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 Concussion Myths Debunked
November 8, 2022
Awareness about the dangers of concussions is at an all-time high. In response, athletic organizations — from Pop Warner football (a nonprofit program for kids 5 to 16) to USA Hockey — have safe-play protocols in place. But misconceptions about injury — prevention, management and return to play — are still all too common.
"It's great that parents, coaches and athletes are focused on the potential for concussions, but they also need to be aware of the complexities involved in evaluating, diagnosing and managing concussion," says Jeffrey Kutcher, M.D., a sports neurologist who treats athletes at the Henry Ford Kutcher Clinic for Concussion and Sports Neurology.
The best way to get the knowledge you need? Learn how to separate fact from fiction.
Separating Concussion Fact From Fiction
Here’s the truth behind five common concussion myths:
Myth #1: Concussions are only caused by blows to the head.
Concussions happen in response to force. While they often result from a blow to the head, they can also occur after a hit to the neck, shoulders or anywhere else on the body. To cause brain injury, the force of the impact only needs to cause the head to move rapidly back and forth (think whiplash from a car crash or a spill down the stairs).
Myth #2: Concussions always involve a loss of consciousness.
A very small percentage of all concussions, 10 percent or less, result in a loss of consciousness. For the remaining injuries, parents, coaches and medical providers should watch for additional symptoms such as:
· Confusion
· Balance problems
· Slurred speech
· Physical complaints including headache, nausea and vomiting.
Myth #3: You should keep a person awake overnight after a concussion has occurred.
It's important to observe and interact with a recently concussed person for the first few hours to recognize the potential signs of a more serious injury. However, if they are interacting normally after four hours, it’s okay to let them sleep. If you have any doubts or questions, always err on the side of caution and seek medical attention.
Myth #4: After a concussion, kids should avoid digital media until they feel better.
Unless digital activities or screen time significantly worsen symptoms, there's no reason to avoid them. "You shouldn't force people who have suffered a concussion to rest too much — or deprive them of sensory input — if they are comfortable engaging in activity," Dr. Kutcher says. What’s more, taking away activities that bring a person joy or keep them socially connected could end up prolonging their recovery by creating additional symptoms.
Myth #5: All physical activity should be avoided after a concussion.
It’s important to rest for the first two to three days after a concussion. However, you need to be careful not to rest too much or avoid all activity for too long.
Engaging in physical, mental and social activities can be beneficial. But knowing how much to do and when to take it easy can be difficult. If you have any questions, consult a sports neurologist for specific recommendations.
Ground Rules for Concussion Prevention and Management
When it comes to preventing concussion, common sense offers the greatest impact, Dr. Kutcher notes. He recommends starting with these four tenets:
- Whenever possible, limit the amount of contact in practices and games.
- Wear proper fitting and certified helmets or other head protection whenever appropriate.
- Spread contact drills out over time as much as possible.
- Practice good technique and play by the rules.
Athletes — especially those who play contact sports — should undergo an annual neurological evaluation that includes a comprehensive, focused neurological history and examination. This information provides a critical point of reference for medical professionals.
Knowing the truth about concussions — including what to watch for and what to do if one occurs — is really the best game plan.
Dr. Jeffrey Kutcher is a sports neurologist at the Henry Ford Concussion and Sports Neurology Clinic and the global director of the Kutcher Clinic.
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.
Visit henryford.com/sports or call (313) 972-4216 for an appointment within 24 business hours.