ACL Injuries Growing Occurrence – How To Prevent & Rehabilitate Them!

By: Rachel Amarosa, ATC

With the growing popularity and participation of adolescence sports, there has been a substantial increase in the occurrence of youth athletic injuries nationwide. ACL injuries are one of the more devastating and frequent injuries that occur in our athletic youth population today. The ACL or Anterior Cruicate Ligament, is one of four major ligaments that provides stability in the knee joint. Ligaments are non-stretchable, strong fibers that hold bones together. A lot of times when the ACL is either injured or torn – it is common to have an injury to the MCL (Medial Cruicate Ligament) and / or the meniscus structures as well. The MCL is another one of the four major ligaments of the knee that provides stability and the meniscus is soft tissue that acts like a cushion within the knee joint, between the tibia and femur bones. An injury to the MCL or mensicus in association with an ACL injury can make the overall return to sport slightly more complicated and usually longer.

Here Comes The Shocking News: Nearly one in every sixty adolescent athletes will suffer an ACL injury during their athletic participation. Many of these athletes will then undergo an ACL Reconstruction (which is a 6 to 12 month recovery). In adolescent athletes, females are up to eight times more likely to tear their ACLs compared to their male counterparts. There are several studies that indicate anatomical, physiological and behavioral factors between males and females that are the reasons for such a large ratio difference. The differences in strength, landing mechanics, cutting mechanics, hormone levels and training programs have all been identified as possible risk factors for ACL injuries in adolescence females. Furthermore, most of those ACL injuries occur with little to no contact! I will repeat that – Most ACL injuries occur with little to no contact! Most non-contact ACL injuries occur from cutting (a sudden change in direction), sudden deceleration, or by landing incorrectly from a jump. All these movements happen across most sports, making it all the more important to learn what you can do to help reduce the risk!

Many well designed sports training programs will create comprehensive workouts to prevent several types of sports related injuries. For an ACL prevention training program, it needs to include – balance, proprioception, strengthening, endurance, conditioning, agility, proper landing mechanics and sports specific exercises. Key is to make sure you are doing exercises properly with a focus on quality of movement! In addition to learning general prevention of an initial ACL injury, it’s important to consider how athletes return to sports following an ACL injury. After an ACL reconstruction, an athlete can expect to need Physical Therapy for a minimum of 6 months and upwards of one full year! Physical Therapy will help you regain full range of motion, stability and strength. They will also address proper movement patterns, landing techniques and sports specific training. However, it then becomes essential to continue a comprehensive training program because adolescent athletes with an ACL injury have a 15 times greater risk, compared to an athlete without a previous ACL injury, of sustaining a second ACL injury of either the same or opposite leg after returning to sports. Research has shown that even though an athlete is cleared to return to their sport, often times there continues to be some residual muscle weakness and asymmetry, along with compensatory movement patterns. This fact not only shines a light of focus on continuing a training program after sustaining an ACL injury but should make you do whatever you can to prevent an ACL injury in the first place!

Understanding the need and timing of certain interventions is hard for an adolescent athlete to do on their own. It can require some help from their families, coaches and local professionals. Physical Therapists and Certified Athletic Trainers are healthcare professionals that can perform extensive functional assessments and screenings to help determine where the weaknesses, imbalances and concerns can be for your athlete. For the female adolescent athlete there is a hyper focus on assessing their proper landing mechanics, form when squatting & lunging, and general testing of their overall lower extremity strength. They then use the information to provide a comprehensive training program designed to help prevent the risk of an unwanted ACL injury along with many other types of injuries as well!

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