When preparing for an upcoming athletic season, it is important to maintain a good off-season workout routine to get your body in shape for the season. Depending on the sport, it is typical for an off-season program to include cardiovascular endurance training as well as strength training. These are crucial components, but one piece that often gets overlooked is balance training.

Your body is designed with several systems that help control balance in the structure of the body, and 3 separate systems that help maintain your balance from a brain control aspect. In the body we have passive, active and neural control subsystems for balance. The passive subsystem includes bones and ligaments. You don’t have to think about these tissues to maintain your balance, they are just there to hold you in place. The active subsystem includes the muscles and tendons that attach to the bones. When you contract the muscles, this will affect how the body reacts to the various elements you encounter. The neural subsystem blends the structures of the body with the brain component. There are joint receptors throughout the body that can sense how the body is moving and use that information to maintain balance and upright posture. Higher level athletes have a better feel for how their body is moving in space due to these joint receptors.

When discussing balance from a brain control function you have the visual, vestibular and somatosensory systems. Somatosensory is what we discussed with the neural control above with the joint receptors. The visual system is just what you see and is typically what we rely most on. Try balancing on one foot with your eyes closed and you can see how important this is. Finally there is the vestibular system. This includes 3 canals in your ear with fluid inside that sense the position of your head in relation to gravity. If these canals are affected you can develop vertigo or dizziness.

So why is balance training important to prevent an ACL tear? It is reported that 70% of ACL tears are non-contact. This is typically due to making a sharp cut and the leg sliding out, twisting over a fixed foot or landing with poor mechanics causing the knee to cave in. If your muscles are not prepared to handle the forces, the stress shifts to the ligaments which is when a tear occurs. Training your balance can greatly decrease your risk of this happening.

In physical therapy we work on neuromuscular re-education. This is the concept of training your muscles to react to an outside stimulus. If you are running and go to make a sharp cut, your joint receptors have to sense the movements of your ankle, knee and hip as well as their position related to your trunk. Your muscles have to respond to this stimulus and contract appropriately to maintain balance and control. All of this has to happen in a split second and would be impossible to think about as it is happening. That is why it is important to have your muscles ready to react on cue. There are many exercises and balance tasks available to train so if you have any questions give us a call to set up a consultation.

Week 4 of our ACL Prevention program with REAL Jersey FC,  focused on the players working on these balance and stability activities.  Check out the video to see some of their moves.

Sources:

https://www.bettermovement.org/blog/2013/what-is-your-movement-style
https://www.sciencedirect.com/science/article/pii/S0306987713000789
https://www.ncbi.nlm.nih.gov/pubmed/10874221