Most ACL injuries are non-contact in nature, that is, there was no physical contact between athletes when the injuries occurred. These injuries happen mostly with deceleration, abrupt stops or pivots and changing directions. Women have an ACL injury rate two to eight times higher than that for men. Basketball and soccer account for two-thirds of the ACL injuries suffered by U.S. female athletes.

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ACL reconstruction procedures were performed for high school female seniors than for any other age group. The number of procedures for high school senior aged females is three times that for college aged females. Females have 27-32% higher chance of ACL injury due to chemical changes in the body, collagen strength, possibility of stress fractures or bone weakness, and overall strength and power deficit secondary to energy concerns.

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• Over 70% of ACL injuries occurred in recreational and competitive sport activities 

• ACL injuries are estimated at over 3 per 100 athletes over the course of a season 

• High school students have more ACL injuries than college students 

• 1 in every 10 athletes will have knee pain or ACL injury that will result in losing over 50% of a playing season

• Approximately 175,000 primary ACL reconstruction surgeries are performed annually in the U.S.

Female Youth Risk Factors

• Impaired biomechanics and muscular control of hip adduction, internal rotation of the tibia and poor dynamic stability of the quadriceps and hamstrings creates a valgus (knock kneed) force at the knee.

• Landing force often falls medial to the knee joint and transfers stress directly to the ACL rather than to the support musculature.

• Less total muscle mass, delayed muscle activation, slower force generation and decreased ability to generate muscle force with a tendency towards altered recruitment patterns which place the ACL at risk.

• Tend to be quadriceps dominant and demonstrate a slower response time of the hamstrings when anterior translation stressors are placed on the knee; a position which puts the ACL at risk.

• Dynamic stabilization of the knee and neuromuscular control play a large role in preventing the failure of the knee’s soft tissues under excessive force.  And they are the only components that are modifiable.

• Other factors that can’t be changed are intrinsic to the knee itself: lower extremity alignment, width of the notch in which the ACL lies, size of the ACL, hormones, and prior injury.
   

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Our program has been designed to enhance player performance and prevent non-contact ACL injuries in players.  This will be done 3-5 times per week as a warmup to practice.  Each of the exercises is taught in the order in which they will be performed with guidance and modification, when necessary, by your coach, trainer or physical therapist. The program falls into five categories with some optional additions and progressions that will be added when needed:

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• Avoidance/Warm Up: Stresses avoiding injury by teaching good running techniques. Always warm up and never stretch a cold muscle.  

• Flexibility: These stretches can improve your range of motion, reduce joint stiffness, reduce post exercise soreness, and improve your overall performance.

• Strengthening: By increasing the strength of the leg muscles, you can increase the stability of the hip, knee and ankle, reducing the risk of injury.

• Plyometrics: These exercises are explosive and help to build power, strength and speed.  

• Agilities: These exercises involve proprioceptive training that is developing your sense of joint position.  This allows you to train the knee and ankle joints to deal with situations encountered. 

 

This is why a prevention program is so important. ACL prevention programs have shown a 20-80% decrease in the incidence of ACL injuries in female athletes.  This means they will have less season ending injuries, a decrease in missed play time, more players available to start and overall healthier players. Education is the key to the success of these programs! 
 

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If young athletes experience pain or other symptoms during their preparation for the upcoming sports season, it’s important to seek medical attention from an orthopaedic sports specialist. At Snow Sport and Spine, we can diagnose and treat a wide range of sports injuries, allowing young athletes to get back to the game as quickly and safely as possible.

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• Proactive Injury Prevention – programs to strengthen key muscle groups and enforce proper techniques so your athlete can play safely, reduce the risk of injury improve athletic performance, and prevent injuries that occur throughout the course of training and gameplay.

• Restorative Care – diagnose, provide treatments to reduce pain and restore function, allowing a return to play in a timely and safe manner, with the added benefit of acquiring techniques that can prevent reinjuries.​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​