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 Be Proactive About Concussions In Student Athletes
December 5, 2023
Most people have seen the headlines about concussions as a common sports injury—and it's natural that parents of athletes may have concerns. A large misconception in sports is that previous concussions are to be blamed for ongoing headaches, blurred vision and memory loss, among other symptoms.
“It’s really important to think about concussions in tandem with overall brain health,” says Jake Carpenter-Thompson, M.D., Ph.D., a board-certified neurologist at the Henry Ford Kutcher Clinic for Concussion and Sports Neurology. “Concussions can be concerning, but they shouldn’t be looked at in a vacuum. It is important to understand an athlete’s overall brain health to help manage recovery after any impact.”
One way to do that is to consult with your child’s doctor or a sports neurologist for an annual evaluation. A sports neurologist focuses on managing sports-related brain and nervous system injuries and conditions in athletes, such as concussions, post-concussion syndrome, peripheral nerve injuries, migraines, epilepsy and more.
“Having an annual evaluation of your athlete’s brain health when they are at their baseline – and uninjured – can help diagnose and treat issues when they arise,” says Dr. Carpenter-Thompson.
A qualified healthcare professional can use the baseline evaluation results as an important comparison tool if an athlete develops a suspected concussion.
Best Practices For Keeping Athletes Safe
Dr. Carpenter-Thompson shares these tips to ensure you keep front of mind your child’s brain health and safety, not just their athletic performance:
- Get a brain health baseline test. This should include a personal and family neurological history, with a focus on current issues. It is important to note any neurological conditions that may influence concussion recovery, such as ADHD, depression, anxiety or migraine headaches.
- Encourage your children to listen to their body. There are risks to playing any sport. Encourage your child to listen to and be honest about how they’re feeling. It’s the best way to prevent and treat injuries.
- In the event of an injury, look for the signs. Within 24 hours after an injury, an athlete should be evaluated if they are experiencing: headaches, fatigue, dizziness and nausea, changes in sleep habits, trouble with memory, confusion, irritability and anxiety, or light sensitivity.
- Know that brain injuries don’t just occur with a blow to the head. They can also occur from falls, car accidents or even whiplash. If your child is experiencing any symptoms, consult your physician.
- Remember that brain health is more than just concussions. If your athlete is complaining of chronic headaches, migraines, dizziness, memory or mood issues, there may be an underlying issue.
“There is no magic number of concussions a brain can sustain. Each person is different,” says Dr. Carpenter-Thompson. “The severity of the impact and recovery time can vary greatly for numerous reasons. By getting a brain health assessment before the injury, we can provide more targeted care to improve an athlete's overall clinical course.”
To find a sports medicine doctor or athletic trainer at Henry Ford, visit henryford.com/athletes.