As summer is coming to an end fall
sports are starting to begin. Young athletes are pumping up their soccer balls
and getting their running shoes on. Unfortunately this also means sport
injuries. One injury in particular, the ACL tear, has been gaining more
headlines recently especially with female soccer players.
What is the ACL?
The anterior cruciate ligament, ACL, stops the knee from
hyperextending and controls rotational forces in the knee.
How is it torn?
The tear can be due to contact or non-contact injuries.
During soccer a tear can occur during a quick stop combined with a direction
change while running, pivoting, landing from a jump or overextending the knee
(hyperextending).
What is the incidence of tears in the US?
Tears occur in 1 out of 3500 people each year. Female
athletes have an incidence of ACL injury 9.5 times greater then males. About
70% of all ACL injuries are a result of sports participation.
Why does it occur more in females?
There are anatomical, physiological, and neuromuscular risk factors
that are responsible for the higher percentage of tears in females. The
anatomical factors include less muscle mass, greater joint hyperextension and
laxity, increased pronation (flat feet), wider hips, and smaller skeletal size.
The physiological factors include a possible correlation between menstruation
and ACL tears. The neuromuscular factors include increased contraction of the
quadriceps versus the hamstrings, which supports the ACL, and the tendency of females
to land from jumps and perform cutting activities in more upright position.
Are ACL prevention programs effective?
A recent study by Madelbaum et al. shows a decrease of 88%
after 1-year and a reduction of 74% after a 2-year follow-up in the incidence
of ACL injuries for over 1000 female soccer players participating in a
sports-specific prevention program.
How do I find an ACL program?
The study mentioned above used the PEP program, which can be
found at the Santa Monica Orthopaedic and Sports Medicine Group at: http://aclprevent.com/pepprogram.htm
Once an injury occurs it usually requires a surgery followed
by many months of rehabilitation. If you are a parent of a young athlete,
especially a female soccer player, ask either your child if they are
participating in a program or contact the coach. If the coach does not have a
prevention program in place try to suggest the one mentioned above. If you have
any further questions do not hesitate to contact either one of our offices.