Contributor: Susan Joy, MD, sports and exercise medicine physician
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Athletes know the unmistakable “pop” when they’ve torn their anterior cruciate ligament (ACL). It can put a quick end to the season and sometimes require surgery and extensive rehabilitation.
To prevent this, athletes need to practice proper form.
If you play soccer, basketball and volleyball, you should be especially mindful of two things: how you take hard, quick steps to accelerate in another direction (or “cut”) and how you land on your feet from a jump or a step (“plant”).
These cutting and planting maneuvers cause about 70 percent of all ACL injuries.
The jumping, landing and pivoting involved in these sports all stress the knee’s ACL – particularly in female athletes. Initiating a cut (or landing after a jump) can compromise the ACL’s ability to resist rotational forces. Planting incorrectly can overwhelm the ACL’s ability to move the knee the way it is designed to do.
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How the ACL works
The knee’s four main ligaments tether the tibia (shin bone) to the femur (thigh bone) where they meet at the knee.
The ACL plays a vital stabilizing role. It keeps the tibia from sliding up under the femur. It also limits over-rotation of the knee joint.
Female athletes at higher risk
Male and female athletes tend to have differences in how they maneuver in a jump or cut, which puts women at higher risk for injury.
Women tend to activate their quadriceps first, while men tend to activate their hamstrings first. This difference in activation may alter the amount of strain applied to the ACL and other knee ligaments.
In addition, after a jump, women tend to land with their knees closer together than men. Athletes who land with their knees farther apart seem to have less risk of ACL injury.
Fatigue: a problem for both sexes
Fatigue is a hazard for both male and female athletes. Tired athletes are more likely to use poor mechanics. For example, they may land with their knees closer together. This is especially true when a fatigued athlete makes a split-second decision to execute an unexpected move.
Supervised training reduces risks
Studies show that training programs supervised by sports health professionals improve athletes’ leg strength and jump-landing techniques.
Proper training decreases ACL injury rates in basketball, volleyball and soccer. The techniques that improve ACL safety can also enhance performance, and increase vertical jump height, acceleration and the ability to change direction.
Nothing can prevent ACL injuries altogether. But exploring their potential causes and maximizing prevention strategies can stop the “pop” and its frustrating consequences.
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