ACL Injury Prevention: The Female Soccer Player

Brought to you by the Bone & Joint Clinic

Soccer remains the top spectator sport worldwide, with an estimated 300 million active participants to date. In the past twenty years, US Youth Soccer Association’s numbers have increased by 200, 000 participants. Unfortunately, the increased number of participants has also contributed to increased injuries in the sport. ACL tears are among the most severe and most frequent activity and sport related injuries in active adolescents. This year in the United States alone, an estimated 250,000 people will tear their ACL. The vast majority will affect women among ages 15 to 25, as females are up to 8 times more
likely to injure their ACL than males of the same age.

The anterior cruciate ligament, or ACL, is one of four ligaments that keep the knee from
wobbling or giving way when we move. To fully understand the impact of an ACL tear, it helps to know a little about how the knee works. As you can see in the diagram below, the knee is a large joint where the tibia meets the femur. The ACL connects the front of the tibia to the back of the femur. Its job is to make sure that the tibia does not slide in front of the femur, helping to maintain the stability of the joint.

When the knee is forced into an unusual position, the ACL can tear. In the summer of 2000, the Journal of the American Academy of Orthopedic Surgeons published the findings of a study group convened to look at non-contact ACL injuries. They cited four categories of risk factors for these injuries: environmental, anatomic, hormonal, and biomechanical.
ACL tears typically require surgical intervention followed by an extensive course of
rehabilitation. The injury inevitably leads to a prolonged absence from sport and a probable increased risk for developing early knee osteoarthritis.

Fortunately, recent evidence confirms that specific evaluation and training programs can help to reduce the high rate of injury in females. This ultimately avoids the high cost and time required to repair an ACL tear.

Studies have shown that the difference in neuromuscular control between male and female
athletes is the largest contributor to the increased rate of injury in females. In other words, the way females control the knee when they jump, land, and run, places them at a higher risk for injury. Research over the past 5-10 years has confirmed preventative programs addressing neuromuscular control can help to reduce the rate of female injury to equal that of their male counterparts. The training method must be methodical and very form focused in order to avoid retraining already existing bad habits. Side benefits of the program include improved speed, strength and agility, which will also improve sports performance.

For more information about programs like this contact your local physician or physical therapist.

QUICK FACTS:
• Females are five to eight times more likely to injure their ACL than males of the same age
• The way females control the knee when they jump, land and run places them at a higher
risk
• Preventative programs that emphasize the athlete’s mechanics can lower a female’s risk  of injury to that of their male counterparts

Your Clinical Team Members
David Pope, M.D.
Orthopedic surgeon at the Bone and Joint Clinic with subspecialty in Sports Medicine and special interest in the management of knee injuries

Stephanie Wilks, PT, DPT
Former LSU soccer player, Pediatric and Sports Medicine Director at Hennessy Physical Therapy, providing youth sports orthopedic rehabilitation