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.
6 Tips for the Best Cold-Weather Workout
December 6, 2022
With temperatures getting colder, it may be tempting to get back to the gym.
But it’s still possible to get your exercise outdoors if you prepare properly to counter the chillier conditions that accompany living in Michigan this time of year.
Winter Weather Workout Tips
While cold air can make it challenging to breathe, our bodies adjust to reduced temperatures over time. The key thing to watch for is hypothermia (dangerously low body heat).
"Viruses are more likely to attack our bodies if we're in a cold state," says Ramsey Shehab, M.D., a sports medicine specialist at Henry Ford Health. "If your internal body temperature drops significantly, it can suppress your immune system and make you more vulnerable to infection."
The good news: Adopting these six strategies can help ensure your outdoor workouts are safe and effective.
Check the forecast. Know what the outdoor weather is and plan accordingly. Pay attention to the temperature, wind and moisture level. If temps dip below zero, the wind chill is extreme, or it's raining or snowing, exercising outside can be risky.
Dress in layers. Dressing too warmly can increase your risk of overheating (even in frigid air). Instead, dress in layers so you can remove layers as you warm up. "The innermost layer should be made of moisture-wicking material," Dr. Shehab says. "The middle layer should have thermal protection like wool or fleece, and the outermost layer should be waterproof and breathable to protect you from wind, rain and sleet." If you get wet and moisture soaks through your clothing, you may not be able to keep your core body temperature up.
Pay attention to your hands, feet and head. When you're engaged in a heart-pumping workout, blood flows to your core, leaving your fingers, toes and head vulnerable to the cold. Wear a hat, gloves and warm socks. If it's especially chilly, consider wearing a scarf.
Take time to warm up (and cool down). Instead of leaving your cozy house and launching straight into a sprint, take time to warm up your major muscle groups. "Your joints may be stiffer when it's cold, so warming up and stretching out is especially important during the winter months," Dr. Shehab says.
Stay hydrated. People tend to think more about dehydration during the summer months, but you can get dehydrated in the winter, too. "Proper hydration before, during and after exercise is very important, not just to maintain health and well-being, but also to stave off infection," Dr. Shehab says.
Take a vitamin D supplement. Even though you're exercising outdoors, sunlight is in low supply in Michigan during the winter. To keep your immune system humming, consider taking a vitamin D supplement. "Making sure you have sufficient vitamin D can enhance your bone health, boost your immune system and keep your hormones in balance," Dr. Shehab says.
Get Savvy About Outdoor Workouts
Frigid temperatures can create obstacles for even the most enthusiastic exercisers. While it's tempting to table exercise until warmer weather returns, there are things you can do to make outdoor — and indoor — workouts more enjoyable.
You don't have to stick to the same routine of running, walking and circuit training. Take advantage of the winter chill to participate in activities like ice skating, sledding, hiking, skiing and cross-country skiing. You can even take interval workouts outdoors. Climb stairs, hike up hills or just play with a kettlebell in the snow.
"Exercise is medicine," Dr. Shehab says. "It can sometimes replace medication for people who have diabetes, hypertension and other chronic conditions. It's good for the mind and the body, and it can help stave off infections, including COVID-19."
The caveat: Working out, outdoors or indoors, is not recommended for people who are currently battling the coronavirus. Instead, it's important to preserve your energy. Once your symptoms begin to improve, you can gradually increase your exercise level.
To find a doctor or athletic trainer at Henry Ford, visit henryford.com or call 1-800-HENRYFORD (436-7936).
Dr. Ramsey Shehab is the deputy chief of Sports Medicine at Henry Ford Health. He sees patients at the Henry Ford Center for Athletic Medicine and Henry Ford Medical Center - Bloomfield Township.