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I've had to give up teaching Attack after tearing my ACL during the leap lunges in the pylo track. I felt it go with a major ping but carrried on teaching - you know how it is - 30 people hyped up wanting more, its not easy to say sorry I've hurt myself gotta cancel the class.

 I have to except that I will never teach Attack again, and emotionally it has been very hard. Attack is like a drug - it lifts you places that you never though possible, and drives you to keep going beyond your limits and I love it. So not teaching it has been heart breaking.

I am now like a recovering addict, and attending 1 class a week and staying completely low impact ( and have been amazed that if you do actually do big full arm moves then you can get your heart rate up into the high 80's - haven't got to 90 yet). And staying low impact is so very hard - I wanna jack and leg kick but I hold back.

 The reason for my post is to ask what others have heard about torn ACL injuries and a womans menstral cycle. Weird I know!!!

But having read up about ACL injuries in women, it seems that they are more likely to occur in the first 3 days of a womans period than at any other time. If this is true (and the research seems to suggest it is - and if anyone knows differently please please please tell me), then should we as instructors not have been told this during training? And should we not be informing our classes that it may be better to stay low/medium impact on those 3 days? And believe me I am not suggesting we stand at the front of the class and say if you are on your period then low impact for you!!! But more place it in Attack literature. What is the view? 

Hi minxymia,

so sorry for your injury!

I found an article, that might be helpful. Unfortunately the text is only available in German, but the summary is in English:

http://www.zeitschrift-sportmedizin.de/Inhalt/images/Heft%200605/150-156.pdf

The influence of hormones is discussed in the first article: high estrogen might influence the elasticity of the ligament, but several studies came to different conclusions. While one study did not find any influence, another study found a significant correlation between high estrogen and ligament elasticity. That also might lead to the conclusion, that a higher elasticity might result in a higher protection, because the ligament would rather elongate that rupturate; on the other hand proprioceptive feedback might have a negative influence (hope, my translation is ok). So research literature is contradictory on this issue.

 

 

Yes, there is literature to suggest hormonal fluctuations influence joint stability. Have you seen a podiatrist to check the biomechanics of your plyo lunging 'cause for that to occur in what is essentially a forward and back movement is quite rare.  You might have a misalignment somewhere causing you to twist your knee in (or out, I can't remember) to cause it. ACL tears are common in sports where there's twisting (e.g., netball) or games where you legs are taken out from underneath you from the side (e.g., most forms of 'football').

You'd probably just want to stress with your classes the importance of maintaining correct knee/toe/hip alignment in plyo lunges - and in fact in all movements.

Any podiatrists/physiotherapists wanna chip in? Are females just more prone because of their wider hips? What stabilising exercises can you suggest?

Hi!  I also tore my ACL in Attack!  I came down from an air jack and landed on the side of my foot.  It was the end of track 9 so i just talked them through the rest, but I taught Pump right after!  Anyway-I am four months post surgery and now have to have a manipulation to get my range of motion back so I'm able to teach Attack and Step again.  Why are you not able to ever teach Attack again?  Did you have reconstruction surgery?  i was told i will be able to return to what I was active in before.  Just wondering your situation?

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Joy Grove Fitness Manager Five Points Washington Washington, IL 309-444-3901 JoyG@FivePointswashington.org

Women are prone to ACL injuries b/c of their hormonal fluctuations & yes, because of wider hips (i.e. increased Q angle is what you usually see in scientific literature), and possibly lack of preventative training or inappropriate prevention training (e.g., women on same lifting programs as men, is this appropriate from a prehab point of view). It's a huge area of research & the menstrual cycle has been examined. I don't know if it increases the risk of injury enough, and/or the evidence from research is strong enough, to warrant actually warning classes and placing it in Attack literature.

In my second personal training cert (CHEK Institute) I remember actually being told to place women on more stable programs in/near their menstrual cycle, as it is more difficult to activate core musculature, and that joints are also more lax, not to mention some women simply suffer from mild fatigue during that wonderful time. I would have to do some serious digging to find references for this statement though. I will say that I can usually tell when my client is in/near based on their performance. Some are entirely unaffected, others do indeed become more easily fatigued, and many do indeed have trouble stabilizing their core. Whether or not I choose to modify their program is based on their performance - I don't make it a black & white rule to simplify. 

I would imagine that during the lunge you somehow landed crooked - your foot went one place & your knee went another. 

Hope you heal quickly! 

A quick MedLine search suggests that there is a significantly higher risk in the first part (i.e: pre-ovulatory) of the cycle.

I've taken the liberty of obtaining a couple of review articles for your perusal:

Beynnon BD et al. Anterior Alignment, Menstrual Cycle Phase, and the Risk of Anterior Cruciate Ligament Injury. Journal of Athletic Training 2008;43(5):541-2 (full-text)

Hewett TE et al. Effects of the menstrual cycle on anterior cruciate ligament injury risk: a systematic review. American Journal of Sports Medicine 2007;35(4):659-68 (abstract only)

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Recently published - my review of BodyPump 73 is available on my blog at:
http://rickinoz.com/2010/03/07/bodypump-73-review

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The forum member "pipera" is not a Les Mills Instructor, though his posts, signature and profile will falsely claim otherwise.

Since he has been economical with the truth on his profile, read the real facts here.

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katherine:

Women are prone to ACL injuries b/c of their hormonal fluctuations & yes, because of wider hips (i.e. increased Q angle is what you usually see in scientific literature), and possibly lack of preventative training or inappropriate prevention training (e.g., women on same lifting programs as men, is this appropriate from a prehab point of view). It's a huge area of research & the menstrual cycle has been examined. I don't know if it increases the risk of injury enough, and/or the evidence from research is strong enough, to warrant actually warning classes and placing it in Attack literature.

In my second personal training cert (CHEK Institute) I remember actually being told to place women on more stable programs in/near their menstrual cycle, as it is more difficult to activate core musculature, and that joints are also more lax, not to mention some women simply suffer from mild fatigue during that wonderful time. I would have to do some serious digging to find references for this statement though. I will say that I can usually tell when my client is in/near based on their performance. Some are entirely unaffected, others do indeed become more easily fatigued, and many do indeed have trouble stabilizing their core. Whether or not I choose to modify their program is based on their performance - I don't make it a black & white rule to simplify. 

I would imagine that during the lunge you somehow landed crooked - your foot went one place & your knee went another. 

Hope you heal quickly! 

I am 1/2 supporter of Check but after being in school as long as I have, there are always other finding and I am glad that you noted that.  There is support for both sides for and against and honestly not enough information yet...to conditionally support this theory fully. 

My question to you.  Why have you had your ACL repaired and why are you not teaching Attack anymore?  I work with some of the best surgeons here in Toronto, Canada, and they rehab professional sports players in the NFL, NHL and they return to play even women at that caliber do as well.  Why have you not? There must be other migrating factors as well.  What are they?

And remember in the lower body there are two joints you mentioned that go one way then the other.  The ankle does not need to displace medially to laterally to tear the ACL, remember your biomechanics, its usually a rotation or torque combined with force and can be from an anterior translation of the tibia on the femur.  Its only about 38mm long and can also be injured in a knee hyper extension.  You usually not dealing with the ankle except from planting, and its the rotation of the femur on the tibia.

I hope this helps.  I am glad to see you are studying with Chek. 

 

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Yours In Safe & Rapid Return to Play, Rachel Leroux, B.A. Athletic Therapy Student "Life is like riding a bicycle; in order to keep your balance, keep moving."

Hiya,

Why have I not had surgery? Why give up Attack? There are a number of reasons why

- I am self employed and I can not afford to take the recovery time off. Just having an arthroscopy meant I was off teaching Pump, Spin and TBC for almost 2 weeks and that was hard on the finances. My surgeon quoted between 3-6 months recovery for a reconstruction - and I cannot afford that at the moment.

-  My sureon also said that he would be uneasy to do reconstruction surgery if I was going to carry on teaching Attack, as  I would be much more likely to injure that knee again if I was doing the same kind of exercise that caused the injury in the first place.

- I also work as a Mind and Body coach and have a firm belief that every injury and every illness come from an emotional perspective (the body and mind act as one). So what is the point of fixing the body if the mind hasn't been examined, and sorted. How many people have re-occuring injuries, go to the physio and get it fixed - and then 3 months later the same injury comes back. I have done a lot of work on why my injury occurred - what was its positive intention for me.

The injury happened at a club were one of my attack participants had an affair with my partner (I got rid of the partner). But I couldn't get rid of her - she was a paying member and turned up every week - seriously to this day I still marvel at the cheek of her. I wanted to show I was strong, I wanted to show I was professional, and I wanted to show I was better than her - and I did that. Underneath the bravado it hurt, and it hurt like hell - this B***H had an affair with my partner,  told me and behaved like she was the one hard done by, and the continued to come to my class - I wanted out of the situation, but loved my Attack class and loved teaching it and at the time I could not see a way out. So my body did the one thing it could do to get me out of the situation and it gave me an injury that only ever really affects my Attack teaching. I was carrying a very raw and huge emotional hurt, I didn't want to admit it - and thought I'll just ignore it and it will go away!!!!!!

 My knee is improving fantastically well since I acknowledged and let go of the emotional pain of that situation. The physio rehab is also working all the muscles and strengthening up my legs. Maybe in the future I will feel my knee is recovered enough to teach attack again and at the moment I am not putting that pressure on myself to have that as my goal. I've lived and worked with a torn ACL for years now, and sometimes I am quite thankful for it as it has sent me on a different path. A path a little less intense physically, but just as fun.

 

 

katherine:

Women are prone to ACL injuries b/c of their hormonal fluctuations & yes, because of wider hips (i.e. increased Q angle is what you usually see in scientific literature), 

 

as this might be true, it's also true that gymnasts tear ACL's all the time, and women gymnasts have neither wide hips or (usually) menstral cycles... in fact one of the most common "retirement" injuries for gymnasts is a torn ACL... however gymnastics is out on a limb by itself i dont think any other sport in the world is as psycho as gym... 

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"This is my body and I can do whatever I want to it. I can push it, study it, tweak it, listen to it. Everybody wants to know what I'm on... What am I on!?! I'm on my bike, busting my ass 6 hours a day. What are you on???"