ARE YOU AT RISK?

ACL & Knee Injury Facts

Females suffer 2-10 x more serious noncontact knee ligament injuries than males participating in the same sport.

2/3 of all ACL tears are noncontact.

1 in 100 high school female athletes will suffer a serious knee injury this year!

Over 100,000 ACL injuries occurring in US each year.

Reconstruction and rehabilitation can cost an individual anywhere from $17,000 to $25,000 per an injury(This does not include the loss of scholarship if the athlete can no longer participate in their sport after reconstruction.)

Potential Risk Factors for Noncontact ACL Injury

  1. Q-Angle: Q-angle is the width of the female pelvis relative to the length of the femur. The widening of the hips is going to cause the Q-angle to increase thus increasing the valgus movement of the knee.
  2. Muscular Imbalances (Hamstring/Quad): If there is not a 2:3 Hamstring:Quad muscular ratio, the upper thigh muscles are imbalanced and cannot properly control sudden deceleration forces. Females tend to have more muscle in the quad compared to hamstrings. Muscle recruitment for females compared to males:

Females- Quads-Hamstrings-GastrocMales- Hamstrings-Quads-Gastroc

  1. Improper technique (Landing planting, cutting): It is pertinent that athletes load the hips while landing, planting, or cutting because the hips have to be loaded in order to fire the gluteals during muscle pattern movement. When the gluteals become the prime mover in lower body activity, it transfers most of the shock absorption from the knees and ankles into the hips. Proper landing, cutting, and planting technique training increases hip strength and teaches the athlete to load through the hip vs. knee; which decreases valgus rotation.
  2. Hormonal: The effects of female hormones during the menstrual cycle increase and can be considered as an underlying cause to ACL injury because joint laxity increases and collagen strength decreases during this time.

Lower Limb and Knee Position during ACL Injury (Noncontact)

Landing: Valgus movement of the knee and anterior tibial shear force.

Deceleration: High quad activity

Outside cut: Internal rotation of the knee

Change of direction: Anterior tibeal shear force

Reducing Risk Factors for ACL Injuries

Pre-testing and Screening

•Utilizing Sportsmetrics software

•Mobility and flexibility of the ankle,

knee and hip field test/screening

Muscular Strength

•Muscular imbalances (Hamstring/Quads)

•Gluteal firing/Trunk control

•Muscular endurance training

Technique Training

•Landing/Planting/Cutting (Loading the Hips)

•Foot Contact (Balls of Feet)

Balance/Stabilization/Proprioception Training

•Core strength

•Staying on top of feet and hip

•Proper alignment