A DOSE OF PREVENTION.

Byline: Curtis Anderson The Register-Guard

WILLAMETTE'S DENISE HILL has watched the video a hundred times.

Yet, the 6-foot senior still winces slightly when she views the tape and sees her knee pop out of joint as she crashes to the floor on a hard drive to the basket during a girls basketball game against Sheldon in late January.

The two-time Midwestern League MVP managed to break her fall with her left wrist, but she could only imagine the worst as she lay crumpled on the floor with Willamette athletic trainer Jeanne Bullock hovering over her.

`It happened so fast, I felt my knee pop out and I immediately thought my ACL was gone,' Hill said. `The pain wasn't that bad, but it scared me more than anything. I thought my season was over.'

As it turned out, Hill's season wasn't over.

Although she missed several games with a broken wrist, her knee was intact. There was some initial soreness and swelling, but a subsequent MRI showed only a bone bruise, with no damage to the ligaments.

The reaction in the Wolverine training room? Lots of high-fives.

`We did the ACL prevention dance,' Bullock said.

`The fact that she didn't hurt herself more seriously is a true testament to her strength.'

It also owes a debt to a `leg workout' that Bullock incorporated into the school's basketball class in the fall as a preventive measure to help fight a rash of anterior cruciate ligament injuries that plagued the Wolverines girls basketball program during the previous season.

Three varsity players went down with ACL injuries either before or during the 2001-02 season, compared with none this year after the implementation of the leg workout.

`Studies show that preventive programs reduce the risk (of ACL injuries) almost three times in female athletes,' Bullock said. `Did we get lucky this year? You bet. This is the pilot program, and if anything, it made these girls more aware of their bodies and they totally loved it ... it's not the cure-all, but it's a way of doing something pro-active.'

Numerous studies have documented that females are two to eight times more likely than males to tear the ACL ligament, especially in high-risk sports such as soccer, basketball and volleyball. However, there is no definitive reason why.

Some researchers speculate that high estrogen levels in the mid-point of the menstrual cycle may soften and stretch ligaments slightly, but whether this makes them more vulnerable is disputed.

Others point to muscular imbalance and differences in jumping, landing and pivoting.

Dr. Frank Noyes, director of the Cincinnati Sports Medicine and Orthopedic Center, states that females tend to rely on their quadriceps when performing those activities, while males depend more on their hamstrings.

Because the hamstring muscles are more protective of the ACL, that muscular imbalance is considered a risk factor in knee injuries. Studies also show that females tend to run, jump and land in a more upright position than males.

While medical experts remain puzzled on the degree to which each of these factors affect the likelihood of ACL injuries, they do agree there are preventive measures that can be taken to lower the risk.

At Willamette High School, Bullock was spurred to action when Keri Seidemann, Siena Ranuio-Nunes and Stacy Cordell all had their basketball seasons end prematurely with ACL tears.

After consulting with Grace Golden, an athletic trainer and strength and conditioning coach who is working on her doctorate in exercise physiology at Oregon State University, Bullock's leg workout began to take shape.

The workout uses a variety of leg exercises - body weight squats, lunges, step-ups, jump squats and knee drives - to build strength and endurance and increase balance and flexibility.

By videotaping the workouts, Bullock also showed each athlete what she was doing right and wrong in relation to body positioning.

`It didn't take long before I could feel and see the difference,' said Hill, who will play basketball at Boise State in the fall. `I actually saw some quad definition for once in my life.'

Paul Brothers, the Willamette girls basketball coach, was so enamored with the program that when basketball class ended at the conclusion of the academic term, he sacrificed practice time to keep the leg workouts going.

`That was a valuable program for us,' Brothers said. `If you see the video of Denise's injury, and how ugly and brutal that thing was, and the fact she didn't tear the ACL, you have to give at least partial credit to that program.

`In the last month of the season, when the basketball class no longer existed, we gave up practice time in order for (Jeanne) to continue the program because we felt so strongly that it was doing our kids a lot of good.'

Among girls basketball teams in the Midwestern League, Willamette, Sheldon and Marshfield got through this past season with no ACL tears among their players.

On the other end of the spectrum, Springfield lost four players to ACL injuries, three in basketball and one in soccer. Lebanon and South Eugene each had three players go down with ACL injuries, and Churchill, Thurston and North Eugene lost one apiece.

In athletics, there will always be a risk of injury, but as Bullock and her student-athletes discovered, there is something you can do about it.

CAPTION(S):

Willamette's Denise Hill went down hard and her knee popped out of joint during a girls basketball game in January, but the senior avoided serious injury thanks, at least in part, to a leg workout trainer Jeanne Bullock designed for the team. Bullock tends to Hill after the Willamette star went down Jan. 23. Hill avoided a serious ACL injury, as did the entire team this past season. `We did the ACL prevention dance,' Bullock said of learning that Hill's injury was not serious. Wayne Eastburn / The Register-Guard `If you see the video of Denise's injury, and how ugly and brutal that thing was, and the fact she didn't tear the ACL, you have to give at least partial credit to that program. PAUL BROTHERS WILLAMETTE GIRLS BASKETBALL COACH