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.
Add Rest Days to Your Workout Routine
June 2, 2020
Henry Ford Health System
Whether you're new to exercise or a seasoned enthusiast, it's tempting to adopt an all-go, no-quit attitude. This is especially common when you're are trying to achieve a fitness goal. Maybe you want to run a 5K, or maybe you have 10 pounds you want to shed before going on vacation.
"Whatever the driver, it's important to remember that scheduling time for rest and rejuvenation is a critical component of any workout regimen," says James Moeller, M.D., a sports medicine specialist at Henry Ford Health System.
Building in Rest Days
From high-intensity interval training (HIIT) and spin to barre and Zumba, popular workouts increasingly push exercisers to go faster, longer, stronger. This prolonged physical stress can lead to overuse injuries, such as stress fractures, muscle strains and joint pain. Excessive exercise can also lead to hormonal changes, disrupted sleep patterns, decreased immunity and mood swings.
“Working out, especially resistance training, breaks tissues down, causing microscopic damage,” Dr. Moeller says. "Rest days allow your muscles time to rebuild."
So how much rest do you really need? There isn't a one-size-fits-all prescription. Factors like your age, fitness level, the intensity of your workout and the amount of training you do weekly will impact the amount of recovery time you need. But there are some basic guidelines for rest days:
1. Go easy: Rest is a relative term. "It's not just sitting on the couch with an iced tea," says Dr. Moeller. "You may still be exercising on 'rest' days, but at a lower intensity." Maybe you go for a brisk walk or ride your bike to work. Take a yoga class or do some dynamic stretching. The key is to make sure you're not overworking the same body parts.
2. Get sufficient sleep: Sleep is a key component of muscle repair and rebuilding. During sleep, your body’s production of growth hormone increases. Not getting quality shuteye thwarts your body's production of growth hormone and can impact your performance.
3. Give overtaxed muscles a break: You don't need to skip the gym on specific days each week, but you do need to rotate which body parts you're working. The general rule is to give muscles 48 hours to recover after a workout. So it's a good idea to take two to three days off before working the same muscle groups again.
4. Stay hydrated: Make sure to restore lost fluids before, during and after a workout. Dehydration can lead to overheating, headaches and muscle fatigue, among other ailments. You don’t need a sports drink; water is best. "Sports drinks aren't required unless you're getting into very high intensity activity, or exercising for more than one hour at a time," Dr. Moeller says.
5. Pay attention to your body: A lot of people try to work out through pain and fatigue. If there's a heaviness to your movements, or if you feel like your muscles are not responding appropriately to the stress you're providing, take a time out. "It's really about learning to read your body's signals," says Dr. Moeller.
Health authorities and news headlines widely publicize the health benefits of exercise — and the consequences of inactivity. The American Heart Association recommends that adults get at least 150 minutes of moderate-intensity exercise per week, plus strength training two or three days per week. Less discussed are the negative effects of not allowing your body sufficient time to rest.
Getting sufficient rest between workouts is just as important as participating in regular exercise. "Both are part of the total process required to build strength, endurance and muscle mass," Dr. Moeller says.
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.