ACL risk: Lower your chances of a dreaded ligament tear
The following article is sponsored by University of Utah Health Care.
Skyline High basketball player Sarah had no idea her knees collapsed inward when landing on her feet after jumping. It’s a tendency that makes her an at-risk athlete for tearing her anterior cruciate ligament, or ACL, a dreaded injury in sports that can cost an athlete a full year of participation with one “pop.”
“I was shocked. I thought I was a good lander,” said the sophomore guard-forward after seeing a video of her knees caving into an almost knock-kneed position during a screening with physical therapists who run University of Utah Health Care’s ACL injury risk prevention program.
Sarah’s movement patterns are common in women and girls, and evidence suggests these patterns may be a key reason why female athletes have higher incidence of ACL injuries than their male counterparts, said Amy Powell, M.D., a University of Utah Health Care sports medicine physician. Men are more likely to be injured from contact (a football helmet colliding with a knee) while women are more likely to suffer a noncontact injury that seemingly happens out of nowhere.
“The knee basically just buckles when they try to cut, pivot or change directions,” Powell said. “It typically happens in basketball, volleyball and soccer.”
Physical therapists are able to assess athletes’ risk level by examining how they move. They watch for movements that put the knees in vulnerable positions, especially the knock-kneed landing.
“Many women have that movement pattern when we’re not doing sports. So when we’re in sports and we’re evading other people, we’re more likely to injure ourselves,” said University of Utah Health Care physical therapist Barbara Fink, D.P.T., O.C.S., who runs the injury prevention program. “There’s a high price to be paid for an ACL tear, so our goal is to decrease, as substantially as we can, the risk of ACL injuries for recreational and competitive athletes.”
Once risk levels are determined, physical therapists work with athletes to re-train their bodies’ motion patterns.
“We teach athletes to keep the knee more in line with the toes and land bigger and softer,” Fink said. “When athletes train out of that pattern and build hip and leg strength, we see a marked decrease in the incidence of ACL tears.”
Injury risk reduction training and exercises can reduce ACL injuries by 25 to 40 percent, depending on the study, Powell said.
Strength training is a vital component of the process.
“For example, if the hips aren’t strong enough, it makes you more vulnerable to collapse inward so we’ll work on strengthening the hips,” Powell said. “Our programs are multifactorial. While the ultimate goal is to change how a person moves, we achieve that by working on strength of the leg and the hip, and by improving balance, coordination and agility. All of these areas combine to help a person optimize how they move and decrease their risk.”
Programs are tailored to the needs of individuals, groups of athletes and even entire teams. Sarah took part in a 6-week program that met three times a week in which she developed strength and balance and learned to force her knees outward — a stance she said is now second nature.
“They taught me the proper technique, and I have a stronger core because of it,” said Sarah who remains ACL-injury free.
Fink and her colleagues also train coaches and athletic trainers the techniques so they can lead their own exercises at the beginning of practices.
Powell said ACL injuries often strike the same athlete more than once. Tear one ACL, and you’re more likely to hurt the other. She recommends starting a new sports season slowly, noting that injuries occur most commonly at the beginning of high-intensity training.
“Preseason conditioning is very important,” Powell said. “It’s also important to try to maintain a good level of activity through the year rather than just seasonally.”
For more information about the University Orthopaedic Center’s ACL Protection & Prevention Program, click here or call 801-587-7005.