Anterior Cruciate Ligament (ACL) Injuries

Adolescent females  that participate in landing, cutting and pivoting sports sustain anterior cruciate ligament (ACL) injuries up to 10 x  more than that of an adolescent male participating in the same sport.  In the U.S, more than 125,000 ACL injuries occur every year.  Moreover,   ACL surgery and rehabilitation costs over $1 billion annually in varsity female sports.  Consequently,  there is a 50-100% prevalence of osteoarthritis in this high risk population.

But why?

During adolescence,  there is a growth spurt in males and females.  However, males seem to exhibit an increase in power and strength whereas females show little change in adolescence.  For example, Kellis et al performed a study on male and female basketball players and results indicated that female basketball players did not significantly increase in vertical jump performance with increasing age, whereas males did with age.  Furthermore, female athletes typically demonstrate decreased dynamic knee stability versus their male counterparts after a growth spurt.  These limited neuromuscular changes during the extensive skeletal growth spurt may lead to imbalances and biomechanical alterations that increase ACL injury risk to girls and young women.

So what can we do?

Based on the decreased knee stability, strength and power in this population, the best thing to do is to improve upon these. The most validated prevention program is the FIFA 11+  which addresses muscle strength and balance. Many studies have confirmed the effectiveness of the FIFA 11+ program, showing significantly reduced injury rates of around 45 % and decreased time lost to injury by 30% to competitive soccer players.

The issue with the FIFA 11+ or any strength training program:

It is all about monitoring!  Many coaches who work with this high risk population have been told to institute this program as it has been shown to decrease injury.  The exercises may seem easy and straightforward (see link to FIFA 11+ below), however, a trained eye in movement analysis and proper biomechanics should be involved to provide feedback to these athletes.

What will this person be looking for? Movement impairments, poor biomechanics, compensatory movements for muscle weakness are all things that need to be monitored and corrected during the implementation of this program.  It is absolutely critical to have someone who can provide feedback to the athletes during the FIFA 11+/or any training program.

What can we do?

We can assist you (and your team) at the field or training facility with any training program, whether it be the FIFA 11+ or sport specific agility training. We believe that a comprehensive approach to injury prevention should include:

• Education on the mechanics of proper jumping and landing, starting, stopping and pivoting
• Screen for high risk athletes (interview, movement screens, previous injury, laxity etc)
• Training program (such as the FIFA 11+)

Contact us today to keep your knees safe and healthy!

Knee abduction moments in females: https://mayoclinic.pure.elsevier.com/en/publications/longitudinal-increases-in-knee-abduction-moments-in-females-durin

Does FIFA 11+ decrease injury: https://link.springer.com/article/10.1007/s11999-017-5342-5

FIFA 11+ program: http://kneesurgerysydney.com.au/wp-content/uploads/2017/05/FIFA-11-summary-poster.pdf