ACL Injuries | Why I Think It's Easy to Miss the Point. (ft. Nic Naitanui)

Dec 29, 2008
3,181
6,188
Mornington Peninsula
AFL Club
Hawthorn
Hey all,

I'm not sure if these posts get annoying, but I'm back with what I think is a really important one.

For those who don't know, I'm a big fat nerd of a Physio whose passionate about uncovering the true cause of injuries.

Following Nic Naitanui's most recent ACL misfortune, I've decided to pen some thoughts on what I think my industry is missing with these shitty, shitty injuries.

From my experience I think we collectively lack the necessary perspective to truly put a cork in them. Hopefully I can shed some light on what I think we are missing with the help of Nic Nat.

If interested, please feel free to click through and have a read.

I'd appreciate any feedback and welcome any and all questions and discussion.

I'll post this in a few forums so please forgive me if it becomes a bit tedious. Hopefully it doesn't because the feature image took me half a bloody day to put together!

Cheers.

http://yourwellnessnerd.com/definitive-acl-injury-guide/

The-Definitive-ACL-Injury-Guide.png
 
Last edited:

Kent Brockman

Team Captain
Aug 22, 2015
454
1,624
AFL Club
Brisbane Lions
Hey all,

I'm not sure if these posts get annoying, but I'm back with what I think is a really important one.

For those who don't know, I'm a big fat nerd of a Physio whose passionate about uncovering the true cause of injuries.

Following Nic Naitanui's most recent ACL misfortune, I've decided to pen some thoughts on what I think my industry is missing with these shitty, shitty injuries.

From my experience I think we collectively lack the necessary perspective to truly put a cork in them. Hopefully I can shed some light on what I think we are missing with the help of Nic Nat.

If interested, please feel free to click through and have a read.

I'd appreciate any feedback and welcome any and all questions and discussion.

I'll post this in a few forums so please forgive me if it becomes a bit tedious. Hopefully it doesn't because the feature image took me half a bloody day to put together!

Cheers.


LINK: https://bit.ly/2mNg6iw
5479ec6109dd217061bf2a8ed861f289.jpg

Your previous article about Jaeger was an excellent read. Looking forward to this one too.
 

mouncey2franklin

Norm Smith Medallist
Jun 16, 2018
8,644
15,438
AFL Club
North Melbourne
Thank you for sharing this.

I remember your post about Cyril, I didn't have a bigfooty account back then, but it was brilliant work.

You got my thinking about my own biomechanics, the way that I sit, and how this may be affecting the rest of my body and health.

Truly you are doing good work.

This latest piece is just as interesting. Like you, I wonder how things like ACLs can just be put down to 'luck'.

Did you have to dig far through the players' social media accounts to find those photos of their squat form?

Also I see on your site, it says you are now based in California. When did you move there, and why?
 
Dec 29, 2008
3,181
6,188
Mornington Peninsula
AFL Club
Hawthorn
Thank you for sharing this.

I remember your post about Cyril, I didn't have a bigfooty account back then, but it was brilliant work.

You got my thinking about my own biomechanics, the way that I sit, and how this may be affecting the rest of my body and health.

Truly you are doing good work.

This latest piece is just as interesting. Like you, I wonder how things like ACLs can just be put down to 'luck'.

Did you have to dig far through the players' social media accounts to find those photos of their squat form?

Also I see on your site, it says you are now based in California. When did you move there, and why?

Thanks for the kind words.

I didnt really have to dig too far as once you're looking for something its relatively obvious.

I moved to California about 6 weeks ago as my wife's a bit ill and she needs treatment she cant get back home.

Not all bad, I can still stalk Insta accounts from here and my tan's getting the Terry Wallace treatment atm!
 
Aren't the insta photos a bit of a stretch. I can easily do what you term as a normal squat but would never pose for a photo like that because it'd look psychotic.

On the other hand, the footage of Nic's training session is pretty damning. Or should I say, it's clear his knees are just about knocking together at times, and it's damning that seemingly nobody set about helping him fix those mechanical flaws.

You say you'd like to see another video of Naitanui in 6-9 months with more give in those ankles, what is the likelihood of this? After reading your article I'm pretty pessimistic, thinking he'll just be given more of the same rehab (weights, jumping on trampolines, somersaulting over gym mats) that don't address the core issue.
 
Dec 29, 2008
3,181
6,188
Mornington Peninsula
AFL Club
Hawthorn
Aren't the insta photos a bit of a stretch. I can easily do what you term as a normal squat but would never pose for a photo like that because it'd look psychotic.

On the other hand, the footage of Nic's training session is pretty damning. Or should I say, it's clear his knees are just about knocking together at times, and it's damning that seemingly nobody set about helping him fix those mechanical flaws.

You say you'd like to see another video of Naitanui in 6-9 months with more give in those ankles, what is the likelihood of this? After reading your article I'm pretty pessimistic, thinking he'll just be given more of the same rehab (weights, jumping on trampolines, somersaulting over gym mats) that don't address the core issue.

Insta photos are absolutely a stretch. As I've mentioned they're a terrible source of evidence but they are there to highlight the point I'm making.

Its great you feel you can deep squat.

If his ankles are as stiff as they look to me its not a hard fix long term. There's more to it than just loose ankles but as an outsider looking in from afar it might be something for the powers that be to look at.

The tricky thing about it is that you can only realise he might have stiff ankles if you're hunting specifically for it. Otherwise it won't stand out. It won't hurt for example.

Again I don't mean to pass judgement on anyone involved with Nic Nats knees but its just symptomatic of what I see everyday.
 
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Benji85

Club Legend
Aug 22, 2013
1,978
3,721
AFL Club
West Coast
Hey all,

I'm not sure if these posts get annoying, but I'm back with what I think is a really important one.

For those who don't know, I'm a big fat nerd of a Physio whose passionate about uncovering the true cause of injuries.

Following Nic Naitanui's most recent ACL misfortune, I've decided to pen some thoughts on what I think my industry is missing with these shitty, shitty injuries.

From my experience I think we collectively lack the necessary perspective to truly put a cork in them. Hopefully I can shed some light on what I think we are missing with the help of Nic Nat.

If interested, please feel free to click through and have a read.

I'd appreciate any feedback and welcome any and all questions and discussion.

I'll post this in a few forums so please forgive me if it becomes a bit tedious. Hopefully it doesn't because the feature image took me half a bloody day to put together!

Cheers.


LINK: https://bit.ly/2mNg6iw
5479ec6109dd217061bf2a8ed861f289.jpg


Great insight and a great read, the Poirot of injuries. Top stuff!
 

Rusty Brookes

Norm Smith Medallist
Aug 9, 2001
6,702
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Preston
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Another great read.

Are there any peer reviewed journal articles looking for the link between stiff ankles and ACLs?

It definitely looks like a line of thinking worth investigating in the least.
 

Leeda

Talents B Sharp
Suspended
Sep 26, 2012
9,443
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AFL Club
Hawthorn
the dude's a defective person for the while so he is off limits.. count out the days till he comes back but he is
done.. do the favour and leave him alone for a while.. shut the driver up for now..
 

dave123

Cancelled
Apr 13, 2010
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Players weigh 100kg plus ...nic would be 115 kg

Jumping like he does he’s going to be vulnerable

Plus he twists like a cat at speed .....

That’s my take
 
Dec 29, 2008
3,181
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Mornington Peninsula
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Hawthorn
Players weigh 100kg plus ...nic would be 115 kg

Jumping like he does he’s going to be vulnerable

Plus he twists like a cat at speed .....

That’s my take

Its an interesting take, and one that filters through a lot of people.

The thing about the human body is that Nic Nat is allowed to be 115kg, jump like he does and land like a cat. Essentially there's more to it as those things shouldnt create a new issue, just expose one.
 

dave123

Cancelled
Apr 13, 2010
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somewhere
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West Coast
Its an interesting take, and one that filters through a lot of people.

The thing about the human body is that Nic Nat is allowed to be 115kg, jump like he does and land like a cat. Essentially there's more to it as those things shouldnt create a new issue, just expose one.
The modern player just puts extreme G force on their joints

We are talking Sherman tanks in terms of builds with Ferrari speed

He’s rank yet moves like a sports car

Something has to give
 

Always Ballin

Social Activist. Freedom Fighter. Feminist.
Jan 11, 2015
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The connection between ankles and knees is well known. In the NFL draft they screen the athletes for flat feet as it is a predisposition for ACL injuries. I can't remember where I read this. Might have been in Supple Leopard years ago.

That's one thing I've always noticed about Nic. He has a lot of valgus knee action landing from his high vertical jumps. Just the way he runs around too looks like he's thudding on the heels a bit too much, and not on the balls of the feet, utilizing the foot musculature.

He's a very hip dominant athlete, like a lot of the Polynesian/Melanesian Islanders are. This is due to their anthropometry and leverages. Strong hips are great for injury prevention, particularly on the knee and ankle... But it seems to me he lacks some anterior chain control/proprioception. His landings are rough.

I'd have him ditch any and all shoes and work barefoot. Do a lot of running in the sand later on in his recovery to really get all the little muscles of the feet and lower legs/shanks working.

Anyways that's my two cents. A mechanical framework is always the best first approach to any sports injury, but the research tells us that it is not everything. Nic can do everything right and still lose. Seeing how he moves I think there's still holes in his physical preparation/rehab/recovery.
 

Godchin

Club Legend
Jan 4, 2015
1,196
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AFL Club
Richmond
I've noticed that he walks/runs with out-toeing of his feet and as Always Ballin mentioned, he also flops his feet around a bit. The other player I've noticed who flops his feet around a lot is Luke Parker who has also had knee issues and like Nic Nat, walks/runs with foot pronation (although he in-toes). Tom Hawkins and Ben Brown both flop around, with Hawkins requiring multiple bouts of knee surgery and Brown doing his ACL when he was younger.

I have a theory that in-toeing is terrible for knees. Daniel Menzel does it and he's had a heap of knee reconstructions. Kurt Tippett, now retired of course, was the other big pigeon-toed player in the comp and his career was riddled with knee and ankle injuries. Steve Johnson had rubbish knees. Lynden Dunn has just done his ACL. Jesse Hogan is the only other player who springs to mind and although he has had a few knee injuries, he hasn't gone through anything serious.

Are you aware of any links between foot pronation or 'floppy' feet and knee injuries?
 
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Dec 29, 2008
3,181
6,188
Mornington Peninsula
AFL Club
Hawthorn
I've noticed that he walks/runs with out-toeing of his feet and as Always Ballin mentioned, he also flops his feet around a bit. The other player I've noticed who flops his feet around a lot is Luke Parker who has also had knee issues and like Nic Nat, walks/runs with foot pronation (although he in-toes). Tom Hawkins and Ben Brown both flop around, with Hawkins requiring multiple bouts of knee surgery and Brown doing his ACL when he was younger.

I have a theory that in-toeing is terrible for knees. Daniel Menzel does it and he's had a heap of knee reconstructions. Kurt Tippett, now retired of course, was the other big pigeon-toed player in the comp and his career was riddled with knee and ankle injuries. Steve Johnson had rubbish knees. Lynden Dunn has just done his ACL. Jesse Hogan is the only other player who springs to mind and although he has had a few knee injuries, he hasn't gone through anything serious.

Are you aware of any links between foot pronation or 'floppy' feet and knee injuries?
Flat feet/overpronation is really common with most lower leg issues as it re-orientates the way the entire leg is loaded. One interesting thing about flat feet is that they are looked at in isolation like most issues.

We look at the feet and see a flat arch and assume the arch is the problem.

But like a lot of issues we see a lot its a symptom of what the broader leg is doing.

If you stand up and have your feet straight, you can use your hips to rotate your knees out. If you have your shoes off you'll notice that if you're feet stay pointing straight your arches will lift.

If you let your knees rotate back in again you'll see the arches collapse again - the same mechanism for a lot of ACLs.

Unfortunately it was the same thing that got Scharenberg yesterday...

Its also highlights why orthotics and arch supportive shoes miss the point because they stop the arch from collapsing, but do nothing to fix the underlying reason why its wants to collapse in the first place.

So in short flat arches are absolutely associated with most knee pain, but its also the catalyst for achilles issues (Ryder), plantar fasciitis (Harry Taylor), shin splints etc. Its important to understand that its another symptom of a broader issues.
 
Jun 14, 2015
17,456
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In a house with a sausage dog Trevor
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Hey all,

I'm not sure if these posts get annoying, but I'm back with what I think is a really important one.

For those who don't know, I'm a big fat nerd of a Physio whose passionate about uncovering the true cause of injuries.

Following Nic Naitanui's most recent ACL misfortune, I've decided to pen some thoughts on what I think my industry is missing with these shitty, shitty injuries.

From my experience I think we collectively lack the necessary perspective to truly put a cork in them. Hopefully I can shed some light on what I think we are missing with the help of Nic Nat.

If interested, please feel free to click through and have a read.

I'd appreciate any feedback and welcome any and all questions and discussion.

I'll post this in a few forums so please forgive me if it becomes a bit tedious. Hopefully it doesn't because the feature image took me half a bloody day to put together!

Cheers.


LINK: https://bit.ly/2mNg6iw
5479ec6109dd217061bf2a8ed861f289.jpg
My questions:

1. Are you really big and fat?
2. Are there a higher number of ACL's at Etihad stadium? I read that somewhere. Is it because the surface is s**t?
 
Dec 29, 2008
3,181
6,188
Mornington Peninsula
AFL Club
Hawthorn
Any interest in the NBA? Reckon a look at Derrick Rose and Jabari Parker would be bloody interesting.

Parker lands very stiff all the time and his knees often hit on landing like at 4:27 here



He's done 2 ACLs.
He's not out of the woods if thats his natural landing pattern. Great find.

Not across the NBA much but the mechanics speak for themselves. The next trick for whoever manages him is to work out if its ankles, hips or low back that create it.

Fix that and not only will the likelihood of protecting those knees skyrocket, but his athleticism will get better again.

Imagine how much force they dump out by letting those knees cave in.
 
Dec 29, 2008
3,181
6,188
Mornington Peninsula
AFL Club
Hawthorn
My questions:

1. Are you really big and fat?
2. Are there a higher number of ACL's at Etihad stadium? I read that somewhere. Is it because the surface is s**t?
1. Not really unfortunately. More phat than fat to be honest.
2. Im not sure on the ETIHAD numbers but its not as important if your mechanics are normal enough going into it. Again, a surface can't genuinely create an issue in isolation - more so just expose a pre-existing one. But the hard thing is most pre-existing mechanical issues arent noticeable beforehand so it absolutely feels like it could.
 
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