Healthcast: ACL Reinjury Prevented by PEP


Orthopedic surgeons started noticing an alarming trend years ago: more and more young female athletes were tearing their ACL’s, and then re-tearing them after surgery and rehab. Bert Mandelbaum, MD, an orthopedic surgeon at Santa Monica Orthopaedic & Sports Medicine Group and co-chair of medical affairs at the Kerlan-Jobe Institute in Los Angeles, spent years figuring out why that happens in girls so much more often than it does in boys. He’s found an answer and has developed a program to keep it from happening in the first place.

Jaimie Goodwin has been a regular on “So you Think you Can Dance” for years. In that time, she’s torn her ACL three times, most recently during taping last year.

“More and more, I saw myself slipping out of alignment when I was dancing and jumping, and then one night I lay down and pushed myself up and my knee just popped right out,” Goodwin said.

This time, Dr. Mandelbaum helped her. His research found that five to 25 percent of young female athletes will re-tear their ACL’s after surgery.

Dr. Mandelbaum said, “The major factor was complex neuromuscular control. The way young girls have been programmed, hardwired to land and jump.”

Dr. Mandelbaum calls it Dynamic Valgus. The femur is internally rotated, pushing the leg out of alignment and overloading the knee, often tearing the ACL.

He’s retraining athletes to move safely, like Goodwin. In a demonstration, her leg is aligned from hip to foot, supporting and protecting her knee.

Goodwin used Dr. Mandelbaum’s “hip strategy” to rehab. It’s a program of plyometrics, stretching, muscle balance, and hip strengthening that works for all kinds of athletes.

“We want them to habituate their bodies to a whole different level of function, to relearn how to land, jump, decelerate in a more safe fashion,” Dr. Mandelbaum explained.

Dr. Mandelbaum said it’s effective. He saw an 88 percent reduction in ACL tears in year one of a study, 74 percent in year two.

Goodwin told us, “I think that alone has totally reset my foundation and I feel much safer moving in to my dance career from here.”

Dr. Mandelbaum’s preventing injury, enhancing performance or “PEP” program is a 15 to 20 minute warm-up that’s been embraced by all levels of athletes, even pro soccer players with FIFA. The NFL is taking a look at it now. Anyone can get it for free on his practice’s website:  

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