PEP program
(Prevent injury and Enhance Performance) 
   This program is in order to implement a strategic training program to decrease the number of lower extremity injuries. This prevention program consists of a warm-up, stretching, strengthening, plyometrics, and sport specific agilities to address potential deficits in the strength and coordination of the stabilizing muscles around the knee joint. It is important to use proper technique during all of the exercises. The coaches and trainers need emphasize correct posture, straight up and down jumps without excessive side-to-side movement, and reinforce soft landings. This program should be completed two to three times a week at least. This program should take approximately 15 minutes to complete. Along side each exercise you will notice a box with the approximate amount of time that should be spent on each activity. This will serve as a guideline to you in order to conduct your warm-up in a time efficient manner. 

1.Warm-up; Warming up and cooling down are a crucial part of a training program. The purpose of the warm-up section is
                                to allow the athlete to prepare for activity. By warm-up your muscles first, you greatly reduce the risk of injury.
A. Jogging Elapsed Time; 0 - .5 minute
      Purpose; Allows the athletes to slowly prepare themselves for the training session while minimizing the risk for injury.
                        Educate athletes on good running technique; keep the hip/knee/ankle in straight alignment without the knee caving
                        in or the feet whipping out to the side.
      Instruction; Complete a slow jog
B. Accerate Running Elapsed Time; .5 to 1 minute
      Purpose; Engage hip muscles (inner and outer thigh). This exercise will promote increased speed. Discourage inward
                        caving of the knee joint.
      Instruction; Start is an athletic stance with a slight bend at the knee. Leading with the right foot, sidestep pushing off with the
                           left foot (back leg). When you drive off with the back leg, be sure the hip/knee/ankle are in a straight line. Switch
                           sides at half field(court).
C. Backward Running; Elapsed Time; 1 to 1.5 minute
      Purpose; Continued warm-up; engage hip extensors/hamstrings. Make sure the athlete lands on her toes. Be sure to watch
                        for locking of the knee joint. As the athlete brings her foot back, make sure she maintains a slight bend to the knee.
      Instruction; Land on your toes without snapping the knee back. Stay on your toes and keep the knees slightly bend at all
                           times.
2. Stretching; It is important to incorporate a short warm-up prior to stretching. Never stretch a "cold muscle". By doing the
                                    exercises outlined here, you can improve and maintain your range of motion, reduce stiffness in your joints,
                                    reduce post-exercise soreness, reduce the risk of injury and improve your overall mobility and performance.
                                     - Do a large muscle warm-up such as brisk walking for five to 10 minutes before stretching.
                                     - Hold the stretch for 30 seconds. Concentrate on lengthening the muscles when you are stretching.
                                     - Breathe normally. Do Not hold your breath. 
  
A. Calf stretch (30 seconds x 2 reps) Elapsed Time; 1.5 to 2.5 minute
      Purpose; Stretch the calf muscle of the lower leg.
      Instruction; Stand leading with your right knee slightly bent and your left leg straight. Make sure your left foot is flat on the
                           ground. Do Not bounce during the stretch. Hold for 30 seconds. Switch sides and repeat.
  
B. Quadriceps stretch (30 seconds x 2 reps) Elapsed Time; 2.5 to 3.5 min
      Purpose; To stretch the quadriceps muscle of the front of the thigh.
      Instruction; Place your left hand on your partner's left shoulder. Reach back with your right hand and grab the front of your
                           right ankle. Bring your heel to buttock. Make sure your knee is pointed down toward the ground. Keep your right
                           leg close to your left. Do Not allow knee to wing out to the side and do not bend at the waist. Hold for 30 seconds
                           and switch sides and repeat.
  
C. Figure Four Hamstrings stretch (30 sec x 2 reps) Elapsed Time; 3.5 to 4.5 minute
       Purpose; to stretch the hamstring muscles of the back of the thigh. 
       Instruction; Sit on the ground with your right leg extended out in front of you. Bend your left knee and rest the bottom of your
                            foot on your right inner thigh. With a straight back, try to bring your chest toward your knee. Do not round your
                            back. If you can, reach down toward your toes and pull them up toward your head. Do not bounce. Hold for 30
                            seconds and repeat with the other leg.
  
D. Inner Thigh Stretch (20 sec x 3 reps) Elapsed Time; 4.5 to 5.5 min
       Purpose; elongate the muscles of the inner thigh (adductor group)
       Instruction; Remain seated on the ground. Spread your legs evenly apart. Slowly lower yourself to the center with a straight
                             back. You want to feel a stretch in the inner thigh. Now reach toward the right with the right arm. Bring your left
                             arm overhead the stretch over to the right. Hold the stretch and repeat on the opposite side.
  
E. Hip Flexor Stretch (30 sec x 2 reps) Elapsed Time; 5.5 to 6.5 min
       Purpose; elongate the hip flexors of the front of the thigh.
       Instruction; Lunge forward leading with your right leg. Drop your left knee down to the ground. Placing your hands on top of
                            your right thigh, lean forward with your hips. The back for the left ankle and pull your heel to your buttocks. Hold
                            for 30 seconds and repeat on the other side.

3. Strengthening: This portion of the program focuses on increasing leg strength. This will lead to increased leg
                                              strength and a more stable knee joint. Technique is everything; close attention must be paid to the
                                              performance of these exercises in order to avoid injury.
 
A. Walking Lunges (3 sets x 10 reps) (Elapsed Time: 6.5- 7.5 min
      Purpose: Strengthen the thigh (quadriceps) muscle.
      Instruction. Lunge forward leading with your right leg. Push off with your right leg and lunge forward with your left leg. Drop
                           the back knee straight down. Make sure that your keep your front knee over your ankle. Control the motion and try
                           to avoid you front knee from caving inward. If you can't see your toes on your leading leg, you are doing the
                           exercise incorrectly. 
  
B. Russian Hamstring (3 sets x 10 reps) (Elapsed Time: 7.5 - 8.5 min
       Purpose: Strengthen hamstrings muscles
       Instruction: Knee on the ground with hands at your side. Have a partner hold firmly at your ankles. With a straight back, lead
                            forward leading with your hips. Your knee, hip and shoulder should be in a straight line as you lean toward the
                            ground. Do not bend at the waist. You should feel the hamstrings in the back of your thigh working. Repeat the
                            exercise for 3 sets of 10, or a total of 30 reps.
  
C. Single Toe Raises (30 reps x 2 reps) Elapsed Time: 8.5 - 9.5 min
        Purpose: This exercise strengthens the calf muscle and increases balance.
        Instruction: Stand up with your arms at your side. Bend the left knee up and maintain your balance. Slowly rise up on your
                              right toes with good balance. You may hold your arms out ahead of you in order to help. Slowly repeat 30 times
                              and switch to the other side. As you get stronger, you may need to add additional repetitions to this exercise to
                              continue the strengthening effect of the exercise.

4. Plyometrics -These exercises are explosive and help to build, power, strength and speed. The most important
                                         element when considering performance technique is the landing. It must be soft! When you land from a
                                         jump, you want to softly accept your weight on the balls of your feet slowly rolling back to the heel with a
                                         bent knee and a straight hip. These exercises are basic, however, it is critical to perform them correctly.
                                         Please take the time to ensure safe and correct completion of these exercises.
   
A. Lateral Hops over Cone (20 reps) Elapsed Time: 9.5 -10min
         Purpose: Increase power/strength emphasizing neuromuscular control
         Instruction: Stand with a 6" cone to your left. Hop to the left over the cone softly landing on the balls of your feet land bending
                              at the knee. Repeat this exercise hopping to the right.
   
B. Forward/Backward Hops over cone (20 reps) Elapsed Time: 10 - 10.5 min
         Purpose: Increase power/strength emphasizing neuromuscular control
         Instruction: Hop over the cone/ball softly landing on the balls of your feet and bending at the knee. Now, hop backwards
                              over the ball using the same landing technique. Be careful not to snap your knee back to straighten it. You want
                               to maintain a slight bend to the knee. Repeat for 20 reps.
   
C. Single Leg hops over cone (20 reps) Elapsed Time: 10.5 - 11 min
         Purpose: Increase power/strength emphasizing neuromuscular control.
         Instruction: Hop over the cone/ball landing on the ball of your foot bending at the knee. Now, hop backwards over the ball
                              using the same landing technique. Be careful not to snap your knee back to straighten it. You want to maintain
                               a slight bend to the knee. Repeat for 20 reps. Now, stand on the left leg and repeat the exercise. Increase the
                               number of repetitions as needed.
   
D. Vertical J umps with headers (20 reps) Elapsed Time: 11 - 11.5 min
         Purpose: Increase height of vertical jump.
         Instruction: Stand forward with hands at your side. Slightly bend the knees and push off jumping straight up. Remember
                               the proper landing technique; accept the weight on the ball of your foot with a slight bend to the knee. Repeat
                              20 times and switch sides.
   
E. Scissors Jump (20 reps) Elapsed Time: 11.5 - 12 min
        Purpose: Increase power and strength of vertical jump.
        Instruction: Lunge forward leading with your right leg. Keep your knee over your ankle. Now, push off with your right foot and
                             propel your left leg forward into a lunge position. Be sure your knee does not cave in or out. It should be stable
                             and directly over the ankle. Remember the proper landing technique; accept the weight on the ball of your foot
                             with a slight bend to the knee. Repeat 20 times.  

5. Agilities;
   
A. Shuttle run with forward/backward running Elapsed Time 12-13 min
         Purpose; Increase dynamic stability of the ankle/knee/hip complex
         Instruction; Starting at the first cone, sprint forward to the second cone, run backward to the third cone, sprint forward to the
                              fourth cone.
  
B. Diagonal runs (3 passes) Elapsed Time 13-14 min
        Purpose; To encourage proper technique/stabilization of the outside planted foot to deter the position from occurring.
        Instruction; Face forward and run to the first cone on the left. Pivot off the left foot and run to the second cone. Now pivot off
                             the right leg and continue onto the third cone. Make sure that the outside leg does not cave in. Keep a slight
                             bend to the knee and make sure the knee stays over the ankle joint.
 
C. Bounding run (40 yards)Elapsed Time 14-15 min
        Purpose; To increase hip flexion strength/increase power/speed
        Instruction; Starting on the sideline, run to another side with knees up toward chest. Bring your knees up high. Land on the
                              ball of your foot with a slight bend at the knee and a straight hip. Increase the distance as the exercise gets
                              easier(10 yeards each time).
6. Alternative Exercises -Warm Down and Cool Down  We all know how imperative a cool down is. Please don't skip it. It
                                                                        allows the muscles that have been working hard throughout the training session to elongate and
                                                                       deters the onset of muscle soreness. Please emphasize the importance of adequate fluid intake
                                                                       (optimally water). Athletes should have a water bottle by their side during the cool down. The cool
                                                                        down should take approximately 10 minutes. It should begin with a slow jog to allow the heart rate
                                                                        to come down before stretching. This should be followed by some light strength training
                                                                        exercises. I  recommend two strengthening exercises (see below). Finally, stretch the
                                                                        hamstrings, calves, inner thigh, quadriceps, and low back (all of these are explained in the
                                                                        protocol). In addition to those basic stretches, I offer some additional stretches to target
                                                                        three muscle groups that are often forgotten.
  
A. Bridging with Alternating Hip Flexion (30 reps)
       Purpose: Strengthen outer hip muscles (Hip abductors, flexors) and buttocks
       Instruction: Lie on the ground with your knees bent with feet on the ground. Raise your buttocks up off the ground and squeeze. Now,
                            lift your right foot off the ground and make sure that your right hip does not dip down. Lower your right foot and now lift your
                            left foot making sure your left hip does not dip down. Repeat 30 times on each side. As you get stronger, you will place
                            your feet on top of a ball and repeat the exercise.
    
B. Abdominal Crunches (30 reps x 2 reps)
       Purpose: Strengthen the abdominals (rectus abdominus, obliques)
       Instruction: Lie on the ground with you knees bent. Place your hands behind your head with your elbows out wide. Support your neck
                            lightly with your fingers. Take a deep breath in and slowly contract your abdominal muscles as you exhale. Repeat 30
                            times. Drop your legs off to the right side. Slowly crunch up with your elbows out wide. You should feel your oblique
                            muscles working on the side of your waist. Repeat 30 times and Switch to the other side.
    
C. Single and Double Knee to Chest (supine) (30 sec x 2 reps)
       Purpose: Elongate the low back muscles
       Instruction: Lie on your back. Bring your right knee toward your chest and hug firmly. Keep your left leg out straight in front of you. You
                            should feel a stretch along your low back and into your buttocks. Hold the stretch for 30 seconds and switch sides. Now,
                            bring both knees to chest. If you feel any pain in the low back, discontinue the stretch and inform your coach/trainer .
 
D. Figure Four Piriformis stretch-supine (30 sec x 2 reps)
         Purpose: Elongate the rotators of the hip.
         Instruction: Lie on your back and bend both of your knees. Fold your left ankle over your right knee. Place your hands behind your
                              right thigh and pull your right knee to chest. You should feel a good stretch in the left gluteals region and the side of the
                              thigh. Hold for 30 seconds and repeat on the other side. If you experience and low back pain with this stretch, slowly lower                                your legs down and let your coach/trainer know.
     
F. Seated Butterfly stretch-seated (30 sec x 2 reps)
        Purpose: Elongate the inner thigh muscles (adductors).
        Instruction: Sit up bringing your feet in so that the soles of your feet are touching. Gently place your elbows on your knees   
                             and slowly push down. You should feel a good stretch of the inner thigh. Hold this for 30 seconds and repeat 2 to 3 times.