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.
Pandemic Planning: Creating a Schedule
December 15, 2020
By Stacy Leatherwood Cannon, M.D.
Henry Ford Health System
With coronavirus continuing to grab headlines and physical distancing orders still in place, every day tends to feel the same.
More parents than ever are working from home, have reduced hours or may even be out of work due to the pandemic. Those who are working at full capacity may feel the strain of trying to balance work and childcare. Many schools and extracurricular programs have been moved online or canceled.
With both parents and kids feeling the stress of new daily routines, it's more important than ever to create a schedule that all family members can follow.
Staying On Schedule
When schedules are off (particularly sleep schedules), children and teens may be at greater risk for depression and anxiety. Younger children may act out because they have increased energy with no outlet. The good news: Creating a schedule — and sticking with it — can help everyone feel more grounded.
Children thrive with an understanding of the daily routine. Knowing what to expect and what they need to do reduces anxiety and helps kids feel more in control.
A few ways to achieve an effective schedule:
• Make it a family affair: Instead of drawing up a schedule and expecting everyone to stick to it, involve your children in the process. Call a family meeting where you come up with sleep and waking times, mealtimes and breaks. Kids are more likely to embrace a new schedule if they played a hand in creating it.
• Enforce bedtime: Children doing remote learning may not have to rise as early to make it to school on time. Even so, it's important to set a regular bedtime so they can remain on task during daylight hours. Your best bet: Establish a bedtime routine that includes calming activities (like a bath and reading) and ensure your children go to bed at an appropriate hour. School-aged kids should get about 9 to 10 hours of sleep each night.
• Stick to mealtimes: Keeping mealtime consistent allows for a structured break where kids and parents can reconnect and troubleshoot when necessary. This is especially important with older adolescents who may work independently during the school day. Unfortunately, what works for one family member may not work for another. Ideally, families should work together to establish mealtimes, then adjust based on each individual's needs and assignments.
• Encourage breaks: Kids and adults alike become zombie-like after sitting in front of a screen for extended periods. For children who are distance learning, frequent breaks are especially important. The younger the child is, the more breaks they need to stay engaged. That said, even older kids should take breaks every 30 minutes or so to walk around, get a snack and do some simple stretches. Better yet, take your breaks together and do some jumping jacks or share a snack as a family.
Successful Scheduling
Coming up with an effective schedule that the whole family can follow is not something you do at the last minute. Plan for the week ahead over the weekend. Sit down as a family and discuss what worked — and what didn't — the previous week. Then tweak as necessary.
Most important, be patient. These are unprecedented times for all of us. And while we have months of experience dealing with this pandemic, transitioning back to school has brought new challenges.
Try to shift your focus toward the perks of this experience. This is a rare moment in history when families can come together and spend a lot of quality time together. It could be a time of growth and transformation for your whole family.
Concerned about how your children are managing the pandemic? Help is available. To find a doctor or pediatrician at Henry Ford, visit henryford.com or call 1-800-HENRYFORD (436-7936).
Stacy Leatherwood Cannon, M.D., is a board-certified pediatrician and the physician champion for childhood wellness for Henry Ford LiveWell. She sees patients at Henry Ford Medical Centers in midtown Detroit and Sterling Heights. Learn more about Dr. Leatherwood Cannon
PHOTO: Novi's Abigail Pheiffer, a senior on the MHSAA Student Advisory Council, gets in some wall sits during a break in her day.