Women & ACL Injuries: Know Risks, Steps for Prevention
August 10, 2021
Whether you’re a casual jogger or elite athlete, you’re at risk for an injury to your anterior cruciate ligament (ACL). If you’re a woman, you are at even greater risk for these injuries.
But there are steps you can take to prevent them.
“Among athletes, women are more than twice as likely to have an ACL injury than men,” says Nithin Natwa, M.D., a sports medicine specialist and primary care physician at Henry Ford Health System. “Once you have an ACL injury, you are at greater risk for having further soft tissue injuries in the future. That’s why it is important to prevent these injuries and follow your treatment plan if injured.”
What Is An ACL Injury?
An ACL injury is a strain or tear in the ACL, one of the four major ligaments that support the knee so it can flex and bend. The ACL is a strong band of tissue that helps connect your thigh bone (femur) to your shin bone (tibia). “An ACL injury usually occurs without contact when you turn suddenly while running or land off-balance on one leg. These actions overload the knee joint and cause the ACL to be torn,” says Dr. Natwa.
In the United States, 100,000 people have ACL injuries each year. Anyone can experience an ACL injury, though athletes participating in sports like football, basketball, soccer and gymnastics are at highest risk. And summer is a peak time for outdoor sports injuries.
Seek immediate care if you have any of these signs of an ACL injury:
• An audible “pop” in the knee
• Intense knee pain and rapid-onset swelling (within hours)
• Loss of range of motion
• An unstable feeling or locking of your knee
The most common treatment for ACL injuries is surgery followed by physical therapy. After treatment, you can expect to return to normal activities in 6 to 9 months. However, peak athletic performance can take up to two years.
Why Are Women At Higher Risk For ACL Injuries?
According to Dr. Natwa, the differences in athletic training techniques for males versus females have left women at greater risk for ACL injuries. “There has been more emphasis on overall conditioning and mechanics for boys participating in sports compared to girls,” he says.
As a result, women are at greater risk for ACL tears and sprains due to:
• Differences in neuromuscular control: Without conditioning from an early age, women may not have the same ability to land and perform athletic motions that men do. For example, women are at higher risk for an ACL injury after landing from a jump.
• Strength imbalance for muscles that support the knee: Female athletes tend to have more defined quadriceps muscles but weaker hamstrings than men, putting them at greater risk for injury.
According to Dr. Natwa, there are many theories about women’s risk for ACL injury that lack scientific evidence, including:
• Width of the pelvis: Some people have suggested that the wider width of a woman’s pelvis puts more pressure on the knee joint and increases the risk for injury. However, this difference has not been shown to impact a women’s risk for ACL tears or sprains.
• Knee anatomy: The ACL runs through a section of the femur called the intercondylar notch. Women tend to have a narrower notch than men. Regardless of gender, individuals who possess smaller notch dimensions appear to be at greater risk for injury than individuals with larger notches.
• Hormones: Men and women have different hormone levels. But there is currently no concrete evidence that female hormones place women at higher risk for ACL injures.
Steps To Prevent ACL Injuries – Conditioning Early, Often
“The best way to prevent ACL injuries is to begin and maintain regular conditioning exercises at an early age,” Dr. Natwa says. “The more frequently you engage in proper exercises, the lower your risk for injury.”
Consult with a sports medicine specialist, physical therapist or athletic trainer to develop a training routine to prevent ACL and other injuries. Your training program should include exercises that:
• Strengthen the muscles that support your knee: Add strength training to build up your calves, hamstrings and quadriceps muscles. These muscles help stabilize your knee as you move. By strengthening these muscle groups evenly, you can lower your risk for injury.
• Improve overall neuromuscular control: Focus on adding neuromuscular exercises that train your nerves and muscles to react and communicate. For example, you may work on your balance by standing on one leg or sit upright on an exercise ball for short periods of time. And core exercises can strengthen the muscles that support your abdomen and back and help improve your posture as you move. These moves can strengthen your joints and help you learn appropriate balance and technique.
“Exercise really is the best medicine. It can improve your balance and agility as you participate in a sport or prevent injury as you move through your daily activities,” says Dr. Natwa. “Consider adding these exercises to your wellness program.”
Dr. Nithin Natwa is a sports medicine doctor who sees patients at Henry Ford Macomb Health Center in Chesterfield and Henry Ford Macomb Orthopedics and Wound Care in Clinton Township.
Want to learn more? Henry Ford Health System sports medicine experts are treating the whole athlete, in a whole new way. From nutrition to neurology, and from injury prevention to treatment of sports-related conditions, they can give your athlete a unique game plan. To find a sports medicine physician at Henry Ford, visit henryford.com or call 1-800-436-7936.
How To Stay Hydrated: 7 Tips For An Active Summer
By
Nick Parkinson, M.Ed., AT, ATC, TSAC-F
Henry Ford Health
June 4, 2024
Not only is water an essential nutrient, it makes up your entire being. We’re 40 to 70 percent water, depending on fitness level and age. And while staying hydrated is always important, it may become more challenging as the weather heats up. Hard-working muscles generate more heat when they’re surrounded by hot air, making it harder for your body to maintain a normal temperature.
Even a 1 to 2 percent loss of body weight from water can compromise your performance and impact your body’s ability to cool itself. The heart pumps harder, circulation slows and muscles fatigue more quickly. If the loss creeps up to 3 or 4 percent, you’ll be at increased risk of developing heat-related illness and injury, including cramps, heat exhaustion and heat stroke.
Even when you’re not active, your body loses more than a quart of water every day through urine, perspiration, sweat and breath, according to the National Institutes of Health. And most days, it’s more than 2.5 quarts.
The goal, of course, is to replace what’s lost. And with a little planning and preparation, you can during any outdoor activity, no matter what the thermometer says. Here’s how:
- Drink before you’re thirsty. Need to quench your thirst? Chances are you’re already dehydrated. Your best defense against dehydration is drinking water on a consistent basis so you never reach the point of thirst.
- Take frequent water breaks. While you might not want to disrupt your workout for a water break, taking time out for some much-needed liquid nourishment will pay off in the long run. Drink 8 to 10 ounces of water (about one full glass) before starting any activity. Once the games begin, drink another 7 to 10 ounces every 20 to 30 minutes.
- Track your intake. Many people don’t know how much water they should drink daily—or even how much water they’re typically downing. If you’re sipping on a 16-ounce bottle, drink eight of them each day—and even more if you’re exercising heavily.
- Consider an electrolyte drink. Working out for more than an hour? Consider sipping a sports drink—or nibbling on some pretzels or a banana to restore lost electrolytes (minerals in the blood that regulate bodily systems). Your body loses important electrolytes like sodium, potassium and chloride when you sweat. A good sports drink can help you replenish them. Coconut water is a great choice, but there are a slew of healthy, low-sugar options on the market.
- Munch on water-rich produce. Water-packed snacks, including melon, berries, bell peppers and grapes, are all good options. A bonus: All of these foods boast a decent hit of electrolytes, too!
- Step on the scale. Weigh yourself before and after a workout. If the scale shows a loss, replenish it with water (gulp 20 to 24 ounces of water for every pound lost). If you’ve lost 3 percent or more of your body weight, chances are you’re severely dehydrated.
- Watch your urine stream. It may seem gross, but checking your pee is probably the best way to determine whether you’re dehydrated. If it looks like watered down, colored lemonade, you’re probably in the clear. But if it’s a deep yellow or light orange, you’re probably not drinking enough fluids.
Keep in mind that heat exhaustion happens quickly—especially during summer activities. It can easily turn into heat stroke, a dangerous condition that can lead to organ damage, seizures, coma and even death. If you feel dehydrated, dizzy or overheated, get out of the sun, sip some water (slowly) and apply cooling compresses to your head, neck and chest. If your symptoms don’t improve quickly, get to a doctor or call 9-1-1.
Nick Parkinson, M.Ed., AT, ATC, TSAC-F, is the supervisor of athletic training and sports performance at Henry Ford Health. Learn more about Nick.
To find a sports medicine provider at Henry Ford Health, visit henryford.com/athletes or call 313-651-1969.