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.
How Can COVID-19 Impact Student-Athletes' Return-To-Play?
October 5, 2021
COVID-19 And Student Athletes: How Can the Virus Impact Return-To-Play?
The end of summer marked the start of the school year, and for student athletes, the kickoff of the fall sports season. For many, COVID-19 sidelined practices, team gatherings and games to some extent last year. And while there is still hope that young athletes will have more opportunity to play this season despite rising cases of the Delta variant, there are other factors causing concern among athletes and their parents.
According to Ramsey Shehab, M.D., a sports medicine physician for Henry Ford Health System, many athletes are concerned about reaching peak performance after a long time off or after they have recovered from a COVID diagnosis. He reassures students that the feeling of exhaustion or even underperformance compared to past years is to be expected when you take time off or after fighting an illness.
“When you are infected with a virus, it taxes your immune system, and all of your energy goes towards fighting off that infection,” says Dr. Shehab. “You’ll likely feel weak and more tired during this time.”
Fortunately, as the body begins to recover, you’ll start to feel more like yourself again as you get your energy back. But this doesn’t mean that you won’t lose some of that fitness and endurance you’ve built up.
“It only takes about a week of deconditioning to set you back from peak athletic abilities,” says Dr. Shehab. “It is completely expected that your body will need time to get back to performing at your best.”
Playing Sports After Recovering From COVID-19
The unfortunate news: COVID-19 affects people differently in the long term. Some people are able to recover and get back to their routine without delay, whereas others see further complications months after an infection.
Akshay Khandelwal, M.D., a cardiologist with Henry Ford Health System, breaks down some of the more serious findings regarding COVID-19 and your heart health.
“With COVID-19, there is a risk of direct injury like heart failure or an arrhythmia due to the stress your body is under while fighting off the virus,” says Dr. Khandelwal. “As a result, having the virus can cause inflammation of the heart, a condition called myocarditis.”
Because of this, talking to your doctor before returning to a sport is a must if you had COVID or are recovering from the virus. It is important to make sure there are no systemic changes to your body such as overall heart health and lung function. They will be able to rule out any long-term effects that could impact your fitness output.
Expert-Recommended Steps for Return-To-Play
As you get back to your game, both experts share their insights for a healthy recovery:
1. Take quarantine periods seriously. If you are sick, even if you don’t necessarily feel sick, make sure you are taking time to rest and recover properly. “Don’t try to push or overexert yourself,” says Dr. Khandelwal. “It could prolong your recovery.”
2. Get back to training slowly. “Start using low-exertion activities to get your body used to working out again,” says Dr. Shehab. “Once you are able to handle each activity, you can push ahead to something more challenging.” Realistically, it may take a couple of weeks before you are able to get back to your peak.
3. Listen to your body. If workouts seem increasingly difficult, talk with your doctor or trainer before pushing yourself further. You can also help your body recover by making healthy, thoughtful choices:
► Get plenty of sleep
► Warm up and cool down before and after workouts
► Stay hydrated
► Take breaks when you’re tired
► Practice injury prevention
► Make smart food choices
4. Get vaccinated. If medical or religious reasons, or age requirements aren’t stopping you from getting the vaccine, consider getting the shot for yourself and those around you. The Delta variant is highly transmittable, meaning that, it is much easier for it to spread to teammates and family members than the original strain of the virus.
To learn more about the COVID-19 vaccine, visit our Vaccine FAQs page.
Talk to your doctor to learn more about safely returning to a sport. To find a doctor, visit henryford.com or call 1-800-436-7936.
Dr. Ramsey Shehab is the deputy chief of Sports Medicine at Henry Ford Health System. He sees patients at the Henry Ford Center for Athletic Medicine and Henry Ford Medical Center - Bloomfield Township.
Dr. Akshay Khandelwal is an interventional cardiologist who sees patients at Henry Ford Medical Center – Second Avenue.