June 23, 1972 marked an important day in history for the American, educational system. On this day, the United States government passed an amendment called Title IX, which prohibited discrimination against females in any type of government-funded school athletic program.
As a result, a new generation of female professional and recreational athletes emerged in the United States. While this was a step in the right direction, orthopedists began to notice that certain athletic injuries were common amongst women. The ACL tear is one of them.
What is an ACL?
The anterior cruciate ligament, often called the ACL, is one of the four, knee ligaments that connect the thigh bone with the tibia or shin bone. It is responsible for limiting rotation and forward motion of the tibia. ACL injuries occur usually during three specific circumstances: planting and cutting moves, straight-legged landing jumps or pivoting with a hyper-extended knee.
Symptoms and Treatment
In most cases, a loud popping sound announces the unfortunate arrival of an ACL tear. Extreme pain ensues, followed by inflammation and the inability to bear weight. But physical pain is just part of the problem. A torn ACL requires costly and complex surgery, extensive and expensive post-op physical therapy and up to six-months away from your sport. To add insult to injury, knees with reconstructed ACL’s are 105% more susceptible to developing osteoarthritis than those without reconstructive surgery.
If you are female, you share a susceptibility to ACL injury with your sisters in sport. In fact, physical therapist Maureen Madden of the Stone Clinic in San Francisco asserts that female athletes are eight times more likely than males to sustain an ACL injury, and that during activity, incidence of female knee injury is five times higher per hour for females than for males.
When combined with faulty technique and inappropriate equipment, numerous biological factors increase the ligament’s propensity toward tearing. Athletes in the following sports are most vulnerable to ACL tears: skiing, volley Ball Gymnastics Soccer Hockey Basketball Rugby Wrestling Lacrosse and Football. These factors may include the following issues.
Hamstring/quadriceps muscle imbalances: Your quadriceps and hamstrings should have no more than a 60 to 40 percent strength ratio. Women, unfortunately, have significantly weaker hamstrings. This causes a biological domino effect. Your quadriceps straighten your legs, and your hamstrings flex your knees. Weak hamstrings causes women to land from a jump with knees in a locked position, thereby placing too much stress on the shinbone and tearing the ACL.
Hormonal Issues: Androgen is a male hormone. It increases your ability to build muscle – muscle that your knees require to enhance their stability. Women have more estrogen, which increases joint laxity. Flexibility usually comes easily to women, but excess flexibility increases joint instability. In fact, the results of a 1988 Swedish study of 108 female soccer players indicate that women have susceptibility to ACL injuries during their menstrual cycles. The players’ injuries decreased when their physicians put them on birth control pills. Flexibility is helpful, but not to the point that it compromises joint stability. There’s a big difference between the flexibility required for sports conditioning and the flexibility needed for performing in Cirque du Soleil. Re-evaluate your fitness programing. Chances are you need less yoga and more strength training.
A wider Q angle: The “Q” or quadriceps angle describes the angle between the hip and knee. It’s steeper in women, which leaves the female knee prone to slipping and sliding under duress.
In the next article, we’ll explore more factors involved with ACL injuries.