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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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5 Tips to Prevent Sports-Related Injuries
December 3, 2019
Henry Ford Health System
Participating in sports provides so many benefits to kids and teens. There are the obvious benefits of physical fitness and promoting regular exercise. Then, there are also the character-building lessons learned from being part of a team, working hard toward a goal, celebrating tough competition and gracefully accepting defeat. But sports don’t come without some risk.
Sports-related injuries are the leading cause of emergency room visits for kids ages 12-17, according to the Centers for Disease Control and Prevention (CDC).
These injuries impact twice as many males as females. Not surprisingly, contact sports also have higher injury rates. Football, basketball, baseball and soccer account for roughly 80 percent of all sports-related emergency room visits for children.
Sports injuries depend on the age of the athlete and the type of sport played, according to Bridget McArdle, D.O., a Henry Ford pediatrician. Generally, she says, sports injuries are divided into two groups: injuries from overuse like strains and tendonitis, and acute injuries such as concussions, fractures and tears.
The teen years pose special hazards, too. The adolescent growth spurt places teens at higher risk for injuries.
“The growth plates could still be open, which increases the risk for damage,” Dr. McArdle says. “This can lead to long-term problems.”
5 Important Injury Prevention Tips
Fortunately, many sports-related injuries can be prevented — the CDC estimates that as many as half of them could be avoided.
Here are Dr. McArdle’s tips for injury prevention for parents and coaches:
1. Ease into training. It’s important to start gradually in order to decrease the chance of sports injuries. “When you train too quickly at full peak, you are more likely to get hurt. Ease into it – and don’t overdo it,” says Dr. McArdle.
2. Cross train. Changing up the way your child trains is one way to help prevent sports injuries. “Taking a break from one sport to play another is important,” she recommends. Training a different way and using different muscles decreases the strain placed on the same body parts. Practicing gentle stretching exercises such as yoga or Pilates can also help, she adds.
3. Use the right equipment. Everything from the proper shoes and appropriate, properly fitted safety gear for the particular sport are essential for minimizing the risk of injury, as well.
4. Avoid excessive heat. The American Academy of Pediatrics (AAP) recommends young athletes avoid heat illness by wearing light clothing and drinking plenty of fluids before, during and after exercise or play. Coaches should decrease or stop practices during high heat or high humidity periods.
5. Take time to recover. If a sports injury does occur, taking time to recover is very important. Returning to play too soon increases the risk of making the injury worse, and increases the chance of long-term consequences. “Make sure the injury is completely healed before returning. Don’t allow your child to play through pain,” advises Dr. McArdle.
If you have questions or concerns about your child’s readiness to play, be sure to get a sports physical and talk with your pediatrician or primary care provider.
Dr. Bridget McArdle is a board-certified pediatrician, seeing patients at Henry Ford Medical Center – Sterling Heights.
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.