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.
Why Athletes Should See A Sport Psychologist
By
Elizabeth Swanson
Henry Ford Health
January 9, 2024
Whether at the professional or intramural level, there are so many benefits to being an athlete. Participating in a sport teaches communication skills, how to overcome adversity—and regular exercise has so many incredible health effects on the mind and body.
But that’s not to say athletes don’t have their own set of challenges. Pressures to perform, physical injuries and intense schedules can take a toll on anyone’s mental health, which is where a sport psychologist comes in.
“It’s helpful that a sport psychologist knows the culture of athletics and the typical stressors that athletes face,” says Seth Swary, Ph.D., a sport psychology clinician at the Henry Ford Center for Athletic Medicine. “We’re familiar with the influence the world of athletics can have on someone and how it can affect their well-being.
“Athletes have a whole team around them to help them perform — athletic trainers, nutritionists, etc.— so why shouldn’t they have an expert who is dedicated to supporting their mental health? A sport psychologist acts as a strength-training coach for the mind.”
Mental Health Challenges That Athletes Face & How Sport Psychology Can Help
Athletes often have a built-in support system: teammates and coaches who know what they’re going through and trainers and physicians who can help manage aches and injuries. But still, it’s not always easy. Some of the difficulties that athletes face include:
- Increased attention on body image. Especially if you play a sport that requires revealing outfits — or a sport with increased focus on weight — it might be difficult to maintain a healthy body image. For some, this can lead to an increased risk of developing an eating disorder.
- The pressure to perform. “If you’re an athlete at the college or professional level and play badly during a game, you get roasted on Twitter,” says Dr. Swary. “But even if you’re not in the public eye, there is pressure to perform — from coaches, teammates, family members.”
- Navigating demanding schedules. “I work with many college athletes and their schedules are packed — practicing at least two hours a day, team meetings, traveling to and from games — and then they’re trying to keep up with school,” says Dr. Swary. “It can be stressful.”
- Debilitating physical injuries. The physical demand of sports can also bring about its own set of challenges — especially when injuries occur. “You’re not only dealing with surgery and rehabilitation, but you’re also out of the game for a while,” says Dr. Swary.
- Making career transitions. “I’ve worked with many athletes who are transitioning from one level of athletics to another (for example, middle school to high school, high school to college, college to professional) along with athletes who are transitioning out of their career,” says Dr. Swary. “They wonder how they can leave this sport they’ve been doing their whole lives — some since they were 3 or 4 years old. It can be a huge part of their identity and a tough transition to make. Even more so if it’s an injury that abruptly derails their career. We can provide them with ways to make a smooth, healthy transition.”
That said, nothing “bad” has to happen to benefit from sport psychology. As Dr. Swary says, you don’t see a personal trainer because you’re not strong, you see a personal trainer because you could benefit from being stronger. It’s the same with sport psychology — and it can help improve your performance.
“We have specific skills we work on for performance optimization,” says Dr. Swary. “How do we talk to ourselves? How do we respond in certain situations? How do we stay in the moment when we’re distracted?
“A high school athlete may have had a rough day at school; then they have to refocus and find energy at the end of the day for their game. It can be helpful for any athlete at any time.”
Reviewed by Seth Swary, Ph.D., a sport psychology clinician at the Henry Ford Center for Athletic Medicine.
To learn more about the sport psychology program at Henry Ford or to request an appointment, visit henryford.com/sportpsychology.