Abstract
Neuromuscular warm-up has been shown to decrease the risk of anterior cruciate ligament (ACL) injury improving muscular firing patterns. All preventive training programs described in the literature have a duration of several weeks. To date, no studies have explored the immediate effect of a neuromuscular warm-up exercise on pre-activation time of the knee stabilizer muscles. Thus, this proof-of-principle study aimed at evaluating the acute effects of a neuromuscular warm-up exercises on the electromyographic activation of knee stabilizer muscles’ activation pattern. We included 11 professional football players, mean aged 23.2 ± 4.5 years, from a Southern Italy football team. All of them underwent a standard warm-up exercise protocol at the first day of the evaluation. At 1 week, they underwent a structured neuromuscular warm-up exercise protocol. We assessed as outcome measure the pre-activation time (ms) of rectus femoris (RF), vastus medialis (VM), biceps femoris (BF), and medial hamstrings (MH) upon landing. Outcomes were assessed before and after the standard warm-up and neuromuscular warm-up. Pre-activation time of RF, VM, BF and MH significantly improved only after neuromuscular warm-up (p < 0.05); moreover, there was a significant (p < 0.05) between-group difference in pre-activation time of all muscles after the neuromuscular warm-up compared with the standard warm-up. These findings suggested that physical exercise consisting of a structured injury prevention neuromuscular warm-up might have an immediate effect in improving the activation time of the knee stabilizer muscles, thus potentially reducing the risk of ACL injury.
Highlights
Anterior cruciate ligament (ACL) injuries affect recreational, competitive, and professional athletes and, in particular, football players with a negative impact on their quality of life [1]
ACL injury is related to a higher risk of a knee re-injury [5], and long-term medical disability due to early osteoarthritis occurring in half of the individuals 10–15 years later [6,7]
This proof-of-principle study explored the effect of a neuromuscular warm-up on the activation pattern of the knee stabilizer muscle in professional football players
Summary
Anterior cruciate ligament (ACL) injuries affect recreational, competitive, and professional athletes and, in particular, football players with a negative impact on their quality of life [1]. 70% of players return to play (RTP) [2], only two-thirds of players with a complete ACL lesion play at the high level 3 years later [4]. ACL injury is related to a higher risk of a knee re-injury [5], and long-term medical disability due to early osteoarthritis occurring in half of the individuals 10–15 years later [6,7]. There are four main situational patterns of ACL injuries in football players: pressing/. In most cases (81%) a mechanical perturbation causes a high knee valgus loading [8]. When a perturbation alters the equilibrium of a system, a preparatory contraction of the muscles stiffens the joint as a protective reaction to prevent injury with a feedforward mechanism
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