“If you had ten minutes…”

Monday I did an interview with Paige Greenfield, a writer for ESPN for their women’s sports site. The question she asked was simple enough. If you had ten minutes to prevent injuries in female athletes, what would you do? I gave her several ideas, but after thinking about athletes I’ve seen in my clinics lately, there is one that I wanted to share with female athletes and their families.

Readers of this sports section, and sports fans in general, are surely familiar with anterior cruciate ligament tears. The ACL is the main stabilizing ligament of the knee, and they are often injured in college and professional athletes. But I doubt that many realize that stars like Tom Brady are not the most common athletes to be sidelined by them.

Soccer is a common sport for ACL injuries in female athletes.

According to most studies, ACL tears occur between two and ten times more frequently in female athletes than males. If you were an orthopaedic surgeon who wanted to specialize in these surgeries, taking care of pro sports teams wouldn’t be very productive. Females who play jumping sports, like basketball and volleyball, or sports that require cutting and pivoting, like soccer and lacrosse, are the most likely victims. These athletes, and their coaches and parents, need to be familiar with the injury.  Tweet this statistic

Female athletes are prone to ACL injuries because their knees are susceptible to the common mechanisms of injury. Getting tackled and having the knee twisted, like Tom Brady did, is actually not the normal injury pattern. An athlete who tears her ACL typically cites one of two events. She can land from a jump with her knees fully extended and the knee gives way. Or she can be running and plant her foot to change directions. The foot sticks but the knee rotates. Either way, she likely will feel a pop, have rapid swelling, and have difficulty bearing weight. Just like that, her season is over.

I have to deliver the news that an athlete has torn her ACL well over 100 times per year, and I have seen how devastated these athletes are. The thought of surgery and 5-6 months of rehab are often not as scary as missing the rest of the season and letting their coaches, parents, and teammates down.

Emily Gossen, the goalkeeper of Academic Magnet’s girls’ soccer team that won the state championship this year, tore her ACL as a freshman. She recollects, “Tearing my ACL was awful. I was not able to complete my high school season, and I got a late start into my club season. I was miserable because I felt so weak and couldn’t partake in typical activities that I enjoyed.”

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So what would I recommend to prevent ACL injuries? First, I would recommend that parents of female athletes spend time finding a sports medicine program that teaches an ACL injury prevention program, specifically one that is tailored to that sport. Girls tend to land and turn with their knees fully extended (unlike boys), which put the ACL at risk. Fortunately exercise programs can teach girls to jump and turn with their knees bent.

These goal teach females to land and turn with their knees bent to try to minimize forces on the ACL.

And to answer the ESPN question, the ten minutes is spent daily performing the exercise program. These exercises, once learned, should be done every day before practices and games. They replace the traditional warm-up exercises players do. In fact, if someone watches athletes doing them and doesn’t know, it looks like they are doing a normal warm-up. But done every day, these programs have been shown to at least decrease the chance of ACL tears occurring.

And what is the risk? If a girls’ soccer player doesn’t tear her ACL, one could argue that she might not have torn it anyway. But if these programs prevented even one injury, it would be worth it. A torn ACL usually requires surgery and about six months of physical therapy. But more importantly, the team often loses a valuable member who is difficult to replace. ACL tears can devastate players and teams alike.

One of my partners once jokingly asked me why I promote prevention programs that could cut into surgeries that make money. Quite simply, it is the right thing to do. Sports medicine needs to evolve into a field that tries to prevent injuries instead of simply treating them.

I am going to write about the other idea I gave ESPNW for spending 10 minutes to prevent female athletic injuries, but I want to hear from you. What ideas to you have for spending 10 minutes to prevent or decrease injuries?

Note: This post appears in a modified format in the June 8, 2011 edition of The Post and Courier.

7 Responses to “If you had ten minutes…”

  1. Having trained more than 600 adolescent female athletes in every sport and cheering since 1995 with remarkable results, I agree wholeheartedly with Dr. Geier; what I call BNP [balance, neuromuscular control, and proprioception] training is what every female athlete requires to meet their sports related challenges.

    Next 10 minutes: advanced balance exercises so female athletes “lock in” their gains from a preseason training program and maintain those gains during their seasons; travel and high school. I do not see enough maintenance going on so their body does not breakdown over time.

    • I agree completely. These efforts must be maintained throughout seasons and not just in a preseason program. Thanks for sharing your experiences!

  2. Do you have a prevention programme for males also? If so is it available to the public? I would love to try it as I return to sport

    • Most of the neuromuscular ACL programs work for male and female athletes. A physical therapist or sports medicine program could teach you the exercises from one of these programs.

  3. I’ve seen a few high school football players go down with ACL sprains. I had no idea that such injuries were so prevalent in every sport. I’ll try to spread this helpful overview

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david-headshot I am an orthopaedic surgeon and sports medicine specialist in Charleston, South Carolina.

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