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 Exercise Can Help Reduce Your Anxiety
January 6, 2022
Stress and anxiety at any level can be hard to manage. If you’re searching for relief, try turning to exercise. Even the smallest amount of physical activity can make a significant difference and reduce stress.
“Anxiety affects our minds and bodies. Exercise can serve as a natural antidepressant, boosting our mood at the same time it improves our health,” said Megan LaDrigue, ATC CSCS, an athletic trainer at Henry Ford Health System. “You don’t need to join a gym to exercise. The world is full of opportunities to be more active. You can add in short exercise sessions throughout the day to recharge your mood and energy.”
How Anxiety Impacts Your Health
If not addressed, anxiety can impact your mental and physical health. “Anxiety causes an imbalance in the chemicals and hormones that support our brain, immune system, digestive health and sleep,” said LaDrigue.
Chronic stress can lower our feel-good hormones – serotonin, dopamine and epinephrine. At the same time, the stress hormone cortisol increases when we’re under pressure or anxious. As a result of these shifts, you may experience:
► Trouble concentrating and loss of productivity at work or school
► Irritability and moodiness
► Difficulty sleeping
► Weight gain and digestive problems
► High blood pressure and increased risk for other diseases
How Exercise Can Break The Stress Cycle
“By adding exercise into your daily routine, you can begin to manage anxiety and improve your overall health,” said Ladrigue. Exercise offers many benefits, including:
► Shifting your focus: Focusing on your physical activity is a chance to take a mental break from daily tasks and recharge.
► Improving mood and confidence: When you exercise, your heart contracts more frequently, increasing blood flow to the brain and triggering changes in those feel-good chemicals. These changes improve mood and confidence. Over time, exercise can also help build resilience by increasing your ability to tolerate stress.
► Enhancing concentration and productivity: Exercise activates the areas in the brain that control how we think and act. For example, physical activity can improve your ability to plan, organize and monitor behavior and tasks.
► Improving sleep: Fatigue can increase feelings of stress and anxiety, which increase your risk for insomnia or poor sleep. Exercise improves your ability to get the quality, restorative sleep that you need to recharge your mind and body.
3 Steps To Starting An Anxiety-Fighting Exercise Routine
The U.S. Department of Health and Human Services recommends adults get 150 minutes of moderate exercise per week. “But you don’t need to do all of that exercise at once. If you’re just getting started, gradually build exercise into your daily routine to create a healthy habit,” LaDrigue said.
Ladrigue recommends these three steps to build an anxiety-busting fitness routine:
- Make it fun: Whether it’s walking or weightlifting, if exercise doesn’t inspire you and make you feel good, it won’t help you manage anxiety. If being social helps motivate you, find a workout buddy and encourage each other to keep moving. Explore new types of exercise by taking an online or in-person fitness class.
- Create a flexible schedule: If finding time in your day to exercise adds to your stress, try working in shorter activity periods. Do some stretches while you’re waiting for the coffee to brew. Take a walk during lunch or while you’re talking on the phone. Use the stairs instead of the elevator. Park your car farther away from your destination and walk the extra distance.
- Set goals: Start by setting short-term goals for your fitness routine. Record your progress to stay focused and motivated. As exercise becomes a daily habit, set longer-term goals. For example, try a community walk or run, join a hiking club or participate in a local sports league.
Build An Effective Workout Plan
If you’re new to exercise or have an underlying health condition, check with your primary care physician before starting a fitness routine. Had an injury in the past? See a physical therapist or sports medicine provider to avoid future injuries.
If you’ve taken a break from exercise or are exercising for the first time, start slowly. Over time, you can gradually increase the time and intensity of your workout to meet your goals.
When picking an exercise program, Ladrigue suggests including these elements:
► Warm up: Start with five minutes of activity like jumping jacks or running in place to increase the blood flow to your muscles.
► Dynamic stretching: Gently move through small or large ranges of motion to elongate the muscle tissue. For example, you can try arm circles or walking quad stretches to get your muscles warmed up.
► Strength training: If you’re new to strength training, start with light weights. You can start with three sets of 10 repetitions for each muscle group. Combine sets for a muscle group on the front of the body immediately followed with a set for a muscle group on the back of the body, like biceps and triceps. This approach is called “super-setting.” It keeps your heart rate elevated while giving the working muscle group time to recover. It also increases your metabolic burn, the rate at which you burn calories during exercise.
► Aerobic activity: Choose from a variety of activities, like walking, running, biking, swimming or dancing. Light- to moderate-intensity exercise can help you recover at the end of a strength training workout while increasing oxygen and blood flow to the working tissues.
► Cool down: Hold stretches for 20 to 30 seconds to elongate the muscle tissue used in your workout. This type of stretching helps prevent or minimize soreness.
“While starting a new habit like exercise can seem daunting, stay positive. Feel empowered – you’re taking steps that will improve your overall mental and physical health for years to come,” said LaDrigue.
To find a primary care or sports medicine specialist at Henry Ford, visit henryford.com or call 1-800-436-7936.
Megan LaDrigue is an athletic trainer who works with the Henry Ford Sports Medicine Sports Performance Program.