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.
Snap, Crackle & Pop: Why Do My Knees Make Noises - And Should I See a Doctor?
April 5, 2022
Do you ever just go about your daily life and then, seemingly out of nowhere, your knee makes a noise?
You might call it a weird idiosyncrasy and not think twice about it—or you might turn to the Internet to try and find all of the potential issues that might be wrong with your knee.
But if your knee pops or cracks once in a while, it’s usually no cause for concern. After all, joints sometimes make noises, and knees are no exception (especially when you squat or sit down.)
“Infrequent knee pops and cracks are more common in the younger population, says Nancy White, M.D., a sports medicine physician at Henry Ford Health. “When you feel that ‘pop,’ it means your kneecap was pulled a bit outside of where it’s supposed to be, and so it’s correcting itself and getting back into position. You can kind of feel that something moved.”
If, however, pain or swelling accompanies a noisy knee, you should have it evaluated by a sports medicine provider. And if your knee is popping or cracking regularly, that's another sign you should have it checked out.
“If you let it go, your knee could get worse,” says Dr. White. “There are recommendations a doctor can make to prevent this from happening, such as strengthening and flexibility exercises.”
What Is Knee Crepitus?
If your knee sounds like Rice Krispies crackling (or you experience a grinding sensation) it likely means you have knee crepitus, which can signify the beginning of osteoarthritis behind the kneecap.
“Knee crepitus is primarily caused by an issue called patellofemoral dysfunction,” says Dr. White. That sounds like a mouthful, but it means that your knee isn’t tracking straight up and down like it’s supposed to.
“There’s cartilage on the back of your kneecap and on the front part of your thigh, and the cartilage on the front part of your thighbone makes a groove so the kneecap can glide straight up and down in a floating position,” says Dr. White. “If the cartilage is worn down (and inflamed, worn-down cartilage signifies osteoarthritis), the kneecap can’t smoothly glide up and down, causing knee crepitus.”
If you are experiencing knee crepitus, you should see a sports medicine primary care physician, especially if it is accompanied by pain. They can recommend a variety of treatments, such as physical therapy and cortisone injections.
Still not sure if your noisy knees are cause for concern? When in doubt, call your doctor. After all, the sooner your doctor can examine it, the sooner you can prevent an issue from getting worse.
To learn more about your orthopedic condition or to find a provider, visit henryford.com/ortho.
Dr. Nancy White is a sports medicine physician with Henry Ford Health. She sees patients at Henry Ford Medical Center – Novi, and Henry Ford Medical Center – Bloomfield Township.