Tag Archives: ACL
“Lacrosse Magazine Oct 2013” Issue Features Sports Science & Safety, ACL Injuries, Hall Of Fame Class, Chesapeake Bayhawks’ John Grant Jr And Casey Powell, And Team USA Men’s Lacrosse
Lacrosse ACL Knee Injuries: “Champion Magazine” Features “Obstacle Course: After Reconstructive Surgery, Student-Athletes Face A Grueling Path To Emotional And Physical Recovery”
A YEARLONG BATTLE
“No matter how strong you are, you’re still at risk,” says Dr. Leland Winston, head physician for Rice athletics. “When the ACL tears, your muscles don’t have time to react quickly enough to protect it.”
Student-athletes crumple into a heap on a court or a field, clutching vainly at a knee. Slow-motion replays show the joint contorting, buckling, twisting. Questionable return, the announcers say. Torn ACL, the newspapers read. We’ll see him next season, fans think. Bring in the next player.
Then they turn the page.
But what is an ACL? Why does it matter? Why does it so frequently interject itself into discussions of college athletics? After all, it’s merely one of four major ligaments that stabilize the knee. But it runs vertically through the middle of the joint, serving as its backbone, keeping the femur and tibia in place as players cut, jump and accelerate through practice and competition. Though student-athletes are faster and stronger than they’ve ever been, a study of NCAA injury data revealed that ACL tears rose by 1.3 percent annually over a recent 16-year period.
But advances in surgical and rehab techniques have shifted the odds dramatically in their favor. Orthopedic surgeons note that roughly 90 percent of athletes recover from ACL tears, most of whom reach pre-injury levels of athleticism. The snap of a ligament and gasps of concerned fans are no longer the requiem for an athletics career.
After they’re stitched – sometimes stapled – together, student-athletes will spend many waking hours in forgotten training rooms where torment and tedium collide. As the graft and the screws settle into tunnels burrowed inside bone, they’ll rehabilitate shriveled muscles, performing endless repetitions of exercises that evoke a startling, unfamiliar brand of pain. They’ll watch the teammates they’ve sweated and bled with go to battle without them. They’ll miss classes in the mostly bedridden week that follows surgery. They’ll tackle homework with minds smothered by pain medication.
And when they’re cleared to play again? Most endure a yearlong battle with themselves, learning once again to trust the joint that’s caused so much strife.
“This is harder than anything you’ll do on the court,” says Oklahoma State basketball athletic trainer Jason Miller. “This is the hardest thing to get through. It’s painful. It hurts. It’s time consuming.”
And student-athletes will navigate the other parts of their lives, the parts not devoted to or defined by basketball or soccer or football, on crutches. Tasks once taken for granted – sleeping comfortably, getting off a toilet, opening a door, maneuvering into a car or comically small college desk, getting a meal in a cafeteria, or carrying a textbook-laden backpack across campus – become monumental obstacles. And stairs sap time and energy, evoking dread and sweat. They’re to be avoided. Except, in college, they seem to be unavoidable; Olukemi lives on the third floor.
“Stairs were the hardest part after surgery,” Olukemi says, more than three weeks into rehab. “They still are.”
Injuries In Lacrosse: Medical Study Finds Almost 50% Of Athletes Who Undergo Isolated “Anterior Cruciate Ligament” (ACL) Reconstructive Surgery Do Not Return Play, Most Citing “Fear Of Re-Injury And Movement” As Primary Reason
“34-47% of individuals do not return to prior sports participation following unilateral, isolated anterior cruciate ligament reconstruction. This number maybe up to 70% for contact sports…”
The group wanted to study whether fear of re-injury and or fear of movement was present, and a factor, in return to sport following anterior cruciate ligament reconstruction. They included individuals in their study who had isolated, unilateral anterior cruciate ligament reconstruction. Return to sport status was measured 1 year post-operatively. Roughly 100 participants were enrolled. They gave participants a questionnaire asking if they had returned to sport. If the answer was no, they gave a list of reasons including pain, weakness, lack of ROM, lack of clearance by MD, fear of re-injury/movement, and some other variables…
- 49% of their cohort had not returned to sport 1 year post operatively
- 50% of those that had not returned to sport cited fear as primary reason
- Fear was the most commonly cited primary or secondary reason for not returning to sport
Clinical Factors Associated with Disability Following ACL Recon:
- Knee Pain Intensity
- Knee Flexion ROM Deficit
- Quadriceps Weakness
- Fear of Movement and Re-Injury
**Multiple studies have supported those findings**
Differences Between Individuals Who Return to Sport and Those Who do Not:
- Knee Pain Intensity
- Quadriceps Weakness
- Self-Reported Disability
For more: http://ptthinktank.com/2011/02/14/fear-of-re-injury-and-return-to-sport-following-acl-reconstruction/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+NPAThinkTank+%28PT+Think+Tank%29&utm_content=FaceBook
Girls Lacrosse Knee Injuries: Girls Have Higher Rate Of ACL Injuries Due To Overreliance On Ligaments To Stop Knee Motion And Must Use And Strengthen Hamstring Muscles More
“The ACL injuries are due to three main differences: the ligament dominance for girls versus muscle strength. Girls have stronger quadricep muscles, but not hamstrings…”
“…Girls contracting the quad much more than the hamstring, so it’s an unbalanced force on the knee.”
Dr. Cynthia LaBella, Medical Director of the Institute for Sports Medicine at Children’s Memorial Hospital: “Girls rely on the skeletal system, their ligaments and their bones, to stop their knee motion.”
In contrast, boys use their muscles to soften the landing and absorb the impact, a lesson Sheila Morrissey learned the hard way after spraining her ankle.
Michael Huxford, Sports Medicine Coordinator of the Institute for Sports Medicine at Children’s Memorial Hospital: “We decided to go after female athletes between the ages of 13 and 18. Why? Because they typically have the majority of ACL tears in athletics, compared to boys playing the same sports.”
Dr. LaBella: “Girls contracting the quad much more than the hamstring, so it’s an unbalanced force on the knee.”
And girls have a dominant leg.
Dr. LaBella: “Girls are much more likely to have one leg slightly stronger than the other, and use that leg more often. Boys are much more likely to have even strength distributed between the two legs.”
Lacrosse Injuries: University Of Michigan “Bone & Joint Injury Prevention & Rehabilitation Center” Conducting Study On Current ACL Prevention Training Programs (Video)
A new study, led by Center members and Kinesiology Professors Riann Palmieri-Smith and Scott McLean, will determine which components of current ACL prevention training programs actually work to reduce injuries.
Lacrosse Injuries: Hilary Bowen Of Northwestern Women’s Lacrosse Tears ACL In Left Knee And Is Out For Season
For 51 straight games, Hilary Bowen focused on her job: scoring goals. Two minutes into Saturday’s game against California, Bowen’s focus shifted to a different feeling: pain.
The extent of her left knee injury suffered in the opening minutes of Saturday’s 21-4 victory over the Golden Bears may be more serious than anticipated.
Bowen reportedly tore the ACL and strained the MCL in her left knee, in addition to a small fracture in her left tibia, the Rochester Democrat and Chronicle reported Tuesday.
“It’s weird because I’ve never been injured before,” Bowen told the Democrat and Chronicle in a telephone interview Monday night.
After an MRI on Sunday, she will reportedly meet with her doctor this week to determine if her career at NU is over.
“I have absolutely no idea,” Bowen told the Democrat and Chronicle. “Right now, my doctor is in Japan and we’re waiting for him to get back.”
Lacrosse Injuries: Female Lacrosse Players “Must Be Involved In A Structured, Sound Strength And Conditioning Program” As Studies Show “Inward Rotation Of The Knee Puts A Much Greater Strain On The Supportive Structures”
Anatomically, females generally display a greater Q-angle. This is characterized by wider hips than boys and their knees appearing as if they are turning inwardly towards each other.
Inward rotation of the knee puts a much greater strain on the supportive structures of the knee joint.
Another explanation for the increased risk of ACL tears has to do with neuromuscular deficits which include ligament, quadriceps, and leg dominances.
The anterior cruciate ligament (ACL) is one of the most important stabilizing ligaments for the knee joint. According to the research, season ending knee injuries have occurred at a rate of 1 in 10 female athletes annually at the intercollegiate level. For female basketball players in high school alone, approximately 1 in 65 will rupture their ACL’s. At a conservative cost for surgery of just under $20,000 and the traumatic effect of loss of playing time and loss of possible scholarship funding due to a severe ACL injury, one can imagine the financial and emotional costs.
With increased participation in sport by females over the last few decades, a dramatic rise in the number of ACL injuries has occurred. A 1993 study reported a six-fold higher incidence of ACL injury in females’ verses males. Furthermore, two thirds of ACL injuries are non-contact in nature. Why then are Females so much more predisposed to tearing their ACL’s than males and why are these injuries predominantly occurring in non-contact situations? To answer this question, one must look at the female anatomy and females’ lack of physical training in preparation for sport.
Anatomically, females generally display a greater Q-angle. This is characterized by wider hips than boys and their knees appearing as if they are turning inwardly towards each other. We have seen this relationship quite frequently in our young adult female athletes. Inward rotation of the knee puts a much greater strain on the supportive structures of the knee joint. Another explanation for the increased risk of ACL tears has to do with neuromuscular deficits which include ligament, quadriceps, and leg dominances.
Ligament dominance refers to the inability of the lower body musculature to adequately absorb the forces occurring in different sporting maneuvers, such as landing from jumps or making sharp cuts to change direction, thus resulting in excessive loading to the knee ligaments. Studies have shown that when females land from jumps they have a greater tendency for their knees to move towards each other (vulgus stress) and for their lower legs to be forced forward (anterior tibial translation). The ACL resists both knee vulgus and anterior tibial translation.
Quadriceps dominance refers to the quadriceps (upper front thigh) muscles being much stronger and recruited more than the hamstring (back of thigh) muscles in sport situations. This also causes greater anterior tibial translation and stress on the ACL. Studies have shown that females tend to rely more on their quadriceps than their hamstrings when landing from jumps.
Leg dominance occurs when there is an imbalance in the strength and power between the legs. As a result, an athlete may rely too much on one leg in sporting maneuvers resulting in repetitive stress while the other weaker leg may not be able to effectively absorb forces when called upon to do so.
What then should young female athletes do to reduce their risk of a very costly ACL rupture?
First of all, all female athletes who compete at a high level must be involved in a structured, sound strength and conditioning program. The history of female athletics, especially in high schools, has been to just play and not train. High school weight rooms have traditionally been reserved for and occupied by the football and other male sport athletes.
This must change!
A sound program should first employ a comprehensive evaluation to determine risk of injury. For those female athletes who are in sports that are at risk for ACL tears, such as basketball, volleyball, soccer, and field hockey, a determination of lower body control through a variety of tests and the identification of the possible imbalance between the left and right legs is crucial. Nearly all of the female athletes we have tested demonstrate improper landing mechanics from jumps of varying heights. This is critical especially in light of studies which have found that for female basketball players the greatest incidence of injury occurs in rebounding.
Next a program must be developed to aid in teaching proper postural control that will result in athletes’ being able to avoid inward movement and rotation of the knees and proper recruitment of their hamstring muscles when jumping, landing from jumps, and cutting. Concurrently, the program must address lower body development, especially strength in the posterior chain: gluteals and hamstrings.
A study conducted in 1999 with approximately 1300 high school female and male athletes demonstrated the benefits of such training. The group of female athletes’ who were involved in a training program throughout their seasons, basketball, volleyball, and soccer, reduced their incidence of serious knee injuries by 62% when compared with female athletes who did not train in-season. The importance of off the field, court, ice etc. training for female athletes cannot be emphasized enough. High school weight rooms should be dominated by female athletes and not shied away from which has been so often the case in the past. Reduce the risk of a catastrophic injury by getting involved in a sound strength and conditioning program and train year-round, not just before the season.
The benefits of not only injury prevention, but also performance enhancement, self-esteem, and a healthy lifestyle are immeasurable!