It was early November of 2013 when I got my first taste of true devastation. My high-school varsity soccer team had made it to the NHIAA semi-final tournament and anyone that knows the small community of Woodsville, knows how huge that was for our school. I took a hit from an opposing player in the first few minutes of the game, unbeknownst of how serious the hit was to my knee at the time. “My kneecap just slipped out again, it’ll be fine within a day or so,” I thought. I hobbled along the sideline testing it out for the remainder of the game as I watched my teammates battle a tied game that ended in a penalty shot kick-off. I was out for the game, but if we won the shoot-out I knew that I would have a chance to make an appearance to the final that next weekend. We did win the shoot-out and we did head to the championship game that next weekend, but we did not win. I had decked my knee out with a bionic-looking brace that restricted quite a bit of range of motion but I was determined to play. Despite the disapproving talk made by the announcers, my coach put me in the game only to watch me stumble with every couple steps. We went into another penalty kick shoot out only the second go around, the win was not in our favor. It was my senior year and I was unable to exert my 110% for the team in those last two games as an Engineer. My heart was broken and the MRI results that I received a few weeks later revealed that my knee was too.
The collision I believed to be a simple knee subluxation or sprain at the time was actually a complete ACL tear. The ACL, or anterior cruciate ligament is the structure deep within the knee that connects the femur to the tibia and provides stability for rotational movements that the knee sustains. (It is shown in the image to the left.)Without this ligament, forceful cutting and pivoting movements common in soccer, football, hockey, etc. become very difficult if not impossible.
I bring up this story of my past because I fit the statistics found in research on the occurrence of ACL injuries. ACL injuries today whether a complete tear of sprain, most commonly occur in adolescent females. Supported by this website, according to the Centers for Disease Control and Prevention, roughly 45,000 female athletes age 19 and younger reported an ACL injury in 2006. Additionally, it is said that females are 8 times more likely to experience and injury to the ACL than males.
Why is this? Many studies suggest it has to do with hormonal and anatomical differences in females compared to males when participating in exercise or sports. A list of these differences that most females posses are as follows: Wider pelvis, more elastic ligaments, slower reflex time, greater quadriceps to hamstring ratio, and changes to estrogen levels.
Having a wider pelvis makes females more prone to ACL injuries because their femurs, or thigh bones angle downward at a sharper angle than males do. This sharp angle then puts pressure on the inside of the knee causing the ACL to tear or rupture during movements such as landing. Females are said to have more “give” to their ligaments as well which increases the risk of injury due to excessive joint motion and flexibility. Slower reflex time is said to contribute to an increased risk of ACL injury because the time it takes muscles to respond during a contraction in females is about a millisecond slower than in males. Another risk factor for females in sustaining ACL injuries is their lack of hamstring strength. Typically females will possess stronger quadriceps and so this uneven ratio between quads and hamstrings can place stress on the ACL as the hamstrings cannot compensate for the power produced by the quads. Lastly, changes in estrogen levels in females is a huge risk factor in that when females are experiencing a menstrual cycle, their estrogen levels can rapidly change, affecting the overall strength of the ACL itself along with other ligaments in the body.
So, why am I telling you about all the risk factors that make females WAY more prone to ACL injuries? For one, to simply make you aware of them, but two, to enforce how important healthy behaviors and training are in your everyday life to help decrease the risk the best we can. Of course I am not implying that a young female attempt to change her natural estrogen levels, but I can weigh heavily on the importance of incorporating some resistance training into workouts to better balance out the muscle ratio between the hamstrings and quadriceps.
Can you reduce your risk of ACL injury? ABSOLUTELY!
Here’s a video by SafeKids that showcases Ali Krieger, a U.S. Women’s Soccer player performing 7 preventative exercises to reduce the risk of ACL injuries. Along with these exercises, athletes should also perform neuromuscular training, practice proper jumping and landing techniques, and wear proper footwear or orthotics if necessary.
At just 17 years old my world seemed to have flipped upside down, but from that disorientation I have been become hungry for knowledge and learned to respect not only the power of sports, but the power of our bodies when we care for it pre and post injury. Shown below is my transformation before surgery to making the college soccer team.