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.
Can A Sports Physical Replace A Wellness Exam?
August 6, 2024
Before your child can take the field or hit the courts, their doctor must give the all-clear for them to play.
Since the sports physical is a pre-requisite to organized activity, you may be tempted to skip your child’s annual well-visit. After all, do you really need to go to the doctor’s office twice if they’re healthy enough to play sports?
Of course, the answer is yes! Each type of visit to your pediatrician serves a different purpose, and one cannot replace the other.
Shoshana Gordon, D.O., a pediatrician for Henry Ford Health, explains the differences between the sports physical and regular wellness examination.
What Happens at a Wellness Exam
An annual wellness exam is a comprehensive visit that allows your child’s pediatrician to monitor all aspects of your child’s development. These appointments can vary quite a bit, depending on your child’s age.
“Your child grows so much early in life that we need to see them several times before their first birthday,” says Dr. Gordon. “As they get older, the conversations at these appointments evolve and expand to include topics like mental health and what to expect from puberty.”
Generally, many aspects of your child’s wellness exam will stay the same over time. Regardless of age, this appointment will include:
- Checking vitals (heart rate, blood pressure)
- A physical exam (to monitor physical growth)
- Discussing developmental milestones
- Developmental and emotional/behavioral screenings
- Conversations about nutrition and any physical activities your child is involved in
- Conversations about how your child is getting on at school
- An opportunity to discuss questions or concerns you or your child may have
One crucial part of the wellness exam is immunization. This appointment is the best time for you to talk with your child’s pediatrician to make sure that your child is up to date on necessary vaccines.
Additionally, wellness exams are the best way for you and your child to develop a relationship with their pediatrician. When you only take your child to the doctor when they are sick, it is harder for your pediatrician to set a baseline for their health.
“Regular wellness visits allow you and your child to get comfortable with asking your doctor questions,” says Dr. Gordon. “Once we develop a good patient-provider relationship, your child’s pediatrician will have an easier time recognizing when your child isn’t feeling like themselves and can better offer alternate approaches to care that best suit your child’s unique needs."
What Happens at a Sports Physical
Sports physicals are used to determine if your child is healthy enough to participate in organized sports. During this appointment, your child’s doctor will screen them for different sports-specific health concerns. They will be evaluating several things including:
- Heart function
- Lung function
- Mobility
- Reflexes
- Endurance
“During a sports physical, we’ll look at both your child’s and your family’s health history to make sure there aren’t any indicators that could impact your child’s ability to play,” says Dr. Gordon. “For example, if your child had COVID or if you have a family history of cardiovascular complications, additional tests may be necessary to make sure this isn’t affecting your child’s health.”
The biggest difference from a wellness exam? Sports physicals don’t include developmental screeners that are essential to your child’s growth.
“At the end of the day, a sports physical cannot take the place of your child’s annual wellness exam,” says Dr. Gordon. “However, when you go for your child’s wellness exam, talk to your child’s pediatrician about including a sports physical as part of the appointment.”
In addition to the developmental, social and emotional evaluations that take place at your child’s annual wellness exam, this is the best time for you and your child to get to know your pediatrician. Establishing yourself with your child’s doctor will make it easier to treat and care for your child as they continue to grow.
To find a sports medicine provider at Henry Ford Health, visit henryford.com/athletes or call 313-651-1969.
Dr. Shoshana Gordon is a pediatrician who sees patients at Henry Ford Medical Center-Royal Oak and Henry Ford Medical Center-Sterling Heights.