b'CODING Update ComplianceLEGAL NUTRITIONUpdateANJC NewsANJC Leadership ANJC News! NUTRITION LEGAL EASEANJC Scholarship REHAB Update Executive Directors Update LEGAL Q&A CHIRO AssistINSURANCE Update INSURANCE Update Legislative UpdateTECHNIQUE UpdateExtremity Concerns MedicareQ&AMedicare Update OUR HEALTHIN TOP ATHLETESBy Dr. Kurt A. JuergensA timely returnof events happen throughout the kinetic chain. The result to competitionis proper support or failure at the ankle, knee and/or hip, is a primarydepending how the foot responds at impact. In order to concern forhelp the athlete reduce the risk of injuries to these areas, athletes.the practitioner must gain an understanding of simple lower Being injuredextremity anatomy and biomechanics and then incorporate and havingspecific evaluation and rehab protocols for the lower to sit on theextremity. sidelines is notA detailed evaluation of both feet is the first step in the only physicallyprevention and rehab of lower extremity injuries. The painful, butfoot is the keystone of the bodys foundation. During the emotionallyweight bearing inspection part of the evaluation, begin by challengingevaluating the feet to determine the foot type. Pronation in as well. Lowervarying degrees is a common finding among athletes. With extremitypronation, the tibia rotates and the knee collapses medially injuries are thecausing a genu valgus deformity. A custom foot orthotic can most commonbe a game changer when it comes to supporting the natural athletic injuriesarchitecture of the foot, which in turn can prevent many in non-contact,lower extremity and spine issues. contact and collision sports.The most common injury in the ankle is a sprain of the Knowinganterior talofibular ligament. The number one risk factor what the most common injuries are and understandingin developing a second ankle sprain is a first ankle sprain. the physiology behind the cause of the injury can help theTherefore, developing strength, coordination, balance athlete spend less time on the sidelines and more time doingand reaction time are of vital importance when it comes to what they love to do.COMPETE! injury prevention and recovery. A key muscle affected by an When engaging in most sports, an athletic position isankle sprain is the peroneus longus muscle and its role as a required to help the athlete react quickly and efficiently.positioner during the gait cycle. With this injury, the pero-The athletic position is accomplished with the feet shoulderneus longus is commonly compromised resulting in a 50% width apart, weight on the balls of the feet, and the kneesreduction in both contraction intensity and muscle response bent at 30 degrees of flexion. It is in this position that thetime. During the swing phase of the gait cycle, the peroneus body reacts appropriately, timely and efficiently. Whenlongus muscle contracts and positions the foot to strike the an athlete changes positions in response to action, whatground securely. When this muscle is compromised, the happens next determines whether or not an injury occurs.risk of landing improperly increases dramatically. If an ankle To prevent injury and failure, it is imperative that thesprain is not rehabilitated properly then the compromised musculoskeletal structures are adequately conditioned andperoneus longus will persist indefinitely, increasing the risk that the foot foundation provides the necessary support tofor a repeat injury. allow a smooth progression from heel strike to the toe-offRegarding knee injuries, the most commonly injured phase of the gait cycle. If one or both of these areas are notligament in the male athlete is the medial collateral ligament functioning properly, failure will result and an injury will mostand for the female athlete it is the anterior cruciate ligament. likely ensue.There are special considerations in the female athlete, The top two musculoskeletal injuries in the athlete, at anynamely anatomical and neuromuscular issues, that make level, involve the ankle and the knee. Addressing technicalthe ACL more at risk for injury. It should be noted that the issues within the feet, increasing strength, and improvingligaments are not the primary stabilizers of the knee. Rather, reaction time are the keys to injury prevention and recovery.it is co-contraction of the quadricep and hamstring muscles Seventy percent of lower extremity injuries are non-contactthat provides dynamic stabilization of the knee. Maximum in nature. These injuries result from a lack of intrinsicco-contraction occurs in the athletic position where the strength, coordination, balance and reaction time. Duringknees are flexed to 30 degrees. When these two muscles the gait cycle, the foot strikes the ground and a cascadework together, the knee is dynamically supported and the 16 I Summer 2020 www.anjc.info'