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. 

5 Ways Acupuncture Can Enhance Athletic Performance

May 9, 2023

In the ancient Chinese medicine of acupuncture, thin needles are gently inserted into specific areas of the body, stimulating blood flow to speed the recovery of certain ailments.

Henry Ford HealthIt can be used as a treatment for everything from headaches and unbalanced hormones to joint pain and weakened immune systems. Acupuncture is also popular among athletes, as many of them incorporate it into their wellness regimens to stay in peak physical condition.

“Back in the day, athletes ate steak, smoked cigars and drank whiskey during the week and then played football on Sunday,” says Thomas Betts, a sports medicine acupuncturist with Henry Ford Health System. “But today, to improve their performance, athletes are attacking the body from every angle possible with diet, lifestyle and exercise. NBA players, for example, have talked about how acupuncture keeps them feeling their best.”

But you don’t have to be an NBA star to reap the benefits of acupuncture. Whether you’re a professional or student athlete, or you exercise and play sports for fun or to challenge yourself, here are ways acupuncture can boost your game:

  1. Acupuncture can help you recover more quickly from an injury. “If a muscle is torn, acupuncture won’t put it back together, but for sprains and strains, muscle soreness and tendonitis, acupuncture can decrease inflammation and speed the healing process,” says Betts.
     
  2. Acupuncture can reduce the need for “rest days.” If you just had an intense workout and your muscles are sore, getting acupuncture afterward can loosen the muscles and decrease soreness so you don’t have to take a day off to recuperate before training again.
     
  3. Acupuncture can improve flexibility, decrease muscle tension and increase muscle activation. “This is done with motor point acupuncture,” says Betts. “The motor point is where the brain attaches to the muscle via the motor nerve. By using needles to stimulate a motor point, it is like rebooting a phone or computer that isn’t working well: Motor point acupuncture is autoregulating, in that it can deactivate a tight muscle or reactivate an inhibited or weak muscle.”
     
  4. Acupuncture can provide immediate pain relief. “Some studies show that acupuncture can provide as much as, if not more pain relief than medication,” Betts says. “It differs for everyone, and it depends on what is being treated, but some people say they feel a difference right after a session, and others say they feel better about 20 to 30 minutes later.” Pain relief can last from a few hours to a few days.
     
  5. Acupuncture can help prevent injuryBecause acupuncture can reactivate weak muscles and decrease muscle tension, it can also be used as a preventative measure against injury, Betts says. But you should always still stretch before and after exercising!

Learn more about acupuncture and other integrative medicine services at Henry Ford. To make an appointment, you can request one online or by calling 1-833-246-4347.

Thomas Betts, DOAM, RAc, is a certified sports acupuncturist with Henry Ford Health. He sees patients at the Henry Ford Center for Athletic Medicine in Detroit.