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Summer is the off-season for school sports and the time of the year
when athletes are working hard to become the best in the game. Kids
compete in every league available to fine-tune their skills so that
next season they will be one of the best competitors in their sport.
Some get private lessons from professionals, while others hit the
gym twice as hard. Athletes focus on getting in shape and developing
their skills so that next season they will be in the best shape they
have ever been in. However, within the next season there will be injuries.
Injuries, such as an anterior cruciate ligament (ACL) tear within
the knee, may end an athlete’s season.
ACL injuries have become more and more common, with female athletes
suffering an ACL tear 3-4 times more often than male athletes. 70%
of ACL injuries associated with sports are non-contact injuries.
Therefore, athletes participating in sports such as basketball,
volleyball, tennis, and soccer are at risk for an ACL tear.
How a non-contact ACL tear occurs
The ACL is a major ligament within the knee; it joins the femur
to the tibia (thigh bone to the shin bone). It crosses inside the
knee joint with the posterior cruciate ligament (PCL) resembling
an X. This X of ligaments provides 80% of the stability of the knee.
The crossing with the PCL helps prevent rotation at the knee, and
alone the ACL prevents the tibia (shin bone) from moving or shifting
in the forward direction.
A non-contact ACL tear involves rapid deceleration of the knee
joint that occurs when landing from a jump or planting the foot
too quickly when changing directions. When the knee is not in a
stable position during these activities an ACL tear can occur. Athlete’s
involved in sports demanding a lot of pivoting and fast changes
of speed and direction need to be capable of performing a controlled
and stable rapid deceleration of the knee in all directions, forwards,
backwards, diagonal, and sideways.
How to prevent an ACL injury
There are several precautions you can take to avoid knee injuries.
These tips can help athletes in general prevent knee injuries, especially
female athletes who want to avoid injury to their ACL.
- Don’t play when you are exhausted or through pain.
Injuries often occur at the end of practice and games when the
muscles are fatigued.
- Make sure you have good muscle balance. There
is a correlation between poor quadriceps-hamstring balance and
ACL tears. Many athletes, especially females, have weak hamstrings.
Strong hamstrings are important in helping the ACL stabilize the
knee during decelerations.
- Learn correct landing techniques. Many athletes
land with their knees hyperextended. Landing with your knees bent
allows the hamstrings to help in stabilizing the knee. Females
tend to land with their knees coming closer together from weakness
in their hip muscles. This increases rotational forces on the
knee, increasing risk of an ACL tear.
- Learn correct techniques for fast stops, cuts and turns.
Many ACL tears occur with deceleration and cutting to change direction
because athletes have never been taught this skill. You should
never make a cut with your leg straight. There must be increased
knee flexion (bending) before planting the foot to change directions.
Often these techniques occur quickly and there isn’t time
to think about performing them correctly. Therefore, separate
drills should be practiced in order to perform them properly without
thought.
- Correct footwear. Athletes should always have
shoes with good support and shock-absorbing capacity as well as
grips that are suitable for the surface their sport is played
on. Some athletes may require assessment of ankle movement that
may put them at risk for knee injury.
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