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.
Adjust Your Workout When Gym Isn't Option
April 6, 2020
Henry Ford Health System
Feeling at a loss about not being able to stick to your normal workout routine? You’re not alone.
Social distancing during the COVID-19 outbreak has resulted in people all over the world having to adjust their schedules to accommodate working from home, schooling and caring for kids, and finding ways to maintain as much of a “normal” schedule as possible.
As a result, many people are struggling to figure out how to get a good workout in without the help of gym equipment or a personal trainer.
“Anxiety over the current situation can add to a lack of motivation to work out,” says Brianna Gauna, an athletic trainer for Henry Ford Health System. “But just remember how beneficial it is to move your body, even if it is just around the house.”
How a Routine Change Affects Your Body
If you are used to working out every day or going hard at the gym on a regular basis, a short rest period from your routine might have its advantages.
“Taking time to rest can actually be a really good thing because it allows your body to recover,” says Gauna. “You might even start to see more muscle tone set in as you give your body a break.”
On the other hand, if you usually work out a few times throughout the week and suddenly stop, the results may cause negative effects. You may experience:
- Increased resting heart rate
- Less energy
- Change in mood or emotions
- Loss of sleep
How to Work Out at Home
Being stuck at home is not an excuse to skip a daily workout. Everyone works out a little differently, and there are plenty of options for you to stay active and try out new forms of exercise.
“Whether you are used to strength training or cardio, think about what your fitness goals are and choose activities based on what you’d like to achieve,” says Gauna.
Here are some ideas to keep you and your family active:
1. Yoga. Practicing yoga requires a great deal of muscle strength and balance. It is best for a full body workout. Look to YouTube or free apps on your phone for beginner workout videos that you can follow along.
2. HIIT workouts. These workouts are best for getting your heart pumping and increasing your stamina. Try choosing four exercises from the following list. (Search YouTube or Google for examples if you are not sure what each of these entails.) Do one exercise at a time for 30 seconds and then give yourself 20 seconds of rest before moving on to the next exercise. After you get through one rotation of those exercises, repeat three more times.
- Squats
- Push-ups
- Lunges
- Burpees
- Mountain climbers
- Glute bridges
3. Running or walking. Many apps allow you to track your run on a map, so you can plan out your route in your own neighborhood. This allows you to adjust how far you run or how much time you have for a run. A brisk walk through the neighborhood also works.
4. Biking. Biking is a great low-impact workout that works to engage and tone leg muscles. (Remember to wear a helmet!)
5. Team sports. If you are looking for something to engage you and your family, team sports are the way to go. Kick a soccer ball around, try to race through an obstacle course while dribbling a basketball or take turns throwing a football. If you don’t have the equipment, try playing keep-away with a stuffed animal or set up a relay race.
Exercise by Age and Fitness Level
The younger you are, chances are you have a faster metabolism. If you can’t get to a gym, think about how active you usually are and gauge the length of your workout from there.
If you are using this time to get started on your fitness journey, use these recommendations as a starting point:
Ages 7-17: 1-2 hours. Athletes that are used to going to weekly practices may find that two-hour workouts are more suitable.
Ages 18-30: About an hour. Look for times throughout the day that you can squeeze in workouts. Maybe you do yoga in the morning, a HIIT workout in the afternoon and a walk after dinner.
Ages 31-49: About a half hour. If you have children or a pet, you may find that you are already spending more time being active than this!
Ages 50 and up: At least 10-15 minutes. Gauge this based on your own abilities. You may live a more active lifestyle that allows you to be very active throughout the day. If you find yourself struggling to meet this mark, consider a walk during the day or stretches in the morning.
Once you get a regular fitness routine in place, work your way up to longer or more intense workouts to keep yourself challenged.
Making Your Own Equipment
If you have a treadmill, stationary bike or elliptical machine at home, now is the time to clear off the laundry it may have been collecting. If you don’t have access to weights or other gym equipment, though, that doesn’t mean you have to miss out on a quality workout. Look for things around your house that you can use in their place – get creative!
- Bags of beans, rice or pet food as added weight for squats or lunges
- Old books/textbooks as dumbbells
- A chair for triceps dips, calf raises or for stability during yoga
- Stairs to run sprints or to help you stretch out leg muscles
When your day-to-day routine is shaken up, do what you can to create normalcy in your life. If you find you have more free time throughout the day, take that time to get moving – even if it’s running up and down the stairs or going for a walk around the block.
“Don’t worry about feeling silly for switching up your routine,” adds Gauna. “Whether that’s using a random object for added weight during a workout or trying to remember how to ride a bike again on your street, think about yourself and your fitness goals first. Don’t let thoughts of what other people think of you get in the way of you reaching your goals!”
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.
PHOTOS: (Clockwise from left) MHSAA Student Advisory Council members Abigail Pheiffer of Novi, Lydia Davenport of Ithaca and Trevin Phillips of Caro will be working to stay in shape while staying home these next many weeks.