Knee injuries may start with strain on the brain, not t...( ANN ARBOR Mich.---New research shows...)

ANN ARBOR, Mich.---New research shows that training your brain may be just as effective as training your muscles in preventing ACL knee injuries, and suggests a shift from performance-based to prevention-based athletic training programs.

The ACL, or anterior cruciate ligament, is one of the four major ligaments of the knee, and ACL injuries pose a rising public health problem as well as an economic strain on the medical system.

University of Michigan researchers studying ACL injuries had subjects perform one-legged squats to fatigue, then tested the reactions to various jumping and movement commands. Researchers found that both legs---not just the fatigued leg---showed equally dangerous and potentially injurious responses, said Scott McLean, assistant professor with the U-M School of Kinesiology. The fatigued subjects showed significant potentially harmful changes in lower body movements that, when preformed improperly, can cause ACL tears.

"These findings suggest that training the central control process---the brain and reflexive responses---may be necessary to counter the fatigue induced ACL injury risk," said McLean, who also has an appointment with the U-M Bone & Joint Injury Prevention Center.

McLean says that most research and prevention of ACL injuries focuses below the waist in a controlled lab setting, but the U-M approach looks a bit north and attempts to untangle the brain's role in movements in a random, realistic and complex sports environments.

The findings could have big implications for training programs, McLean said. Mental imagery or virtual reality technology can immerse athletes to very complex athletic scenarios, thus teaching rapid decision making. It might also be possible to train "hard wired" spinal control mechanisms to combat fatigue fallout.

In a related paper, McLean's group again tested the single leg landings of 13 men and 13 women after working the legs to fatigue. W
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