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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.
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Choose the Right Sports Medicine Expert
July 7, 2020
By Christina Eyers, Ed.D., AT, ATC
Henry Ford Health System
If you're an athlete, chances are you'll require specialized care from a health professional during your career.
Confused about the differences between athletic trainers, sports medicine physicians and exercise physiologists, among other experts? You're not alone!
Each of these professionals has different levels of training, expertise and certifications, but the care they provide often overlaps. That's one reason why they often work together.
Sports Professionals Defined
Caring for athletes isn't always clear-cut. In fact, most athletes require a full team of professionals working in concert to stay at the top of their game. Yet confusion remains about which professionals you need to see for training, injury prevention, and recovery and treatment after an injury.
Each type of professional has its own set of experience, training and certifications. Here’s how they measure up:
· Sports medicine doctor: Sports medicine physicians are typically trained in orthopedic surgery, primary care or emergency medicine. These professionals have medical degrees as well as specialized training in sports medicine, including the prevention and treatment of injury. In addition to caring for conditions ranging from concussion to head colds, sports medicine physicians also focus on helping people return to sports safely and effectively after illness or injury.
· Athletic trainer: Athletic trainers take care of athletes from prevention through rehabilitation. In collaboration with a physician, these professionals offer insights that help minimize risk and prevent injuries. They evaluate athletes and provide immediate care and treatment, sometimes even on the sidelines. They also provide rehabilitation and reconditioning after an injury or illness.
· Exercise physiologist: Exercise physiologists study the effect of exercise on the muscular, cardiovascular, and sympathetic and parasympathetic nervous systems. They examine functional capacity and strength due to endurance training or strength training. These professionals may also test athletes for VO2max (your oxygen volume while training) and body composition (the ratio of fatty mass to lean mass).
· Physical medicine and rehab physician: These professionals treat a variety of medical conditions that affect the brain, spinal cord, nerves, bones, joints, ligaments, muscles and tendons. They take the whole body into account to pinpoint problems and enhance performance without surgery.
· Physical therapist: Physical therapists diagnose and treat individuals of all ages with conditions that limit their ability to move and perform daily activities.
Other Specialized Professionals Who Care for Athletes
In addition to the health care professionals described above, athletes may meet with a host of experts, including:
· Nurses and medical assistants
· Occupational therapists
· Cardiologists
· Neurologists
· Behavioral health specialists
· Dietitians
· Complementary medical practitioners, such as acupuncturists and chiropractors
None of these individuals are "fitness professionals," a term nearly anyone can use to describe a range of professional activities. Rather, these sports medicine experts are part of a comprehensive team that includes at least one physician. They are each licensed by the state to provide specialized care to athletes.
Personal trainers, on the other hand, focus on helping people find their way around the gym, hold them accountable to achieve their goals and help new exercisers and seasoned fitness enthusiasts stick to a workout regimen.
If you're an athlete, you need a team of health professionals who can provide comprehensive care to reach your highest potential.
Christina Eyers, Ed.D., AT, ATC, is the Director of Athletic Training & Community Outreach with Henry Ford Sports Medicine.
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 for an appointment within 24 business hours.