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.
MHSAA Provides Heat Management Reminders in Advance of 2023 Fall Practices
By
Geoff Kimmerly
MHSAA.com senior editor
August 1, 2023
Temperatures reached record highs in some parts of Michigan at the start of this summer, and heat waves have made headlines nationally over the last month. Although the state didn’t experience similar extremes during July, the beginning of August always is a pertinent time for reminders that more hot weather is likely in many areas and should be prepared for as Michigan High School Athletic Association practices are set to begin Monday, Aug. 7.
Each year, the MHSAA provides information to its member schools to help them prepare for hot weather practice and game conditions during the late summer and early fall. Practices for all Fall 2023 sports – cross country, football, Lower Peninsula girls golf, boys soccer, Lower Peninsula girls swimming & diving, Lower Peninsula boys and Upper Peninsula girls tennis, and volleyball – may begin Monday, Aug. 7.
The “Health & Safety” page of the MHSAA Website has links to several information sources, including the MHSAA preseason publication Heat Ways, which is available for download and includes valuable information on heat management in addition to requirements and resources regarding head injuries and sudden cardiac arrest.
The first days of formal practices in hot weather should be more for heat acclimatization than the conditioning of athletes, and practices in such conditions need planning to become longer and more strenuous over a gradual progression of time. Schools also must consider moving practices to different locations or different times of day, or change practice plans to include different activities depending on the conditions. Furthermore, football practice rules allow for only helmets to be worn during the first two days, only shoulder pads to be added on the third and fourth days, and full pads to not be worn until the fifth day of team practice.
The MHSAA advises student-athletes to make sure to hydrate all day long – beginning before practice, continuing during and also after practice is done. Water and properly-formulated sports drinks are the best choices for hydration.
A number of member schools follow the MHSAA’s Model Policy for Managing Heat & Humidity, which while not mandated for member schools was adopted as a rule for MHSAA postseason competition in 2013. The plan directs schools to begin monitoring the heat index at the activity site once the air temperature reaches 80 degrees, and provides recommendations when the heat index reaches certain points, including ceasing activities when it rises above 104 degrees. (When the temperature is below 80 degrees, there is no combination of heat and humidity that will result in a need to curtail activity.) The model heat & humidity policy is outlined in a number of places on the MHSAA Website, including as part of Heat Ways.