Preventing ACL Injuries

 

I’ve got some good news and some bad news.  Which do you want first?

OK. The bad news. Anterior Cruciate Ligament (ACL) injuries continue to occur—at an alarming rate. The statistics just don’t seem to get any better.  There are over 250,000 ACL injuries ever year.

Athletes are at a much higher risk, being involved in over 10 times more ACL injuries than non-athletes.  And even among non-athletes, the person injured is likely to be participating in some sort of physical activity.

Females are between 7 and 9 times more frequent with ACL injuries.  Factors affecting that include physical differences between males and females with females having a wider pelvis and a greater Q-angle at the knee, different hormonal changes, maybe a later start in sports and definitely a later start in weight training.

There are just a few of the possible factors and there is definitely no consensus.  I list these things because that is my opinion—an opinion based on 48 years of clinical practice and a lifetime of clinical research.

The most common mechanism is when you plant your foot and suddenly change directions.  Football, basketball, and soccer are generally the biggest culprits, but part of that may be due to the higher participation rates in those sports in this country.

More bad news—research tells us that if you have one ACL injury, you are 15 times more likely to develop a second ACL injury, in that knee or the other one.

By now, you’re probably asking what the good news might be.

Ah…the good news.  The good news is that there are a lot of things that you can do to prevent ACL injuries.  Nothing is a sure thing but studies have shown that effective intervention programs can cut that incident rate by as much as half. 

That might not seem too profound, but if you’re in the good half, you like those odds.

So, what can you do? First, encourage all children to be physically active from an early age.  Encourage weight training once they reach puberty. Eat healthy and sleep well.

And see a Sports Physical Therapist. You see, those biomechanical issues can be addressed.  Weak hip musculature, particularly for external rotation, can be a huge factor. Foot biomechanics, or the way the foot hits the ground, can be massive.

The Sports PT is trained in biomechanics and is the movement experts, and those two arenas are where you can make the biggest impact in preventing ACL injuries.

An analysis by the Sports PT can serve as the foundation for training and moving forward. Areas that can be addressed include jump landing, core strength, and resolution of other mechanical issues that can contribute to a breakdown in the kinetic chain, too often manifesting as that dreaded ACL injury.

Prevention isn’t easy and it requires dedication and a commitment to ongoing attention to all the details, but doing so might help you avoid an ACL tear. 

And that’s definitely a good thing.