Minimizing The Risk of ACL Injuries

MINIMIZING THE RISK OF

“ACL” INJURIES

Because we all have or know of someone who has a female athlete involved in sports at a highly competitive level, I am passing on the following information relative to the dreaded “ACL” injury. Most of the information provided is taken from “WARRIOR GIRLS – PROTECTING OUR DAUGHTERS AGAINST THE INJURY EPIDEMIC IN WOMEN’S SPORTS” by Michael Sokolove, a book I highly recommend reading for anyone with a female athlete. Some interesting facts brought out: ü Although girls suffer injuries such as shin splints, chronic knee pain, back & hip pain, & stress fractures at a greater rate than boys, the most serious problem, BY FAR, is the incidence of major knee injuries – mainly ACL. Studies show that in sports that boys and girls both play, with similar rules-like soccer, basketball & volleyball, GIRLS TEAR THEIR ACL’s AS HIGH AS 8 TIMES MORE FREQUENTLY AS BOYS!ü Experts in biomechanics know conclusively that most girls, even highly athletic ones, run differently than boys – with less knee bend and a more upright gait. They land harder when jumping and don’t decelerate as safely when slowing to make a cut. These differences appear to be a large factor in ACL tears as well as ankle, hip and back injuries.ü Basketball and soccer have the highest incidence of ACL injuries because they are “unscripted” 360 degree sports where the action occurs from any direction at any time.ü ACL ruptures likely flow from a women’s lesser strength, particularly in the muscles that control the hips, a tendency to run in a more upright position, and a more anterior tilt of the pelvis which can cause the knees and back to hyperextend. (APPLIED NEUROMECHANICS RESEARCH LAB.)ü ACL injuries are “overexposure injuries” and not “overuse injuries”.ü Bad running form is a major cause in non contact ACL injuries.ü There is also research pending which indicates that monthly hormonal changes may increase the incidence of ACL injuries in women.ü Weak abdominal and hip muscles are prime suspects in the case of knee injuries in women.ü Landing from a jump with minimal hip and knee flexion increases the load transmitted to the knee and increases the shear force from the quadriceps putting great stress on the ACL.ü Candace Parker (Standout basketball player at Tennessee and now a pro) suffered two torn ACL’s to the same knee.PREVENTION:No one can completely prevent ACL injuries but they can be GREATLY reduced!ACL injury prevention programs focusing on skiing, basketball, handball, and soccer have been performed in the past with overall reduction in severe ACL injuries ranging from 60% to 89%. One such study implemented a prevention study in two Division I basketball programs during the course of 8 years – geared at changing player technique: stressing knee flexion upon landing, using accelerated rounded turns, and deceleration with a multi-step stop. An 89% reduction in the incidence of ACL injuries in this group was noted. One of the most recent and well documented studies, the “Joint Undertaking To Monitor & Prevent” ACL injuries (J.U.M.P.) was the impetus behind the P.E.P. Program (Prevent Injury & Enhance Performance) from the Santa Monica Orthopaedic & Sports Medicine Group. The program is highly regarded and used widely across the world. The program strongly recommends a customized “warm-up” consisting of stretching, strengthening & balancing exercises. The basic program consists of 19 exercises which take about 25-30 minutes to perform. I’ve attached additional information on the P.E.P. program including the exercises suggested. We all know that a premium is put on practice time. These exercises are recommended to be done 3 times per week and can be done at home-there is no need for special equipment.

One last key recommendation relating to women in basketball and the reduction of ACL injuries that I took from both the book and the study: Girls/Women need to play lower to the ground in an athletic position similar to a baseball infielder:

Head up. . . Shoulders square . . . Knees bent . . . Butt down!!

I hope that this helps minimize the risk that your daughter may face!