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.
Bloomingdale Trainer Performing Invaluable Role in Keeping Athletes Playing
By
Pam Shebest
Special for MHSAA.com
November 22, 2022
BLOOMINGDALE — If Scott Allison looks bored during one of Bloomingdale’s sporting events, that is a good thing.
“Trainers like to be behind the scenes and in the shadows,” the certified athletic trainer said. “We’re only needed in emergencies.
“It’s one of those jobs that if we’re sitting around looking bored, then things are going well.”
But if an athlete goes down with an injury, Allison is quick to run onto the court or field.
In his first year at Bloomingdale, he has found that working with middle and high school students is a lot different than his previous work with the minor-league hockey Kalamazoo Wings.
Treating the hockey team, with whom he spent much of his 22 years, “There was a lot of traumatic stuff like lacerations or deep contusions, overuse injuries like hip flexors or core injuries or broken bones.
“Everything’s acute and fast. It’s a different animal. In hockey, they’re all pro athletes so they know their bodies really well.”
However, high school and middle school athletes are still in a growing phase.
“These kids don’t really know what’s going on a lot of times, so it’s a lot more education on what’s happening,” Allison said.
“Is it an injury, or is it just soreness? You get a lot of kids that don’t understand the difference between aches and pains or an injury. We see a lot of ankle sprains or shin splints because they’re just developing. They’re in that awkward range where their bodies try to grow too fast.”
Allison is the Cardinals’ first certified athletic trainer, a new position for which athletic director Jason Hayes campaigned.
“What we notice is that if a kid’s injured, they’re out a lot less if you have a trainer because it speeds up recovery time,” said Hayes, who also coaches varsity football and is an assistant wrestling coach. “It’s like having a built-in physical therapist on your staff, too.”
Studies support Hayes’ statements.
According to information from The Sports Institute at University of Washington, “‘The athletic trainers know the athletes,” says Stan Herring, M.D., cofounder of The Sports Institute at (University of Washington) Medicine and a team physician for the Seattle Seahawks and Seattle Mariners. “They see the athletes frequently, if not every day. They know when something is wrong. They are medical professionals who evaluate, treat and rehabilitate athletes.’”
The article continued: “Three recent studies suggest that athletic trainers are linked to significant improvements in the diagnosis of concussion in young athletes and significant reductions in ‘time-loss’ injuries that require athletes to take time away from sports.”
Allison sees himself as a teacher as well as a trainer.
“We see a lot more strains or growth issues,” he said. “A lot of it is maintenance and teaching kids what’s going on with their bodies or what they need to do to change things.”
He also meets with parents and coaches to talk about the best way to prevent injuries.
Allison’s day begins about 1:30 or 2 p.m., giving athletes a chance to talk with him before practices or games.
During the action, he always has his first aid backpack filled with the basics: air splints for fractures or dislocations, AED, EpiPens, and bench kits (with taping and bandaging supplies, splints, gauze, ACE wraps, ice bags, latex gloves and other basic first aid supplies.)
He travels with the teams when they are involved in high-impact sports, such as football, and many times he is also called to treat an opposing player if that team has no trainer.
Allison is a perfect fit with Bloomingdale, Hayes said.
His wife, Kirsten, coached the Cardinals girls basketball team for seven years. His daughter Emma, now at Glen Oaks Community College, graduated from there, and his daughter Bailey is an eighth grader.
“We are a very lucky town,” Hayes said. “We had Doc (Robert) Stevens, who had been volunteering as our athletic trainer for 15 years. He’s just aging out.
“About a year ago, he came to me and said that it was his last year. Scott has 22 years experience, and he has relationships here. To me, it was a no-brainer.”
Assistant varsity football coach Lance Flynn, who also coaches the middle school football team, saw Allison in action during competition in the fall.
“First quarter in a middle school football game, a kid broke his arm,” Flynn said. “My own son, Ryder, was on the varsity team and he sprained his AC socket and Scott took care of him.
“If something happens during a game, they can go see him and I don’t have to worry much because I know they’re in good hands.”
Allison’s affiliation with Bronson Sports Medicine is also a plus, the trainer said.
“With Bronson, we can offer a lot more and expedite getting in to see doctors or specialists if we need to,” he said. “We’re on the same system as the doctors, so we can diagnose and send notes to the doctors and they can send notes back to us.
“If there’s anybody we need to keep track of with the doctors, I can talk with the doctors and figure out how that’s going. If anybody needs to see me, they know I’m here early if they just want to come down to talk.”
Bronson also provides certified athletic trainers at 21 other southwest Michigan high schools: Brooke Vandepolder (Battle Creek Central), Lindsay Aarseth-Lindhorst (Climax-Scotts), Amanda Monsivaes (Comstock), Makenzie Hodgson (Delton Kellogg), Salvador Robles-Soriano (Gobles), Holly Ives (Richland Gull Lake), Katelyn Baker-Contreras (Kalamazoo Hackett Catholic Prep), Lizzy Smith (Kalamazoo Central), Emma Beener (Kalamazoo Christian), Holly Sisson (Kalamazoo Loy Norrix), Nico Talentino (Mattawan), Aaron Eickhoff (Otsego), Quincey Powell (Parchment), Malorie Most (Paw Paw), Jessica Bakhuyzen (Plainwell), Lance LeTourneau (Portage Central), Janelle Currie (Portage Northern), Carrie Calhoun (Schoolcraft), Chelsea Harrison (South Haven), Alexis Walters (Three Rivers) and Natalie McClish (Vicksburg).
Pam Shebest served as a sportswriter at the Kalamazoo Gazette from 1985-2009 after 11 years part-time with the Gazette while teaching French and English at White Pigeon High School. She can be reached at [email protected] with story ideas for Calhoun, Kalamazoo and Van Buren counties.
PHOTOS (Top) Bloomingdale trainer Scott Allison has several tasks as he works to keep the school’s student-athletes healthy and pain-free. (Middle) Bloomingdale athletic director Jason Hayes, left, and assistant varsity football coach Lance Flynn. (Below) Allison packs his bag for another full afternoon. (Ankle-taping photo by Andreya Robinson; all other photos by Pam Shebest.)