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The OIC Dynamic Injury Prevention Program was designed by OIC orthopedic experts, including Sports Medicine physicians, and is designed to strengthen and stabilize the knee joint. This prevention program consists of a warm-up, stretching, strengthening, plyometrics, and sport specific agilities to address potential deficits in the strength and coordination of the stabilizing muscles around the knee joint. It is important to use proper technique during all of the exercises. It should take approximately 15–20 minutes to complete and should be performed at least 3 times per week.
At OIC, we often treat children with injuries that are caused by improper training that could have been avoided. Educating children on the importance of warming up and cooling down to avoid injury and pain is a critical life lesson from their coach or trainer. Warming up and cooling down are a critical part of this training program. The purpose of the warm-up section is to allow the athlete to prepare for activity. By warming up muscles first, you greatly reduce the risk of injury.
Jog Cone to Cone (30 seconds)
Elapsed Time: 0 – .5 min.
Purpose: Allows the athletes to slowly prepare themselves for training while minimizing the risk for injury.
Instruction: Be sure to keep the hip/knee/ankle in straight alignment without the knee caving in or the feet whipping out to the side. Complete a slow jog from near to far sideline.
Shuttle Run (30 seconds)
Elapsed Time: .5 – 1 min.
Purpose: This engages the hip muscles (inner and outer thigh). It will promote increased speed.
Instruction: Start in an athletic stance with a slight bend at the knee. Leading with the right foot, sidestep pushing off with the left foot (back leg). When driving off with the back leg, be sure the hip/knee/ankle are in a straight line. Switch sides at half field. Try not to cave the knee joint inward.
Backward Running (30 seconds)
Elapsed Time: 1 – 1.5 min.
Purpose: This engages the hip muscles (inner and outer thigh). It will promote increased speed.
Instruction: Start in an athletic stance with a slight bend at the knee. Leading with the right foot, sidestep pushing off with the left foot (back leg). When driving off with the back leg, be sure the hip/knee/ankle are in a straight line. Switch sides at half field. Try not to cave the knee joint inward.
Additional Warm Up Exercises
This portion of the program focuses on increasing leg strength. This will lead to increased leg strength and a more stable knee joint.
Walking Lunges (1 minute)
Elapsed Time: 1.5 – 2.5 min.
Purpose: This exercise strengthens the thigh (quadriceps) muscle.
Instruction. Lunge forward leading with the right leg. Push off with the right leg and lunge forward with the left leg. Drop the back knee straight down. Make sure to keep the front knee over the ankle. Control the motion and try to avoid the front knee from caving inward. If the athlete can’t see their toes on the leading leg, they are doing the exercise incorrectly.
Russian Hamstring (1 minute)
Elapsed Time: 2.5 – 3.5 min.
Purpose: This exercise strengthens the hamstrings muscles.
Instruction: Kneel on the ground with your hands at your side. Have a partner hold you firmly at your ankles. With a straight back, lean forward leading with your hips. Your knee, hip and shoulder should be in a straight line as you lean toward the ground. Do not bend at the waist. You should feel the hamstrings in the back of your thigh working. Repeat the exercise for 30 seconds.
Single Toe Raises (1 minute)
Elapsed Time: 3.5 – 4.5 minutes
Purpose: This exercise strengthens the calf muscles and increases balance.
Instruction: Stand up with one arm at the side and the other arm on a partner’s shoulder. Bend the left knee up and maintain balance. Slowly rise up on the right toes using good balance. Hold your arms out ahead in order to help, if needed. Slowly repeat 30 times and switch to the other side. As athletes get stronger, they may need to add repetitions to this exercise to continue the strengthening effect.
These exercises are explosive and help to build power, strength and speed. The most important element is a soft landing. When landing, always softly accept the weight on the balls of the feet, slowly rolling back to the heel with a bent knee and a bent hip.
Lateral Hops over Cone (30 seconds)
Elapsed Time: 4.5 – 5 min.
Purpose: This exercise increases power/strength while emphasizing neuromuscular control.
Instruction: Stand with a 2” cone to the left. Hop to the left over the cone softly landing on the balls of the feet and bending at the knee. Repeat this exercise hopping to the right. Progress to Single Leg Hops over Cone.
Single Leg Hops over Cone (30 seconds)
Elapsed Time: 5.5 – 6 minutes
Purpose: This exercise increases power/strength emphasizing neuromuscular control.
Instruction: Hop over the cone landing on the ball of the foot, bending at the knee. Now, hop backwards over the ball using the same landing technique. Be careful not to snap the knee back to straighten it. Maintain a slight bend to the knee. Now, stand on the left leg and repeat the exercise. Increase the number of repetitions as needed.
Forward/Backward Hops over Cone (30 seconds)
Elapsed Time: 5 – 5.5 min.
Purpose: This exercise increases power/strength emphasizing neuromuscular control.
Instruction: Hop over the cone softly landing on the balls of the feet and bending at the knee. Now, hop backwards over the cone using the same landing technique. Be careful not to snap the knee back to straighten it. Maintain a slight bend to the knee.
Vertical Jumps with Headers (30 seconds)
Elapsed Time: 6 – 6.5 minutes
Purpose: This exercise increases the height of the vertical jump.
Instruction: Stand forward with hands at side. Slightly bend the knees and push off jumping straight up. Remember the proper landing technique; accept the weight on the ball of the foot with a slight bend to the knee.
Scissors Jump (30 seconds)
Elapsed Time: 6.5 – 7 minutes
Purpose: To increase the power and strength of the vertical jump.
Instruction: Lunge forward leading with the right leg. Keep the knee over the ankle. Now, push off with the right foot and propel the left leg forward into a lunge. Be sure the knee does not cave in or out, but remains stable and directly over the ankle. Remember the proper landing technique; accept the weight on the ball of the foot with a slight bend to the knee. Repeat 20 times.
Forward Run with 3-Step Deceleration (1 minute)
Elapsed Time: 7 – 8 min.
Purpose: To increase dynamic stability of the ankle/knee/hip complex and to teach the athlete how to properly accelerate and decelerate while moving forward using the hip, buttock and hamstring muscles.
Instruction: Starting at the first cone, sprint forward to the second cone. As the athlete approaches the cone, use a 3-step quick stop to decelerate. Continue on to cone 2 using the same strategy to decelerate. Do not let the knee extend over the toe and do not let the knee cave inward.
Lateral Diagonal Runs (3 Passes)
Elapsed Time: 8 – 9 min.
Purpose: This exercise will deter a knock-knee position from occurring. This position is dangerous since it puts the anterior cruciate ligament (ACL) at risk of injury.
Instruction: Face forward and laterally run to the first cone on the left. Pivot off the left foot and shuttle run to the second cone. Now pivot off the right leg and continue onto the third cone. Make sure that the outside leg does not cave in. Keep a slight bend to the knee and hip and make sure the knee stays over the ankle joint. Perform 3 passes.
Bounding Run (44 yds)
Elapsed Time: 9 – 10 minutes
Purpose: To increase hip flexion strength, and increase power and speed.
Instruction: Starting on the near cone, run to the far side with knees up toward the chest. Bring knees up high. Land on the ball of the foot with a slight bend at the knee and a straight hip. Run 44 yards and increase the distance as this exercise gets easier.
Begin your training session with your coach. After the completion of training, resume the DIP program at section.
It is important to incorporate a short warm-up prior to stretching. Never stretch a “cold muscle”. By performing these stretches, you can improve and maintain your range of motion, reduce stiffness in your joints, reduce post-‐‐exercise soreness, reduce the risk of injury and improve your overall mobility and performance.
Note: this portion of the program may be moved to the end of your training session. Do a warm-up such as brisk walking for five to 10 minutes before stretching. Gently stretch to a point of tension and hold. Hold the stretch for 30 seconds. Concentrate on lengthening the muscles you are stretching. Breathe normally.
Calf Stretch (30 seconds)
Elapsed Time: 10 – 11 min.
Purpose: To stretch the calf muscle, which is located at the back of the lower leg.
Instruction: Stand leading with your right leg. Bend forward at the waist and place your hands on the ground in a V formation. Keep your right knee slightly bent and your left leg straight. Make sure your left foot is flat on the ground. Do not bounce during the stretch. Hold for 30 seconds, then switch sides and repeat.
Quadricep Stretch (30 seconds)
Elapsed Time: 11 – 12 min.
Purpose: To stretch the quadricep muscle, which is located on the front of the thigh.
Instruction: Place your left hand on a partner’s left shoulder. Reach back with the right hand and grab the front of the right ankle. Bring the heel to the buttock. Make sure the knee is pointed down toward the ground. Keep your right leg close to the left and don’t allow the knee to wing out to the side and do not bend at the waist. Hold for 30 seconds and switch sides.
Figure Four Hamstring Stretch (30 seconds)
Elapsed Time: 12 – 13 min.
Purpose: To stretch the hamstring muscles which are located on the back of the thigh.
Instruction: Sit on the ground with the right leg extended out in front. Bend the left knee and rest the bottom of the foot on the right inner thigh. With a straight back, try to bring the chest toward the knee without rounding the back. If possible, reach down toward the toes and pull them up toward the head. Do not bounce. Hold for 30 seconds and repeat with the other leg. Do 2 reps.
Inner Thigh Stretch (20 seconds)
Elapsed Time: 13 – 14 min.
Purpose: To elongate the muscles of the inner thigh (adductor group).
Instruction: Remain seated on the ground. Spread your legs evenly apart. Slowly lower yourself to the center with a straight back. You want to feel a stretch in the inner thigh. Now reach toward the right with the right arm. Bring your left arm overhead and stretch over to the right. Hold the stretch and repeat on the opposite side. Do 3 reps.
Hip Flexor Stretch (30 seconds)
Elapsed Time: 14 – 15 min.
Purpose: To elongate the hip flexors which are located at the front of the thigh.
Instruction: Lunge forward leading with the right leg. Drop the left knee down to the ground. Placing hands on top of the right thigh, lean forward with the hips, keeping them square with the shoulders. If possible, maintain balance and lift back for the left ankle and pull the heel to the buttocks. Hold for 30 seconds and repeat on the other side. Do 2 reps.
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