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.
Is My Student Athlete's Pain More Than Just Growing Pains?
February 14, 2023
There are a few factors that can make student athletes prone to injury. They might be overusing their muscles (thanks to a more rigorous exercise regimen), and they might not yet have developed the proper technique for their sport.
“These factors, combined with the fact that student athletes have growing bodies that they’re still getting used to—especially after a growth spurt — can make them more prone to injury,” says Nancy White, M.D., a sports medicine physician with Henry Ford Health System.
However, just because your child is feeling pain doesn’t necessarily mean they’ve sustained an injury. There is such a thing as growing pains, although the term may be misleading. “Most experts feel that growth itself does not cause pain,” says Dr. White. “The most likely reason for ‘growing pains’ is overuse of the muscles, causing pain and soreness after an activity.”
These growing pains typically occur at the front of the thighs, the back of the knees and the calves, she says, and occur commonly in the late afternoon, evening, or night. If your child is experiencing pain outside of these areas or times of day, it might not be growing pains — and it’s a good idea to get it checked out by a doctor.
Tell-Tale Signs That Pain Should Be Examined
If the pain goes away by the next day — if your child has rested during night and feels better the next morning — there’s no need for concern. But you should head to the doctor if:
► the pain is lingering into the next day.
► the pain is also accompanied by bruising, swelling or redness.
► the pain is so intense that they’re unable to put weight on their legs.
“In these cases, don’t wait — the longer you wait, the more dangerous the injury can become,” says Dr. White.
How Student Athletes Can Help Prevent Injuries
Encourage your child to take proper precautions and maintain healthy habits, all of which can lower the likelihood that they’ll sustain an injury. Dr. White recommends the following tips:
- Maintain proper technique. “Knowing and understanding the movements needed for whatever sport they practice is so important,” says Dr. White. “Figure skating and gymnastics are two sports where I tend to see injuries more often during growth phases. These athletes are often learning difficult skills at a time in their lives when they’re going through a growth spurt, and that combination can lead to injury.”
- Stretch before and after playing a sport. “Try dynamic stretching — where you’re actually moving while stretching — instead of static stretching, where you’re holding the stretch,” says Dr. White. “Dynamic stretching is a great warm up. It can help improve flexibility and reduce the risk of injury.”
- Strength train, especially in the core and limbs. Doing so will help create stable, strong muscles to keep the body properly aligned and lessen the chances of injury.
- Eat a balanced diet and stay hydrated. While it’s normal for kids to have sugar every once in a while, filling the bulk of their diet with plenty of water, fresh fruits and vegetables, healthy protein, fats and carbohydrates will help them function to their best ability.
- Get enough rest each night. Sleep is necessary for health and well-being in general, but when it comes to athletes, rest is incredibly important to help their bodies recuperate. In general, kids need about 10 hours of sleep per night. So if your child plays a sport, you want to really be sure that they’re hitting that 10-hour mark, says Dr. White.
Dr. Nancy White is a sports medicine physician with Henry Ford Health System. She sees patients at Henry Ford Medical Center – Columbus in Novi, and Henry Ford Medical Center — Bloomfield 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.