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.
Workout Basics: Warm-Ups & Cool-Downs
February 3, 2021
By Nick Parkinson, M.Ed., AT, ATC, TSAC-F
Henry Ford Health Systems
You may know a good warm-up — and cool-down — are essential to getting a good workout. You may also know that warming up your muscles and stretching them out after exercise can help prevent injury and keep you at the top of your game.
They’re the two bookends that help maximize a workout. Unfortunately, a lot of exercise enthusiasts don’t know how to warm up and cool down correctly.
Warm-Up Basics
A warm-up is exactly what it sounds like: The goal is to warm up your muscles and prepare your body for whatever you’re asking it to do. Warming up increases your body temperature and helps blood flow to the muscles that you’re using.
So if you’re going to play soccer, your warm-up should touch all of the muscles in your legs and core. Shooting hoops? You’ll need to add shoulders and arms to your routine. Circuit training at the gym? Choose a warm-up that flexes all of the muscles you’re about to use.
The thing that all warm-ups have in common is that they require dynamic (or constantly moving) motion, not static stretching (holding poses for a certain amount of time). In fact, static stretching prior to a workout can inhibit power and strength, especially if you’re doing something like weightlifting.
The anatomy of a solid warm-up:
• Before any activity, do about 10 minutes of light cardiovascular activity, whether walking, biking or jogging.
• Dynamic stretches. After you get your muscles moving, do a series of lunges, jumping jacks or toe touches to stretch a bit.
• Dive in. When you start your workout, begin slowly and gradually increase power and speed.
Cool-Down Basics
After you’ve put your body through a challenge, a good cool-down is essential. It helps slow down your heart rate gradually, relax your muscles and stretch them out.
Cool-down routines should always include some type of motion before you get to static stretching, especially if you’ve just finished a high-intensity workout. Static stretching improves flexibility and performance and it can also help stave off future injury.
As with warm-ups, the right cool-down exercises depend on the activity you engaged in. If you biked for 20 miles, you might coast on your cycle for a while before coming to a stop. If you ran, you might jog or walk before you begin stretching. As with your warm-up, the key is addressing every muscle group you worked during your workout.
The anatomy of a solid cool-down:
• At the end of your workout, slow the pace and intensity of whatever activity you’re doing. So, if you’re running, slow to a jog and then a walk for 5 to 10 minutes before stopping.
• Stretch out the muscles you work, but don’t push past the point where you feel tight. Then, hold the position for at least 30 seconds. That’s how long it takes for the body to overcome its stretch reflex.
• Breathe through your stretches and make sure to finish your cool-down with deep, belly breaths.
Running short on time? Target muscle groups you may have injured in the past or that tend to get sore after activity. Cooling down will preserve your athleticism — and your ability to participate in daily activities — over the long term.
Be Good to Your Body
While there’s some controversy about whether warming up and cooling down can help prevent injury, there’s little dispute that they can help you ease in and out of activity.
The key is to find something that works for you. Your warm-up could be as simple as walking to the gym and doing a set of jumping jacks when you arrive. Your cool-down might just involve ending your workout 10 minutes early so you can slow down.
It doesn’t have to be complicated. It just has to give your heart and blood vessels a chance to breathe before and after activity.
Nick Parkinson, M.Ed., AT, ATC, TSAC-F, is the Supervisor of Athletic Training with Henry Ford Sports Medicine and also leads Sports Performance training at the William Clay Ford Center for Athletic Medicine. Learn more about Nick.
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.
Visit henryford.com/sports or call (313) 972-4216.