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 Survey Shows More Than 44 Percent of Athletes Play Multiple Sports
By
Geoff Kimmerly
MHSAA.com senior editor
August 17, 2022
More than 44 percent of athletes at Michigan High School Athletic Association member high schools participated in more than one sport during the 2021-22 school year, according to the Multi-Sport Participation Survey conducted this spring, the fourth such survey conducted by the MHSAA over the last five years to monitor the rate of specialization in school sports.
Early and intense sport specialization has become one of the most serious issues related to health and safety at all levels of youth sports, as overuse injuries and burnout among athletes have been tied to chronic injuries and health-related problems later in life. In early 2016, the MHSAA appointed a Task Force on Multi-Sport Participation as part of a continued effort to promote and protect participant health and address the issues leading to early sport specialization. The annual Multi-Sport Participation Survey, first conducted for the 2017-18 school year, was among results of the task force’s work. (No survey was conducted for 2019-20 as spring sports were canceled due to COVID-19.)
The MHSAA 2021-22 Multi-Sport Participation Survey received responses from 85 percent of member high schools, the highest response rate of the four years the survey has been conducted. Survey results showed a slightly lower percentage of member high school students participating in athletics compared to the inaugural survey in 2017-18 – but a higher percentage of multi-sport athletes among those playing at least one sport.
For 2021-22, schools responding to the survey showed 40.4 percent of their students participated in athletics during the last school year – 43.5 percent of boys and 37 percent of girls. Class D schools enjoyed the highest percentage of athletes among the entire student body, at 51.8 percent, followed by Class C (47.8), Class B (41.3) and Class A (37.7).
Those percentages – total and by Class – all were slightly lower than what was produced by the 2017-18 survey, which saw 42.5 percent of students total participating in athletics. However, the percentage of athletes competing in multiple sports in 2021-22 was higher than in 2017-18, 44.3 percent to 42.8 percent.
For 2021-22, 46.5 percent of male athletes and 41.4 percent of female athletes played multiple sports. Class D again enjoyed the highest percentage of multi-sport athletes among this group, at 60.8 percent, followed by Class C (58.5), Class B (49.5) and Class A (36.7).
Similar results for overall sport participation and multi-sport participation relative to enrollment size were seen by further breaking down Class A into schools of fewer than 1,000 students, 1,000-1,500 students, 1,501-2,000 students and more than 2,000 students. For both sport participation as a whole and multi-sport participation specifically, the smallest Class A schools enjoyed the highest percentages, while percentages then decreased for every larger size group of schools. This has remained consistent over the last five years.
“The multi-sport participation survey again shows that student-athletes across the state continue to focus on participation in several sports and the benefits that come with that participation for their school teams. What the numbers don’t show is the behind-the-scenes benefits of multi-sport participation,” said MHSAA assistant director Cody Inglis, who has served as coordinator of the multi-sport task force. “So many student-athletes see great success on and off the field with their teams, teammates, friends and peers while also developing the lifelong lessons that sports done right provide. We continue to believe and know that student-athletes who are involved in multiple sports are more successful, benefit from the variety of sports and see huge long-term benefits.”
The MHSAA Task Force on Multi-Sport Participation also recommended measuring multi-sport participation in MHSAA member schools to recognize “achievers” – that is, schools that surpass the norm given their enrollment and other factors that affect school sports participation.
In Class A, Bay City Central (78.7) and Livonia Franklin (77.7) posted the highest percentages of multi-sport athletes in 2021-22, with Clinton Township Chippewa Valley (75.6) and Parma Western (75.4) also reaching 75 percent. In Class B, four schools achieved at least 80 percent multi-sport participation – Brooklyn Columbia Central (85.8), Detroit Southeastern (84.6), Warren Michigan Collegiate (84) and Durand (82.6).
Class C saw five schools with more than 80 percent of its athletes taking part in more than one sport: Brown City (95.7), Decatur (87.4), Niles Brandywine (85.6), Ishpeming Westwood (83.2) and Flint Beecher (80.4). Five Class D schools responded at higher than 90 percent multi-sport participation, with Coldwater Pansophia Academy and Kinross Maplewood Baptist both reporting 100 percent of their athletes played multiple sports. McBain Northern Michigan Christian (98.6), Ewen-Trout Creek (94.3) and Detroit Douglass (91.7) were the next highest on the Class D list.
A total of 10 schools have appeared among the top 10 percent in their respective classes for multi-sport participation three of the four years of the survey: Battle Creek Harper Creek, Detroit Cody, Gibraltar Carlson, Grand Rapids Northview, Hamtramck, New Baltimore Anchor Bay, Ovid-Elise, Warren Lincoln, Athens and Maplewood Baptist.
The full summary report on the Multi-Sport Participation Survey is available on the Multi-Sports Benefits page of the MHSAA Website.