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Risk of ACL injuries can be reducedIf you’ve attended enough high school basketball games, you may have witnessed this scene: a young female basketball player comes down from a jump and is suddenly out of commission. The jump wasn’t that high and the landing wasn’t that hard and yet, her knee has given out. A few days later, the doctor confirms the suspicion: the young athlete has torn her Anterior Cruciate Ligament (ACL). The ACL goes right through the middle of the knee and is one of the main supporting structures of the knee, according to Mario DeSouza, MD, an orthopedic surgeon at New Ulm Medical Center. Injuries can occur from a direct impact such as a tackle in football, or can be from a non-contact trauma, such as pivoting the knee. “The main complaint is episodes of having the knee give out followed by pain and swelling,” said DeSouza. Far more high school age youngsters incur ACL tears than older athletes, DeSouza said, “at that age, athletes just compete at a different level than the older athletes who are most likely playing a sport for fun just a couple times a week.” That kind of statistic seems like common sense. A statistic that may not be as understandable is that female athletes who play basketball, volleyball and soccer are four to six times more likely to tear their ACL than their male counterparts, said Shannon Barie, physical therapist at NUMC. “A few researchers have hit this topic hard in the last ten years and the newest research shows that how females land from a jump is the best predictor of future ACL tears,” Barie said. “Those most at risk are landing in a knock-kneed position with not enough knee bend.” In addition to the structure of the female knee being narrower and therefore putting them at greater risk for ACL tears, DeSouza and Barie both said, research shows that female athletes tend to not be conditioned well enough before starting a season of participation in a rigorous sport. “However, women have a real potential to improve quickly with training,” Barie said. “There are some very well tested neuro-muscular control programs that show female athletes can significantly reduce their risk of ACL tears.” Barie said neuro-muscular control programs include strength training, plyometrics (quick knees, bounding, jump-tucks, double leg hops, single leg hops), leg and abdominal strengthening, balance and instruction on landing techniques. “A lot of these studies looked at conditioning three times a week anywhere from 20 minutes to 90 minutes,” Barie said. “Any amount of time would help, but it’s a fairly specific program.” Jill Weiss sees ACL injuries from both sides of the coin: in her work with area athletes as an NUMC athletic trainer and as a very active person herself who has torn the ACL in both her knees. The first tear occurred during a basketball game when she was 16, she said, and having no idea what she had done she feared the worst and that she would never be able to use the leg again. When she tore her other ACL at the age of 30 playing volleyball, she said, “I crawled off the court and I knew exactly what I had done and what I was in for.” What she was in for was a fairly minor same day surgery followed by a major six to nine month recovery. “People considering this surgery must be ready to go through a long rehab program and have to be really dedicated because much of it is done on their own,” said Dr. DeSouza. The surgery involves rebuilding the ligament, usually with tissue from the patient’s patellar tendon. Using that tissue, DeSouza said, has a 90-95% success rate. Physical therapy on the knee is begun immediately after surgery. Following surgery, 90 to 95 percent of athletes can be expected to return to their usual sports, DeSouza said, and the rebuilt ACL tends to be stronger than the original. Patients are more likely to tear their opposite ACL than the graft. Weiss’ original tear at the age of 16 actually steered her toward becoming an athletic trainer, she said. “I love being there for people when they get hurt and helping them get back on the field and doing what they love.” Part of that job for NUMC athletic trainers is developing the strengthening programs aimed at preventing injuries for the athletic programs at all the schools in the area. “High level competition is happening earlier and earlier,” Weiss said. “Girls are participating at a younger age and it’s important that they have the right conditioning program to help prevent whatever injuries we can.” Five keys to preventing ACL tears 1. Practice soft landing with bent knees and land with knees over toes vs knock-kneed position. The key is practice. 2. Coaches can watch for excessive knock-kneed position with landing, cutting, and decelerating to decrease risk. 3. Strength training for legs and abdominals (core strengthening). 4. Neuro-muscular training includes plyometrics, balance, core strengthening, and instruction on landing techniques. 5. Consult with a physical therapist, athletic trainer or other exercise specialist to develop an appropriate program.  Back to Health Edition |
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New Ulm Medical Center
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