Deconstructing Cutting: An Evidence-Based Coaching Framework to Reduce Anterior Cruciate Ligament Injury Risk

Abstract

Few evidence-based guides exist to support coaches in delivering technical elements of cutting that may reduce the risk of anterior cruciate ligament (ACL) rupture. In isolation, balance exercises, jump landing, cutting movements, as well as modifying the penultimate step, may alter biomechanics favorably during this maneuver. By breaking this serial skill into its constituent parts, the coach is afforded an opportunity to observe trainable deficits, and allows the player more opportunity for practice. In addition, factors such as specificity to the direction of load during landings, alongside building capacity, and using externally focused cues may be crucial for adaptation and transference into open sporting scenarios.

Development of a Cutting Technique Modification Training Program and Evaluation of its Effects on Movement Quality and Cutting Performance in Male Adolescent American Football Players

“…Cutting kinematics are closely related to both cutting performance and ACL loading [ 11 , 17 , 32 , 116 , 117 ]. The aims of the present study were twofold: First, to develop a cutting technique modification training program that targets specific kinematics associated with improved performance and reduced injury risk potential while considering various principles from the motor-learning domain, and, second, to investigate its effects on cutting performance and movement quality in adolescent American football players.…”

“…It has been shown that increased velocity at key instances of the penultimate foot contact and final foot contact is largely associated with cutting performance [ 79 , 116 ]. Thus, the underpinning idea is to develop a pronounced deceleration ability to brake effectively (i.e., apply an adequate horizontal braking force to reduce whole-body momentum to an optimal level for the subsequent cutting movement) [ 31 , 125 , 126 ] and rapidly over the shortest possible distance/time (i.e., with very few braking steps/short braking contact time) [ 127 ] prior to direction change to maintain a high approach speed for as long as possible [ 32 ]. Effective braking was also trained in the intervention; however, during testing, some athletes occasionally fell into shuffle-step movement patterns in the transition from approach to cutting, which are associated with lower velocity maintenance [ 8 ].…”

“…The technique modification training program aimed to foster and reinforce specific movement patterns (i.e., penultimate foot contact dominant braking strategy, trunk lean and rotation toward the direction of travel, reduction of tibia abduction angle, and active limb at touchdown) of the sidestep technique [ 18 , 32 ]. The desired movement patterns have been targeted in former technique modification interventions to simultaneously promote higher cutting performance and lower ACL injury risk potential [ 60 , 78 , 79 ].…”

“…Nonetheless, the performance–injury conflict does not generally apply to all kinematics that are associated with reduced injury risk potential. Some of them are largely unrelated to cutting performance (e.g., knee valgus), while other safe cutting kinematics have a positive relationship with performance (e.g., trunk rotation and lateral flexion toward the direction of travel, as well as a clear breaking strategy) [ 11 , 29 , 30 , 31 , 32 ]. It is less likely that athletes and coaches can be convinced to implement technique training programs that sacrifice performance for injury risk mitigation [ 8 ].…”