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 Acupuncture Can Help Soothe Pregame Anxiety
May 7, 2024
The topic of mental health in sports has been mostly ignored until fairly recently. But thanks to several high-profile athletes’ willingness to open up about their struggles, the topic is no longer quite so taboo.
“Athletes at all levels are realizing the importance of their overall mental health, mental preparation before an event and mental recovery afterward,” says Thomas R. Betts, DAOM, LAc, a sports medicine acupuncturist at Henry Ford Health. “Having your mind in the right place pays big dividends in terms of sports performance.”
One of the many tools athletes are using to get their minds healthy is acupuncture. It may be an ancient Chinese practice, but it can be useful to help improve the mental health of modern athletes.
What Is Acupuncture?
Acupuncture is a healing technique that has been used in traditional Chinese medicine for thousands of years. Acupuncture practitioners (acupuncturists) insert very fine, thin needles into the skin at various points on the body, depending on what condition they’re treating.
According to traditional Chinese medicine, the insertion points for the needles correspond to specific internal organs or energy channels in the body. “The philosophy behind traditional Chinese medicine is that acupuncture works by manipulating the flow of blood and energy to create balance and harmony in the body,” says Betts.
From a Western medicine perspective, acupuncture works by stimulating the central nervous system and by having some direct effect on the tissues in which needles are placed. Acupuncture also has a balancing effect on hormones within the body. It works well with other treatments for anxiety such as sports psychology, massage therapy, guided visualization and meditation.
How Can Acupuncture Improve Sports Performance?
Acupuncture has long been used to help people relax, reduce stress and cope with anxiety. And it can have that effect even when the acupuncturist is treating a physical problem. “Even when I’m treating an athlete for a sports injury, when I ask how they feel post treatment the overwhelming response I hear is ‘I feel so relaxed,’” says Betts.
This is why acupuncture seems like a natural fit for helping athletes of all levels cope with performance anxiety, pregame jitters or other competition-related fears. “Reducing stress helps athletes perform better,” says Betts. “And more and more athletes are realizing that taking care of their mental health and using tools to stay mentally focused can really enhance their performance.”
When Should Athletes Try Acupuncture?
Since an acupuncture session can leave you feeling super calm and relaxed, you don’t want to try it for the first time right before a game or competition. “The timing is important,” says Betts. “You want the athlete to feel motivated to compete, not totally Zenned out.”
The best approach is to schedule a series of acupuncture sessions in the weeks leading up to a big game, competition or race. Betts says he typically recommends athletes come in twice a week for three weeks to get started. “It’s not about treating their anxiety in the moments before a game,” he says. “It’s about establishing a baseline of calm that they can carry with them into the competition.”
While there’s still some stigma surrounding athletes and mental health, Betts sees the popularity of acupuncture as one sign of a shift. “I think we’re trending in the right direction for mental health,” he says. “Athletes are starting to understand that if they want longevity and success in their sport, they need to take care of their mental and emotional health—not just the physical.”
Reviewed by Thomas Betts, DOAM, RAc, a certified sports acupuncturist who sees patients at the Henry Ford Center for Athletic Medicine in Detroit.
To find a sports medicine provider at Henry Ford Health, visit henryford.com/athletes or call 313-651-1969.