Costco Connection

By Andrea Downing Peck

FEMALE ATHLETES HAVE an unwelcome advantage over their male counterparts in one statistical category: the number of anterior cruciate ligament (ACL) injuries.

ACL injuries typically occur when an athlete stops and changes directions suddenly or lands a jump, making the knee injury most common in sports such as soccer, basketball, football and volleyball. An estimated 300,000 ACL injuries occur annually in the United States, with girls two to eight times more likely to rupture this ligament, which connects the thigh bone to the shinbone and stabilizes the knee joint. A torn ACL usually requires reconstructive surgery and a six- to 12-month recovery period before an athlete can return to his or her sport.

The exact reason women and girls are more prone to ACL injuries remains elusive. While anatomical differences between men and women often are cited—for example, women have a wider pelvis, meaning the angle of a female’s thigh bone puts more pressure on the inside of the knee—researchers are zeroing in on a handful of neuromuscular factors to explain why women and girls may be more at risk for non-contact ACL injuries:

; When cutting, running and jumping, women and girls exhibit less upper-body control, putting more stress on the knee joint.

; Women and girls rely more on the leg’s quadriceps muscles when decelerating, rather than a combination of hamstrings, glutes and calf muscles.

; Women and girls often land jumps in a knock-kneed position.

; Asymmetrical leg strength makes women and girls more likely to injure their non-dominant leg.

“There are multiple factors, and researchers have been trying to figure out what the

for your health

Acrucial matter Making ACL injury prevention the goal

most important factor is, but we probably need a risk-ratio equation,” says Dr. Mary Lloyd Ireland, a University of Kentucky–based orthopedic surgeon who specializes in sports medicine and injury prevention. “In my opinion, the most important factor is core stability and being able to control your landing patterns from the abdominal, back and hip musculature down.”

Prevention is key

That’s where ACL injury prevention programs come in. Prevention programs can be particularly beneficial for female athletes because they focus on neuromuscular retraining and increasing core strength, agility and coordination.

“I call it driver education,” says Dr. Frank Noyes, whose Cincinnati SportsMedicine Research and Education Foundation has developed a scientifically proven ACL pre-vention-training program. “That’s what Sportsmetrics does. We don’t oversell it. We don’t say we are going to prevent every ACL injury, but we have statistically shown you can reduce the ACL injury rate” among female athletes to a level comparable to male athletes playing the same sports.

Sportsmetrics involves 90 minutes of high-intensity strength and flexibility training, plyo-metric jumping, sport-specific agility drills and cardio workouts performed three times a week for six weeks. During the season, exercises are incorporated into daily warm-ups.

Coaches, however, often are reluctant to dedicate large chunks of time to injury prevention, so they turn to less time-intensive options. The Santa Monica Sports Medicine Foundation’s Prevent Injury and Enhance Performance program is one proven option. This strategic training program also targets female athletes but is condensed into 20-min- ute warm-up sessions performed two or three times per week.

Seattle Pacific University assistant wom-
en’s soccer coach Arby Busey, who also
coaches for one of the Seattle area’s largest
youth programs,
says he incorporates
aspects of different pre-
vention programs into
his practices. He believes
prevention programs are
paying dividends throughout
youth soccer.

The Costco Connection Costco and Costco.com carry a variety of exercise equipment, as well as medications, heat pads and more to help prevent or treat injuries.

Looking at the long term

Noyes, however, is concerned that coaches are looking for a “quick fix” and fail to include all the components necessary for prevention training to be effective.

“The biggest mistake we find is the inten-
sity of the jumping routines is not there,”
Noyes says. “The second thing is they don’t
have an instructor who says to the female ath-
lete, ‘Here’s how you do it.’ If you jump a thou-
sand times, but every jump is incorrect, it
doesn’t make any difference.”
There is no way to prevent all ACL inju-
ries, but Timothy Hewett, director of research,
Ohio State University Sports Medicine, is con-
fident fewer female athletes will be sidelined if
high school and youth sports programs make
prevention an integral part of training.

According to Hewett, a Costco member, “Potentially, if we can get these programs instituted, we have the opportunity to drop the number of ACL injuries by 50 to 60 percent, which would be a huge reduction.” C