Preventing ACL Injuries in Women and Girls
ACL injuries are one of the most common injuries seen by GPs and Physiotherapists today and can lead to a long absence from physical activity. Recovery is an arduous process and can often take 9 months to fully heal. Having had an ACL injury also increases the risk of having further knee problems down the line making injury prevention a major topic in sport science today.
The ACL, or anterior cruciate ligament, is at the front of a pair of ligaments that form a cross within the knee capsule. Its role is to prevent the thigh bone (Femur) from sliding too far forward over the shin bone (tibia).
Why Women and Girls are More Likely to Suffer ACL Injuries
It has been scientifically proven that women are more likely than men to rupture their ACL. But why is this the case, men and women both have knees, don’t they? Indeed, however women are about 4 times more likely to rupture their ACL than men with most ACL tears coming from non-contact injuries that usually occur during an awkward twisting motion. In addition to this, certain sports have a higher risk of ACL tear. Typically, sports that have rapid stopping or changes in direction, landing from a jump or cutting motions are the highest risk. This includes netball, basketball, football and volleyball.
There are several reasons that women and girls are more prone to suffering from ACL injury. Many of these factors, such as female hormones, generally wider hips and more lax or ‘stretchier’ knees obviously cannot be altered. Thus, focusing on preventing ACL injuries is of upmost importance as this is something we can control in maintaining strong and health knees.
Women Land Differently
There are two big factors that can be changed to help reduce the likelihood of ACL injuries in women and girls. The first is how to land from a jump. Two landing patterns that are particularly risky are landing with stiff, straight legs or landing in a knock-kneed position. These landing techniques have been shown to be more common in women than in men and if both occur at the same time this greatly increases the force through the knees as well as the risk of ACL injury.
Hamstrung by Hamstrings
The second factor that can be altered to reduce ACL injury is what is known as neuromuscular adaptation. This refers to the strength, explosivity, timing and coordination of muscular contraction. Having sufficient strength as well as being able to engage the right muscle at the right time during movement is crucial for knee stability. The hamstrings are particularly important in knee stability as like the ACL, they stop the shin bone from gliding too far forwards. Females have been found to take longer than males to produce force in their hamstrings and contract them more slowly which means that the knee is less stable in women.
How to Land Well
To land well and reduce risk of injury try to observe yourself jumping from a plyometric box or workout step in front of a mirror. You could also have a partner observe you or film it on your phone. Start and finish the jump with the knees and hips bent. Make sure you keep your knees over and in line with your second toes as you land and that the knees don’t collapse inwards. Try to land as softly as possible on the front half of the soles of your feet.
Strengthening to Prevent ACL Injuries
Strengthening your hamstrings are important for ACL prevention therefore exercises such as Steamboats are fantastic for activating that area. Having strong glutes (bum muscles) are also important as their main purpose is to help stop the knees from knocking together. Lateral steps using a theraband and single leg bridges can be great for this. Stabilising the trunk through core stability exercises such as plank can also help reduce the risk of leg injuries.
Plyometric drills such as tuck jumps and squat jumps can help with muscle explosivity and timing or muscle contraction. Agility drills such as fast feet can also help improve power and speed while reducing injury risk, all when done correctly with good form of course!
If you master these tips, you’ll greatly reduce your risk of ACL injury.
Dr J Hugh Coyne
Private GP Parsons Green