Welcome to the first part of our 15th blog interview series! This week, we had the privilege of speaking with Craig Twentyman, a renowned expert in athletic performance. Craig boasts an impressive track record, having served as Head of Athletic Performance for the Australian and New Zealand Women's Rugby teams. His notable achievements include a gold medal at the 2016 Olympics and a World Cup victory in 2022. Craig's innovative strength and conditioning programs have significantly minimized ACL (anterior cruciate ligament) injuries among women rugby players. Currently, he is the Head of Athletic Performance at Alinghi RedBull Racing America’s Cup Sailing team.
Craig Twentyman
Tears and injuries of the anterior cruciate ligament (ACL) in the knee are reaching epidemic levels in youth sports. According to the National ACL Injury Coalition, ACL injuries among high school athletes have grown 26% over the past 15 years.To what causes can we attribute this?
There are many different theories on why we are seeing this upward trend in significant knee injuries occurring at this youth level.
Some observations of the current picture of youth sport & some questions we need to explore further are listed below for consideration & to create further discussion-
- Kids are being bought into organised sporting environments earlier than they used to be & are being exposed to organised sport specific trainings at a younger age.
- With longer seasons & many talented youth athletes being pulled in many different directions from the 2/3/4 sports they play all wanting a piece of them are we doing a good enough job of monitoring overall workload? Not just within the same sport (ie: school vs club in the same sport) but between different sports (ie: rugby vs basketball vs football). In my experience at the youth level the answer is no & the best interests of the athletes are not the priority consideration.
- Where is their time to undertake any significant period of general preparation? They may go from in-season in a summer sport straight into a pre-season of a couple of winter sports but these pre-seasons are becoming less about any significant general prep & more about earlier & earlier specific prep.
- With the time demands of training & playing multiple sports at school as well as in their club academies do kids undertake any unstructured play anymore at school or after school? Do they have the energy or time to play touch, football, ball tag, dodge ball or bullrush with their mates at lunch times or after school? This is where fundamental movement skills & physical capacities are developed without the pressure to perform. Kids joke around while practicing both specific & non-specific skills which add to their movement literacy. Without being grouped into position specific work as they may be in their school or academy trainings kids have more opportunity to practice a range of skills & train a broad range of physical capacities in ways that they may when in structured trainings. Pick-up unstructured games also teach kids important cognitive skills such as field scanning & decision making as well as other important aspects of teamwork.
- Are coaches too focussed on training kids like mini adults? Are we too concerned with seeing improvements in numbers & times at this level instead of prioritising movement pattern development, coordination & encouraging young athletes to solve a broad range of movement problems.
Girls are more than twice as likely to have an ACL injury than boys. Why?
2 aspects of biomechanics & physiology which are unique to females vs males MAY increase the risk of a female suffering an ACL injury-
- During puberty there is a change in width of the female pelvis which changes the anatomical alignment of femur & tibia, increasing the Q angle
- Related to the unique hormonal profile across a female’s menstrual cycle several studies have identified a greater risk of ACL injury occurrence in the late follicular/ovulatory phase when estrogen concentrations are highest (e.g.,Wojtys et al., 2002; Beynnon et al.; Ruedl et al., 2009), potentially due to increased ACL laxity (Chidi-Ogbolu and Baar, 2019)
Female athletes must be provided the same access as their male counterparts to training facilities & qualified strength & conditioning coaches to ensure they are following a physical development plan which is designed to enhance lower body strength, power & neuromuscular coordination to ensure they are prepared to withstand the physical demands of their chosen sport. Team sport athletes must be prepared to perform in a chaotic high-speed environment & training/preparation must reflect a well-planned & coached process that ensures as many bases are covered so the athlete doesn’t just survive but can thrive in training & games across a multi-week pre-season & in-season.
Stay tuned! This week, we’re excited to bring you the second part of our interview series, where we delve into effective strategies for preventing ACL injuries and minimizing risk for young athletes.
