As with primary ACL injuries, the majority of secondary ACL injuries occur through non-contact mechanisms (Wright et al, 2010).  This strongly suggests that there are underlying intrinsic, neuromuscular factors contributing to the injury risk.  Multiple studies have demonstrated the effectiveness of neuromuscular retraining in the prevention of secondary ACL injuries (Hewett et al, 1996; Hewett et al, 1999; Myer et al, 2007). This is believed to be related to enhancing athletes function and movement behaviours early after the injury, as well as improving function and movement behaviours following ACLR (Chmielewski et al, 2005; Risberg et al, 2007; Di Stasi et al, 2012).

To facilitate the athlete’s progression through the challenging running, agility, and landings phase, we have developed the kNee Eeducation for Healthy Active Bodies (NE HAB) as a means of providing internal and external feedback and encouraging the athlete to assess their own technique.  This program is designed to teach the athlete about how to effectively recruit lower fibers of gluteus maximus, how to avoid dynamic knee valgus, and how to critique their own jumping, landing and cutting patterns.

NE HAB consists of five different functional activities evaluating the athlete’s knee function during the rehabilitation period. Both the patient and the therapist independently and simultaneously evaluate the athlete’s ability to perform functional tasks. The NE HAB program is incorporated to educate the athlete about correct landing, cutting, running, hopping, and jumping techniques, neuromuscular control, and correct muscle activation; allowing them to assess their own functional performance. NE HAB will be conducted by the therapist at monthly intervals during phase 3 to provide feedback on technique and areas to develop.