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 Enhance Your Running Performance
July 11, 2023
With summer now in full swing, lots of us are hitting the track, the streets and the trails to get and stay fit.
Whether you run marathons or prefer a quick lap around the block, there are many ways to adjust your running routine to get the most out of your workout.
"It's not uncommon for runners to get into a regular running routine," says Jamie Schwab, an athletic trainer at Henry Ford Health. "They'll find a comfortable pace and stick with it, often even doing the same route."
Unfortunately, doing the same run day after day not only leads to boredom, but it can also prevent you from reaching your full potential.
5 Tips To Run Smarter
It’s no secret that running is tough on the body. In fact, runners frequently develop muscle imbalances that make the body work harder. But you can take steps that can help you improve your run, maximize efficiency and get the most out of your running workout. Here's how:
1. Listen to your body: Whether you're a seasoned runner or just starting out, pay close attention to what your body is telling you. If your hips and knees are sore, back off. Feeling strong? Run another mile. The key to improving your run is to gradually increase distance and intensity over time. At first, you may only be able to handle a 10- or 15-minute jog. But if you keep at it, you'll be running for 30 minutes straight in no time.
2. Get the right footwear: If you're not a competitive runner, you might think any pair of running shoes will do. In reality, properly fitted running shoes not only enhance your performance but also reduce your risk of injury. Find a running store that can analyze your form and recommend shoes based on your unique gait and foot strike.
3. Pay attention to your target heart rate: Your target heart rate is 220 minus your age. Once you hit that rate during your run, you're working at maximum capacity. Don't want to invest in a heart rate monitor or be bothered with another tracking device? You're probably hitting the zone if you can still carry on a conversation during your run.
4. Focus on strength: If you're an avid runner but you aren’t strength training, you're setting yourself up for injury. "You're asking your body to do a lot during a run," Schwab says. "Weak glutes or hips add stress to your knees and ankles." Want to stabilize your run? Pay special attention to your core muscles. Solid strength training exercises include lunges, planks, squats and pushups.
5. Keep it interesting: Doing the same running routine day after day can be exhausting. Break out of your comfort zone by trying a different route, playing with your pacing, or running stairs or hills. You might even incorporate plyometric activities into your run. These explosive motions — hopping, skipping and jumping — help build power, strength and performance.
Running Safe
Eating well and getting regular exercise are key to enhancing overall health. Plus, a fit body is better equipped to avoid and battle infection. Running can also protect your sanity.
"Running is a great escape for many exercise enthusiasts," Schwab says. "Many people find they not only feel physically healthier, but their mental and emotional health also gets a boost."
The caveat: When you're running, you're placing double or triple your body weight on one side of your body at a time. So it's critical to pay attention to what shape your body is in before you take to the track. A few questions to ask yourself:
- Am I in good cardiovascular shape?
- Am I recovering from shin splints, knee injuries or hip problems?
- Am I at risk of falls?
- Am I suffering from osteoporosis?
It’s always important to check with your doctor before making changes in your exercise regimen. If running isn't appropriate for you, plenty of other activities, such as swimming, hiking and biking, can get your heart pumping.
To find a sports medicine specialist at Henry Ford, visit henryford.com/sports or call 1-800-436-7936.
Jamie Schwab, AT, ATC, SCAT, CSCS, is an athletic trainer with Henry Ford Sports Medicine and works with student athletes at Edsel Ford High School. She is a National Strength and Conditioning Association certified strength and conditioning specialist.