A ball is kicked toward the goalmouth and a cluster of young women rush to meet it. The players run, jump, twist, kick and slide, trying to drive the ball into the net – or kick it clear. The play ends with the ball squirting out of play and one young woman lying on her back, clutching her knee.
Regrettably, this has become a common scene. More young people than ever, especially girls and young women, are tearing their knee ligaments.
Biggest increase for girls
Researchers from Minnesota and Pennsylvania examined insurance claims data over 20 years and determined that an increasing number of young people are suffering tears of their anterior cruciate ligament, or ACL, which provides stability in the knee. And girls have suffered the greatest increase in ACL tears.
“This is the first study I have seen that shows the incidence has increased over the past few years,” said Eric Marchek, physical therapist and sports manager at the Providence Care Center at Providence Park in Portland, Ore. “The frustrating thing is, there are programs that have been shown to reduce the incidence of ACL tears when performed consistently. Unfortunately, many schools, leagues and clubs still do not incorporate these programs into their practice routines.”
Tearing the ACL
The anterior cruciate is one of the ligaments that helps join the bones that meet at the knee – the femur, the tibia, the fibula and the patella. It can be damaged by impact, overextension or a sharp twisting action, such as when a baseball player slides into a base, a basketball player jumps for a rebound or a soccer player makes a sharp cut while running.
Most common signs of a torn ACL are:
- A popping sound at the time of the injury
- Swelling of the knee within six hours
- Pain, especially when you try to put your weight on the injured knee
Treatment usually involves surgery to rebuild the ligament and extensive physical therapy to improve joint motion and muscle strength.
Preventing ACL injuries
Providence’s Marchek cites such programs as FIFA 11+, SportsMetrics and the PEP Program, which emphasize dynamic warmups to improve strength, flexibility and form. He said if coaches would dedicate 15 minutes of training to such programs, it could reduce the risk of a “devastating injury like an ACL tear.”
As an example of what the workouts entail, here’s the description for FIFA’s 11-plus exercises:
- Running exercises
- Straight ahead
- Hip out
- Hip in
- Circling partner
- Jumping with shoulder contact
- Quick forward and backward sprints
- Strength, plyometrics and balance exercises
- Bench (static, alternate legs, one leg lift and hold, sideways bench static, sideways bench raise and lower hip, sideways bench with leg lift)
- Hamstrings
- Single-leg stance (hold the ball)
- Single-leg balance (throw ball with partner, test your partner)
- Squats (walking lunges, one-leg squats)
- Jumping (vertical jumps, lateral jumps, box jumps)
- Running exercises
- Across the pitch (field)
- Bouncing
- Plant and cut
“If you came to me with a concern about your daughter and reducing her risk for ACL,” Marchek said, “I would first take a look at her form when jumping/landing and assess her trunk and lower extremity strength. If we found any deficits, I would prescribe exercises to address those areas and then talk about ways to keep her strong, flexible and ready for play.”
And, he said, he would always recommend she do a dynamic warmup and strengthening routine, on her own if necessary.
If you’d like to learn more about keeping your young athlete healthy, talk to your health care provider. You can find a Providence provider here.
