the injury. The brain's processing speed really helps connect the dots and is a huge aspect of ACL injuries and rehab.
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