Skyla Lloyd

1/18/19

Annotated Source List

Current Topic

Balogh, D. (n.d.). Neuromuscular training and acl injuries. Retrieved from Peak Performance
Physical Therapy website:
https://peakperformanceompt.com/neuromuscular-training-acl-injuries/
Summary: Website
This article is about neuromuscular training, and how it can help the ACL resist injury.
First the article explains what neuromuscular training is. Neuromuscular training is training to
improve the brain's ability to send signals to your muscles quicker to make quicker contractions,
thus, preventing ACL injury. Studies have shown that neuromuscular training has been able to
lower ACL injury risk by 43.8% to 73.4%, especially in adolescent and female athletes.
Neuromuscular training includes many types of exercises, as long as the exercise increases
strength and balance of the knee. Common neuromuscular strengthening exercises include
plyometric exercise, balance exercises, resistance training, and speed training. While doing all of
this training, it is very important to pay attention to form. Bending of the hips and knees indicate
weakness in the legs and should be corrected, or else improper habits will form.
Application to research
This articles helps my research because it tells me more about what exactly
neuromuscular training is and the success it has had with ACL injury prevention. Additionally,
the articles tells me about what categories of exercises fall under neuromuscular training. I can
use this information later in my paper to argue neuromuscular training is an important aspect of
ACL injury prevention.

Brent, L., Klugman, F., Myer, D., & Hewett, E. (2011). The effects of pre-season and in-season
neuromuscular training on the tuck jump assessment: A test used to identify risk of acl
injury in female athletes.​ The Journal of Strength and Conditioning Research​, 25(1),
120-121. https://doi.org/10.1097/01.JSC.0000395772.66320.ea
Summary: Journal
This journal was created to evaluate a study that. was done to assess the differences
between completing an ACL prevention program in the preseason vs. in the regular season. The
study took 65 female soccer player and divided them into three groups. One group was the
control, one group would receive preseason NMT training, and the last group would receive
in-season NMT training. For the results of this study, the two groups that received training
significantly decreased ACL injury risk in comparison to the control group. The two groups that
received training showed for the most part, the same results, although, the preseason showed
very slightly better results.
Application to Research
This journal benefits my research because prior to reading this report, I was unable to
find any sources that compared in-season training to preseason training. Even through this
journal started that the two groups showed mostly the same results, I can still draw my own
conclusion that training should be done in the preseason to make sure the athlete is already
prepared for the season.

Brophy, R., Silvers, H., Gonzales, T., & Mandelbaum, B. (2010). Gender influences: The role of
leg dominance in ACL injury among soccer players. ​Br J Sports Med,​ ​44(​ 10), 694-697.
https://doi.org/10.1136/bjsm.2008.051243
Summary: Journal
This journal writes about testing leg dominance ACL injury risk for soccer players. This
experiment was to test the hypothesis that soccer players are more likely to tear their
non-dominant ACL than their dominant one in non-contact injuries. At the end of the
experiment, roughly half of the of ACL injuries occured in the dominant kicking leg, however,
separated by gender, 74.1% of the males injuries were in the dominant leg whereas only 32% of
injuries occured on the dominant leg for females.
Application to Research
I can use this to help me with my claim that women have weaker ACL’s. Because female
soccer players are more likely to tear their ACL on their dominant leg, this probably has to do
with biomechanical factors such as the way females hips are and how their legs are naturally
weaker.

Cerulli, G., Benoit, D., Caraffa, A., & Ponteggia, F. (2001). Proprioceptive Training and
Prevention of Anterior Cruciate Ligament Injuries in Soccer. ​The Journal of orthopaedic
and sports physical therapy,​ 31(11). 655-60.
https://doi.org/10.2519/jospt.2001.31.11.655.
Summary: Journal
This journal studied the effects education, stretching, strengthening, plyometrics, and
agility exercises as opposed to the typical sports warm up for female athletes. The study had two
groups that would be tested. One round of people in 2000 season and another round in the 2001
sports season. In 2000, there were 1041 subjects in the group that would participate in the ACL
prevention program and 1905 who would not. The results revealed that there were only 2 ACL
tears for the test group, however, the control group had 32. In 2001, there were 844 trained
subjects and 1913 untrained subjects. These results revealed that 4 people in the trained group
had torn their ACL and 35 in the untrained group tore theirs. These results revealed that this
combination of exercises proved to be very effective in preventing ACL injury.
Application to Research
This study benefits my research because it studies an ACL prevention program that used
all different types of exercises. The study ran the trial two times and the results proved to be very
good and showed a significant decrease in injury. This helps me because now I have a good idea
of what types of exercises should be done at an ACL prevention program.

Denney, L., Sampley, J., & Nessler, T. (2017). Acl injury prevention: What does research tell us?
US National Library of Medicine,​ ​10(​ 3). https://doi.org/10.1007/s12178-017-9416-5
Summary: Journal
This journal was a great source for several different ACL prevention programs. The
journal analyzed all of these programs and was able to put together a list of things that can cause
a better reaction to ACL prevention programs. Along with this list, there is another list of of
different groups of exercises that should be done at an ACL prevention program in order to get
the best possible results. Additionally, the journal makes a suggestion for how frequent and for
how long the training session should be.
Application to Research
This resource is very helpful for my research. It references several different studies that I
can look at later on and see the results of. However, the source takes all of these studies and
draws general conclusions for which ACL prevention programs are most effective. With this list,
I can look into its ideas for which ACL prevention programs are the most effective and find data
to support the claims.

Fukubayashi, T., Nagano, Y., Ida, H., & Akai, M. (2011). Effects of jump and balance training
on
knee kinematics and electromyography of female basketball athletes during a single limb
drop landing: Pre-post intervention study. ​Sports Medicine, Arthroscopy, Rehabilitation,
Therapy & Technology,​ ​3(​ 14), 1-8. ​https://doi.org/10.1186/1758-2555-3-1​4
Summary: Journal
This journal was about a study that tested the effectiveness of an ACL prevention
program through the measure of knee function after the program. This experiment was tested on
eight female basketball athletes. Tests of knee flexibility and other functions was tested both
before and after the program. After the program, it was discovered that the knee had highly
benefited and performed better in each category. This relates back to prevention ACL damage
because when the knee is more flexible and stronger, ACL tear probability is reduced because
the ACL can withstand greater pulls and movements. When the ACL is not flexible or strong,
quick movements such as pivoting wrong can take an athlete out of the game for several months,
therefore, ACL prevention programs are one of the best method an athlete can participate in to
protect themselves against ACL tear.
Application to Research
This journal gave specific examples of exercises done during and ACL prevention
program. Having these examples, I learned what happens during an ACL prevention program
and how it contributes to ACL tear prevention. With this research, I can look into what exercises
best help to prevent ACL and which exercises are not as efficient.

Herbert Stevenson, J., Beattie, C., Schwartz, J., & Busconi, B. (2015). Assessing the
effectiveness of neuromuscular training programs in reducing the incidence of anterior
cruciate ligament injuries in female athletes: A Systematic Review.​ ​The American
Journal of Sports Medicine​,​ ​43​(2), 482–490. https://doi.org/10.1177/0363546514523388
Summary: Journal
This journal reviewed several studies to assess the effectiveness of neuromuscular
training programs in order to reduce ACL injury risk. 10 studies were observed in order to reach
a conclusion. The authors found neuromuscular training to be effective but at different levels.
Some studies showed a significant decrease in ACL injury risk, which others showed a slight
decrease. Two studies even showed an increase and risk. With this information, it was able to be
concluded that the studies that were done in the preseason and utilized plyometric exercises were
the most beneficial.
Application to Research
 This journal benefits my research because it analyzes several studies and draws
conclusions from all of them combined. This source helps me save time because it already found
what is to be true, so now I can use that claim to find information to back it up instead of going
through many sources to draw a conclusion.

Hopper, A., Haff, E., Joyce, C., Lloyd, R., & Haff, G. (2017). Neuromuscular training improves
lower extremity biomechanics associated with knee injury during landing in 11–13 year
old female netball athletes: A randomized control study. ​Frontiers in Physiology​.
https://doi.org/10.3389/fphys.2017.00883
Summary: Journal
This journal examined the effects of neuromuscular training by accessing the landing
biomechanics that are associated with ACL injury. Thirteen athletes participated in the
neuromuscular training whereas ten athletes remained in the control group. The results showed
that the control group increased the bilateral knee marker distance and knee internal rotation was
decreased. This means that the neuromuscular training strengthened the muscles, therefore,
preventing ACL injury risk.
Application to Research
This source bettered my research because now I know for sure that neuromuscular
training has to be apart of a successful ACL prevention program. With this source I now have
enough information to back that claim. Now, I need to find out what other type of training should
be combined with neuromuscular training.

Ireland, M. (2002). The female acl: Why is it more prone to injury? ​Orthopedic Clinics​, ​33​(4),
637-651. https://doi.org/10.1016/S0030-5898(02)00028-7
Summary: Journal
This journal describes the differences between women and men that lead to an increased
risk for women to have an ACL injury. The journal explains that women might be more likely to
injure their ACL’s because because of the position of their pelvis and hip. During a squat, it has
been observed that women have a slight internal rotation, which can put women at a higher risk
for ACL injury. Additionally, women have naturally weaker ACL’s. The female ACL is
typically smaller, therefore, easier to tear, unless there is effort made to strengthen the ACL, and
because women are typically more hypermobile, the female athlete is more likely to tear her
ACL. Because a female athlete is hypermobile, her joints can hyperextend, especially in the
knee, and she can tear her ACL. In addition to the female having a naturally weaker ACL, the
female athlete is more likely to tear her ACL because women are found to be less effective in
stiffening their knees. The the ACL is loose, it is more likely to tear.
Application to Research
This journal benefits my research by collecting several pieces of information for a wide
variety of sources and condensing them into one journal. So far in my research, I have learned
that women are more likely to tear their ACL, but I didn’t know why. This source was able to
provide several reasons, as well as information to support why women are more likely to suffer
an ACL tear.

IUHealth. (2013, September 27). ​Prevent ACL injuries | iu health​ [Video file]. Retrieved from
https://www.youtube.com/watch?v=76Y6KQ2ipbE
Summary: Video
This video was created to inform female athletes about the potential risk of ACL tear and
provides exercises for how to prevent this from happening. First, the video goes over proper
squat technique. When a squat is being performed, the knees should not cave in. If they do, an
athlete has weak knees and needs to strengthen them, or they are at risk for acl injury. Next the
video talks about landing technique. After landing from a jump, one should land with the proper
squat technique, using the glute muscles to control the knees when landing. Lastly, the video
gives an example of a plyometric exercise that can strengthen the legs and knees.
Application to Research
I will use this video to help me with my research because it demonstrates proper landing
and squat technique and improper technique. I can use this for my research because when i
possibly write my own program I can put in pictures with the proper technique.

My Doctor - Kaiser Permanente. (2014, April 1). ​ACL injury prevention exercise program - after
practice cool down​ [Video file]. Retrieved from
https://www.youtube.com/watch?v=CKa1svu1__I
Summary: Video
This video is a walkthrough of stretches that should be done post practice to help prevent
ACL injury. The video provides a demonstration and directions for each exercise. The first
stretch is a hamstring stretch. The second is a kneeling hip flexor stretch. Next the video moves
onto a standing quad stretch and then a standing calf stretch knee straight. The video then
finishes with a standing calf stretch knee bent stretch.
Application to Research
This video benefits me research because I don't have that much information yet about
post practice injury prevention. I can use this video to help me pick a post practice cool down
part of my prevention program.

Noyes, F., & Barber-Westin, S. (2015). Neuromuscular retraining in female adolescent athletes:
Effect on athletic performance indices and noncontact anterior cruciate ligament injury
rates. ​Sports,​ ​3(​ 2), 56-76. https://doi.org/10.3390/sports3020056
Summary: Journal
This journal writes about a study tested the effects of a neuromuscular training program
on female athletes to prevent ACL injury. The study consisted on 1000 female athletes in the
experimental group and 1120 female athletes in the control group. All of the athletes were aged
13-18, and only 700 if the 1000 athletes were compared to the control group. At the end of the
experiment, the experimental group had significant improvements in the drop-jump test, the
single-leg triple crossover hop, the ​t​-test, the multi-stage fitness test, hamstring strength, and
quadriceps strength. Additionally, the experimental group only experienced one ACL injury,
whereas the control group experienced 13 ACL injuries.
Application to Research
This journal helps me with my research because it examines more neuromuscular training
and shows very positive results. I can use this for my final paper when I am arguing that
neuromuscular training is beneficial to ACL injury reduction.

Plummer, J. (2019, January 15). [Personal interview by the author].

Summary: Interview
This interview was conducted by myself on January 15th. I interviewed Josh Plummer, a
physical therapist at Impact Sports Physical Therapy. During the interview, we discussed first
what is the biggest difference between the female and male anatomy. Josh said that the biggest,
most important difference is the differences in strength. Men build and gain muscle mass better
than females, which protects them from ACL injury. Next, we discussed preseason and in-season
training, in-which Josh suggested having both, but preseason should be more intense training and
in-season training should be lighter.
Application to research
This helps my research because it fills many gaps from before. The interview taught me
that a preseason and in-season component is necessary for an ACL prevention instead of just a
preseason one like most sources say. Additionally, I learned that an ACL prevention program
should focus on strength for females. I will use this in my final paper and when I make my ACL
prevention program.

Smith, G., Myer, G., Sugimoto, D., Petushek, E., & Stoolmiller, M. (2018). Evidence-based
best-practice guidelines for preventing anterior cruciate ligament injuries in young female
athletes: A systematic review and meta-analysis. ​The American Journal of Sports
Medicine​. https://doi.org/10.1177/0363546518782460
Summary: Journal
This journal was about the evaluation of several different different ACL prevention
programs. The authors found that the average time for ACL prevention programs were
performed ​24.1 minutes per session, 2.51 times per week. Additionally, throughout several
different sources, the researchers were able to find out an overall trend that ACL prevention
programs were effective for college athletes, however, ACL prevention training that was
conducted for middle school and high school athletes was more effective in preventing ACL
injury. Lastly, the researchers concluded that the best exercises to prevent ACL injury consist of
lower body strength training and practicing landing stabilization.
Application to Research
This journal helps me with my research because in addition to learning what other
exercises should be done at an ACL prevention program, I learned that the younger the athlete,
the more effective the program is. Also, I learned what the average ACL prevention program
time period is.

Stevenson, H., Beattie, C., Schwartz, J., & Busconi, B. (2014). Assessing the effectiveness of
neuromuscular training programs in reducing the incidence of anterior cruciate ligament
injuries in female athletes: A systematic review. ​The American Journal of Sports
Medicine​, ​43​(2), 482-490. https://doi.org/10.1177/0363546514523388
Summary: Journal
This journal was the systematic review of 10 different studies testing neuromuscular
training. Of these 10 studies, only two showed significant results for lowering ACL tear rates.
Two more showed significant decrease in the subgroup analyses only. Four more studies did
show a statistical difference in lowering ACL tear rates, however, it was not very significant.
Lastly, two studies showed an increase in ACL rates. It was noticed that programs with a
preseason component and plyometric exercises showed the best results. It was concluded that
NMT programs can be useful, however, current studies that show bad results make it hard for
them to be recommended.
Application to Research
This source will benefit my research because it compares different programs and supports
the idea that a preseason component is necessary and plyometrics also improve the program. I
can go back and look into the programs that caused more injuries and see what the problems and
differences were from good programs. That way I will know what a program cannot include.

Stieg, C. (2018, August 7). Should you stretch before or after a workout? Retrieved from
Refinery29 website:
https://www.refinery29.com/en-us/stretching-before-after-workout-benefits
Summary: Article
This article discusses stretching when it comes to working out. The article first says that a
workout should never start with static stretch. The article reveals that static stretching can
actually be detrimental for working out before a workout. Therefore, static stretching should be
saved for after a workout once the muscles are warmed and flexible. A study was done that
compared static and dynamic stretching before a workout and neither of them affect athletic
performance. Therefore, the conclusion was made that stretching will not affect athletic
performance as long a there is a proper warm up. Next, the article suggests rolling out before a
workout instead of stretching. Rolling out loosens any tense muscles. Finally, the article
concludes that stretching should take place after the workout.
Application to Research
This article will help me in the long run with my research. At the end of the year when
we have to create something to showcase our research, I plan on creating my own ACL
prevention program. When I do this, I will have to to plan my program very carefully and make
sure things are in the right order. This article will help me plan my warmup and cool down
sections of my program.

The 11 the prevention program​ [PDF]. (n.d.). Retrieved from

https://www.kort.com/uploadedFiles/KORT/Content/Services/Sports_Medicine/Concussi
on_Management/FIFA-the-11-Booklet.pdf
Summary: Book
This program is an ACL prevention program that I found through my previous source.
The 11 is a soccer bases ACL prevention program that is intended to be completes post warm-up,
during the season and includes a shortened version that should be done pregame. This program is
supposed to prevent ACL injury by stretching the important muscle groups. Training includes
core stabilization, eccentric training of thigh muscles, proprioceptive training, dynamic
stabilisation and plyometrics with straight leg alignment.
Application to Research
This source helps my research because the previous source said that this ACL prevention
program is insufficient in actually preventing ACL injury. This will benefit me because I can
compare an insufficient program to one that works well and compare the differences between the
two.
The PEP program: Prevent injury and enhance performance​ [PDF]. (n.d.). Retrieved from
https://www.aclstudygroup.com/pdf/pep-program.pdf
Summary: Book
This source is a an example of an ACL prevention program. The name of this one is the
Prevent Injury and Enhance Performance, also known as the PEP program. The program consists
of a warm up section, strengthening, plyometrics, and sport specific agilities sections. These
exercises will help to stabilize and strengthen the knee joint. Proper technique is necessary
during the program to ensure that progress is being made and incorrect techniques are being
corrected. The program should take around 15-20 minutes and should be performed three times
per week. Next, after the explanation of the program, the actual program is there, including the
exercises and reps.
Application to Research
This resource benefits my research because it provides me with an example of a real ACL
prevention program. I can use this because when I am looking into creating my own program I
can use this one as an example that displays what kinds of exercises should be included.

Voskanian, N. (2013). Acl injury prevention in female athletes: Review of the literature and
practical considerations in implementing an ACL prevention program. ​Curr Rev
Musculoskelet Med​, ​6​(2), 158-163. https://dx.doi.org/10.1007%2Fs12178-013-9158-y
Summary: Journal
First, the journal starts by saying the reason that noncontact ACL injuries are more
common. The reason for that is mostly from technical errors such as landing technique. In order
to fix these problems, ACL prevention programs should include muscle strengthening, muscle
recruitment patterns, ​landing and decelerating patterns, proprioception, and plyometrics.
Additionally, studies have shown that balance training reduces ACL injury risk in combinations
with other prevention exercises, not alone. Next the journal gets into NMT and explains how it
helps prevent injury through the explanation of a study. Last, the journal goes through key
elements of an ideal ACL prevention program. These elements include:
● Prior to puberty (prevents incorrect landing methods from developing)
● neuromuscular training/control, muscle strengthening, and plyometrics
● education and feedback regarding body mechanics and proper landing patterns
● Completed in the preseason
● At least 15-20 mins per session 3x per week
● Still worked on in the season to maintain proper technique
● Strengthens the hamstrings, hip abductors, glutes
Application to research:
I found this journal helpful because it provided me with information I have not learned
yet. For example, I did not know much about what non contact injury meant and how it
happened before. Additionally, this source gave a good list from several different sources for the
most ideal ACL prevention program conditions.

Webb, Jeff. (2011). ​ACL injury preventio​n [PowerPoint slides]. ​Retrieved from
http://ctaeir.org/Unit%20Plan/Physical%20Medicine/Principles%20of%20Physical%20
Medcine/HS_PPM_3/HS_PPM_3_ACLInjuryPreventionPresentation.pdf
Summary: Powerpoint
 This powerpoint provides information as to why women are more prone to tearing their
ACL’s and gives several ways to help prevent ACL injury. One of the slides explains that
women are more likely to tear their ACL’s mostly because of their generally lower lean body
mass, and smaller ACL sizes. Women can not do much to change these factors, besides build
more muscle, but there are ways to prevent ACL injury. In order to prevent ACL injury, the
power point says one should wear the proper footwear/cleats and women can take prevention
hormones. Additionally, the powerpoint talks about a study done by D1 basketball athletes.
Through this study, it was discovered that ACL prevention programs reduced ACL injury by
89%, thus making these prevention programs the most effective method of ACL prevention.
Application to Research
With this powerpoint, I not only learned that women tear their ACL’s easier than men do,
but I also learned why. Additionally, I learned how effective ACL prevention programs can be.
With this information, I want to further research different types of ACL prevention programs,
what occurs at the programs, and different studies. As well as prevention programs, the ideas of
correct footwear and prevention programs are completely new to me as a method of ACL
prevention. Therefore, I want to further investigate these methods as well.

Previous Topic

Bellenir, K. (2008). Knee injuries. In K. Bellenir (Ed.), ​Teen Health Series: Sports injuries
information for teens​ (2nd ed., Vol. 2, pp. 205-215). Omnigraphics.
Summary: Book
This book provides basic knowledge for people who are trying to learn about ACL and
knee injuries. The book gives knowledge about the ACL, and shows a diagram of the knee and
other ligaments in it. Additionally, the book talks a little bit about how the ACL can be torn
along with other knee injuries and tears.
Application to research
This book benefits my research because it provides basic information about the ACL that
people need to know before they learn about ACL prevention programs. I can use this book in
my paper to provide background information in the introduction or when I introduce a new topic.

Boguszewski, D., Szkoda, S., Grzegorz Adamczyk, J., & Białoszewski, D. (2015). Sports mass
age therapy on the reduction of delayed onset muscle soreness of the quadriceps femoris.
Sciendo​, ​15​(4), 234-237. https://doi.org/10.1515/humo-2015-0017
Summary: Journal
This journal was about an experiment experiment took a look at the correlation between
massage therapy and the reduction of soreness from physical activity. Massage therapy is a type
of physical therapy that can be used to treat athletes. Massage therapy can be done after
workouts for the purpose of reducing soreness and injury as a result from overtraining. In the
experiment, there were two groups of women. Both groups had to complete the same exercises,
however, one group had massage therapy treatment about two hours after their workouts each
day. At the end of the experiment, it was concluded that massage therapy does help to reduce
pain. The women in the experimental group shared that they had little pain after days of
workouts and massage therapy, meanwhile the control group had reported they experienced a lot
of pain.
 Application to research
With this information, I have learned about massage massage therapy. Before for my
research, I had only thought about stretching as a way athletes could protect themselves from
injury and prevent muscle soreness. However, with this new information, I have learned another
way athletes can achieve a more painless workout. Next for my research, I would like to learn
how athletes can conduct their own massage therapy at home instead of having to see a physical
therapist after workouts.

Dunderdale, P., Edmonson, B., & Sweeney, E. (Directors). (2009). ​ACL tissue​ ​engineering
[Video file]. Retrieved from https://www.youtube.com/watch?v=F7WTe7_m76g
Summary: Video
This video provides several methods of surgical ACL reconstruction such as an
autographed or allograft ACL. An autographed ACL is the use of the patient's own tissue to
recreate or repair the ACL. Different autograph procedures include the bone patellar bone
procedure, using the hamstring tendon, and using the quadriceps tendon to repair the ACL.
Allografts procedures are more complicated. Different procedures include using soft tissue
harvested from human donors, harvested patellar tendon, and harvested achilles tendons.
Allograft procedure have a higher risk of disease transmission because they come from donors,
and deterioration of the graft if it is rejected. Due to advantages and disadvantages of these
procedures, tissue engineers are trying to find different ways to repair the ACL such as using
new cells to grow a new ligament, biocompatible scaffolds. Using stem cells still requires more
research, however, biocompatible scaffolds have often times been rejected by the body,
therefore, scientists are working on finding new scaffolds to use, such as silk. Silk scaffolds
currently show the most promise and success, however, more research is necessary on all
methods.
​ Application to Research
This video is very helpful for my research. This source gave me a great overview of
several kinds of ACL reconstruction, as well has in depth descriptions I was able to understand.
The video also explained newer methods that need to be further researched that I can look into.
With this new information, I can use the methods listed to further my research and learn what is
the best surgery to use for different tears.

McGrath, C. (2013, October 3). Why you should be foam rolling. Retrieved from American
Council on Exercise website:
https://www.acefitness.org/education-and-resources/lifestyle/blog/3543/why-you-should-
be-foam-rolling?utm_source=Rakuten&utm_medium=10&ranMID=42334&ranEAID=T
nL5HPStwNw&ranSiteID=TnL5HPStwNw-2iiF7Fl_2nP66dfqRuuyUw
Summary: Article
The article first opens up by talking about the recent popularity surrounding foam rolling
before workouts. Next the article explains what foam rolling does. Foam rolling is a great way to
get out knots in your muscles to become looser and help prevent injury. When someone foam
rolls, they need to learn how to control the pressure of the roller, really tight areas will not
become loose with one rolling, this has to happen over several sessions. Additionally, one should
first find their trigger points and devote more time and attention to them when rolling. Next, the
article says that foam rolling can be done both before and after a workout, and that people should
make sure not to over roll something because this can result in a muscle becoming too relaxed.
Application to Research
Similar to my previous source, I found this source keeping in mind what I want to
accomplish in the future. I was debating whether or not to incorporate foam rolling into my
program. I still am not sure if it’s necessary or not but I will come back to this later.

Schrupp, B., & Heineck, B. (Directors). (2016). ​How flat feet can damage feet knees, & hips
(how you can stop it)​ [Video file]. Retrieved from
https://www.youtube.com/watch?v=K7y1tU8UhTA
Summary: Video
This video informed the viewer on the connection between flat feet and knee injury, as
well as how to prevent flat feet from causing injury. Flat feet are the result of the arch of the foot
being to flat, and on the ground. When someone has flat feet, their knees can face somewhat
inward. As a result, ligaments such as the ACL are stressed and are put at a high risk of injury.
Although someone can have naturally flat feet, there are methods one could take to prevent
injury. The most important method of protection for someone with flat feet is proper footwear.
Someone with flat feet should be wearing shoes with thick, hard to bend souls that also have the
proper arch support. Proper shoes can help prevent damage and injury caused by flat feet.
Application to Research
This video, from two licensed physical therapists, helped to introduce me to another
problem can can cause certain people to be more at risk for ACL injury. Additionally, the video
taught me how this problem can be solved. This video will help me towards my research because
I am researching ACL tear prevention methods, and this video identifies both a problem, and a
solution.

Sharifzadeh, S. R., Shahrezaee, M., Okhovatpour, M. A., Boroujeni, S. A., & Banasiri, M.
(2017). Comparison of the effectiveness of femoral fixation techniques (aperfix and
endobutton) in anterior cruciate ligament surgery: A clinical trial in men with complete
anterior cruciate ligament rupture. ​Australasian Medical Journal,​ ​10(​ 9), 816-820.
https://doi.org/10.21767/AMJ.2017.3138
Summary: Journal
This journal was about researchers who tested the differences in effectiveness and post
surgical knee function between the two surgery methods, aperfix and endobutton, for ACL
reconstruction surgery. The researchers took a group of 100 individuals who needed ACL repair
surgery. These 100 individuals were randomly placed into two different groups, one would
receive aperfix surgery, and the other endobutton surgery. A year after the surgery, lysholm as
well as IKDC scores were measured. The researchers were able to conclude that the aperfix
method of surgery outperformed the endobutton method of surgery. Although the aperfix surgery
showed better results, the gap between the two surgeries was very small, therefore, there was an
actual small difference between the two surgical methods.
Application to Research
With this article, I was able to learn that certain methods of ACL repair surgery make
little difference in the outcome after ACL repair surgery. This related to my topic because there
are many different surgical methods and I want to learn which ones are the most efficient. The
research in this journal was strong enough to support the difference between the two surgical
methods, however, I need to conduct more research on other surgical methods and learn if they
impact the outcome after surgery.

Souissi, S., Wong, D. P., Dellal, A., Croisier, J.-L., Ellouze, Z., & Chamari, K. (2011).
Improving functional performance and muscle power 4-to-6 months after anterior
cruciate ligament reconstruction. ​Journal of Sports Science and Medicine,​ ​10(​ 4),
655-664. Retrieved from Directory of Open Access Journals database.
Summary: Journal
This journal was about a group of researchers attempt to improve knee function after
ACL reconstruction surgery at a faster pace than the typical methods. The researchers in this
experiment had a control group and an experiment group. The experimental group after ACLR
was given a physical therapy plan that involved a two hour, two times a week physical therapist
visit. At their appointments, they had a rigorous more fast paced plan. However, in the control
group, they had the standard three time a week for two hour plan, but this plan moved at a much
slower pace than the other. After months of these plans, the more fast pace plan seemed to be
more effective. When the researchers conducted several athletic tests that tested knee function,
the group with the two times a week plan had performed much better on these tests.
Application to Research
After reading this article, I know for sure that there are different methods of physical
therapy after ACLR, and some prove to be more effective than others. With this new knowledge,
I am now questioning if there is a way to speed up recovery, instead of just making the knee
stronger. In addition, I wonder if the knee would be able to handle this rigorous plan at three
times a week or at the two times a week with an additional easier day. With these new questions,
I am able to look for more in-depth research.

Yates, E. W., Rupani, A., Foley, G. T., Khan, W. S., Cartmell, S., & Anand, S. J. (2012).
Ligament tissue engineering and its potential role in anterior cruciate ligament
reconstruction. ​Hindawi​, ​2012​, 1-6. https://doi.org/10.1155/2012/438125
Summary: Journal
This journal explained the new idea of ligament tissue engineering. Ligament tissue
engineering is a new study that could possibly vastly improve the recovery of ACL and other
ligament tears. The theory is that stem cells could be added to an injured ligament, which would
then turn into the correct ligament fibroblasts in order to repair the ACL, avoiding surgery and
minimizing recovery time. So far, successful experiments have been ran on animals such as pigs
and rabbits, but scientists are still yet to experiment on humans. They want to further research the
topic and run more experiments before the attempt a human experiment.
Application to Research
With this journal, I have learned about new ways scientists are trying to research ACL
repair. Before reading this journal, I was unaware of ligament tissue engineering as a whole, but
now I am aware it could possibly help not only ACL tears, but other ligament tears as well. With
this new information, I want to look more into this topic, and the way stem cells turn into
fibroblasts. Additionally, I also want to know if the repair could be strong enough to heal a
human ACL.