IASIS Healthfix: ACL Injury prevention strategies for female athletes

An anterior cruciate ligament, or ACL, injury is a tear in one of the ligaments that connects the femur to the tibia. The ACL runs diagonally through the middle of the knee joint and functions as a stabilizer, preventing the tibia from sliding out from the femur.

An injury to the ACL can range from a minor tear to a full ligament separation from the bone. ACL injuries often occur during physical activity or sports, especially those involving stop-and-go movements, weaving, pivoting, or jumping. Female athletes have an increased risk of ACL injury, which may be attributed to biomechanics, anatomical differences, and hormonal differences. However, there are preventive measures any athlete can take to improve their strength and modify movement during physical activity.

Symptoms of an ACL injury

• Feeling/hearing a pop in the knee at the time of injury
• Severe pain around the knee
• Knee swelling within the first few hours after injury
• Limited range of motion in the knee
• The knee feeling unstable or buckling

Early Treatment/Home Care—Early treatment includes:

• Rest for several days following injury
• Ice the area for about 20 minutes every few hours
• Apply a compression bandage to help control swelling
• Elevate the injured knee above the heart

Medical Treatment—There are both nonsurgical and surgical treatment options for ACL injuries, which depend on the severity of the injury and the physical demands of the patient. Nonsurgical and surgical treatment options include:

• Physical therapy and rehabilitation
• Wearing a knee brace during physical activity
• Muscle-strengthening and range-of-motion exercises
• ACL reconstructive surgery

Prevention of an ACL injury

While an ACL injury may not be completely avoidable, there are ways athletes, specifically female athletes, can reduce their risk. The best way to prevent an ACL injury is to strengthen the muscles in the leg, primarily focusing on the quadriceps and hamstrings.

There are programs that can help prevent ACL injuries by teaching an athlete safer performance techniques, the best ways to stretch and strengthen muscles, and injury awareness.

Basic Components of the ACL Prevention Program

1. Warm-up (50 yards each)
   1. Jog line to line of soccer field (cone to cone)
   2. Shuttle run (side-to-side)
   3. Backward Running

2. Stretching (30 s x 2 reps each)
   1. Calf stretch
   2. Quadriceps stretch
   3. Figure 4 Hamstring stretch
   4. Inner Thigh stretch
   5. Hip Flexor stretch

3. Strengthening
   1. Walking Lunges (20 yards x 2 sets)
   2. Russian Hamstring (3 sets x 10 reps)
   3. Single toe-raises (30 reps on each side)

4. Plyometrics (20 reps each)
   1. Lateral hops over 2 to 6 inch cone
   2. Forward/backward hops over 2 to 6 inch cone
   3. Single leg hops over 2 to 6 inch cone
   4. Vertical jumps with headers
   5. Scissors jump

5. Agilities
   1. Shuttle run with forward/backward running (40 yards)
   2. Diagonal runs (40 yards)
   3. Bounding run (45-50 yards)