Tag Archives: Knee Injuries

Lacrosse ACL Knee Injuries: “Champion Magazine” Features “Obstacle Course: After Reconstructive Surgery, Student-Athletes Face A Grueling Path To Emotional And Physical Recovery”

Obstacle Course Article On Knee Reconstruction Surgery Champions Magazine

Every year, more than 2,000 NCAA student-athletes across 15 high-risk sports will feel that bomb detonate inside their knee, hear the menacing echo reverberate through their body, endure a few minutes of misery in their final moments on the playing surface and eight or more of the most trying months of their lives off it. Next season isn’t assured.


“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.

ACL InjuriesBut 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.”

Champion Magazine

By Brian Burnsed

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.”

– See more at: http://www.ncaa.org/wps/wcm/connect/public/ncaa/Champion+Features/obstacle+course#sthash.G9jm7nPW.V37R3uhA.dpuf

Women’s Lacrosse: The “40th Anniversary Of Title IX” Has Seen A Tenfold Increase In Girls Playing High School Sports With “Preventable Overuse Injuries” Increasing With Sports Specialization

Despite persistent warnings from orthopedic surgeons and trainers, young athletes bent on specialization continue to suffer from preventable overuse injuries, like stress fractures and stress reactions, according to the American College of Sports Medicine. “More than 50 percent of what we see in sports medicine are overuse injuries, which are entirely preventable,” said Dr. Joel Brenner, chairman of the American Academy of Pediatrics and the Council on Sports Medicine and Fitness.

Since the advent of Title IX, according to the National Federation of State High School Associations, the number of girls playing high school sports has grown

more than tenfold, from 294,000 in 1971 to nearly 3.2 million last year.

But this welcome transformation has come at a serious cost for many female athletes. Title IX has inflicted significant collateral damage, including increased health risks for the players, a drop in the number of women coaches, and increased exposure to sexual abuse.

Like their male counterparts, girls have started to specialize early in their careers, working on just one sport year-round, often as a way to capture the attention of college coaches. With more scholarship money available than ever, girls feel pressured to specialize at a young age in the hopes of winning a spot on an elite team or gaining an edge in the increasingly competitive college admissions game. Of special concern for girls is damage to their anterior cruciate ligament, or A.C.L., the tiny muscle in the knee that connects the two halves of the leg. Female athletes are four or five times more likely than male athletes to have A.C.L tears, says Dr. William Levine, the director of sports medicine at Columbia University and the head physician for its varsity teams.

As Dr. Levine explains, once girls begin to menstruate, they become more “quadricep-dependent” than males, and that thick slug of muscle in the middle of the thigh then works against the A.C.L., sometimes causing tears. “Female athletes jump and land in a more erect posture, which puts increased stress on their A.C.L,” he says.

For more:  http://www.theatlantic.com/entertainment/archive/2012/02/how-title-ix-hurts-female-athletes/253525/

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
  • Fear
  • 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

Injuries In Lacrosse: ACL Tears In Female Athletes Are Four To Ten Times More Likely Due To “Anatomical Stress” On Knees, Lack Of Proper Muscle Development And Fatigue


"These findings suggest that training the central control process—the brain and reflexive responses—may be necessary to counter the fatigue induced ACL injury risk," said McLean, who also has an appointment with the U-M Bone & Joint Injury Prevention Center.

Approximately 200,000 ACL injuries are suffered each year, with about half requiring reconstructive surgery and subsequent rehabilitation, according to the American Academy of Orthopedic Surgeons.



Numerous studies and reports reveal females to be four to 10 times more likely than males to tear their ACLs.

Men typically rupture the ligament because of some external force in football or skiing, while women tend to suffer injuries in lesser-contact activities, primarily basketball, soccer and volleyball.

  • Reasons range widely for female athletes’ propensity to ACL tears. Recurring analysis since the 1980s has arrived at one basic conclusion: blame anatomy.
  • The female shape resembles that of an hourglass. With a wider pelvis and hips than male counterparts, a female athlete’s core structure lends itself to increased pressure on the lower body.
  • “The relationship of the angle from the hips back into the knee is much bigger (in women).
  • We call that the Q-angle,” said physical therapist Kevin Swanson, who in 25 years has overseen more than 1,500 rehabs from ACL reconstructive surgery. “It leads to a (greater) chance for valgus rotational injury.”
  • Valgus indicates a knock-kneed stance, which is far more common in women, while men are naturally bow-legged.
  • “As (women) run, and they get tired, their knees begin to fall in together as they land,” Lindaman said. “That increased stress as they’re landing, the knees are more at an inclined angle.”
  • The ACL crosses the posterior cruciate ligament through the tunnel-shaped intercondylar notch, which is narrower inside a female, and therefore more susceptible to “guillotine” the ACL, according to Swanson. Even menstrual cycles can wreak havoc, making ligaments more pliable and thus easier to tear.
  • Moreover, girls get taller at an earlier age than boys, adding to the wear and tear of physical sports on young bodies.
  • “Most females are skeletally mature,” he said, “whereas guys are still growing (in high school.)”
  • Beyond the subtle differences between male and female bodies, increased opportunities in women’s athletics play a role.
  • “These girls are competing at a very high level at a very young age,” Lindaman said. “Their muscles don’t have a chance to develop. As a result of that, we’re subjecting them to more risk.”
  • The majority of tears happen in competitive environments rather than practice, with Swanson adding more players are at greater risks in the second half of a basketball game – when fatigue sets in.

For more:  http://qctimes.com/sports/high-school/basketball/girls/article_8ab13ca6-301f-11e0-9855-001cc4c002e0.html

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…”

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."

“…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.”

For more:   http://www.wgntv.com/news/medicalwatch/wgntv-knee-injury-prevention-july21,0,5822875.story

Injuries In Lacrosse: Medical Studies Reveal That Delaying ACL Reconstruction Surgery Beyond 12 Weeks Can Result In Up To An “11-Fold Increase In Meniscal And Cartilage Injuries”

 A 14 year review of ACL reconstructions presented by the authors at the 2009 AOSSM Annual Meeting revealed a 4 to 11-fold increase in meniscal and cartilage injuries with a greater than 12 week delay in ACL treatment.

The simulation found that in females in the U.S., delaying ACL reconstruction beyond 12 weeks resulted in 1,560 medial meniscal tears and 2,100 cartilage tears relative to early surgery each year. In males, delayed surgery resulted in 3,300 medial meniscal tears and 5,720 cartilage tears relative to early surgery.

Nearly $30 million a year would be saved in hospital charges if early rather than delayed ACL (anterior cruciate ligament) reconstruction surgery was performed on pediatric patients, according to a study presented today at the American Orthopaedic Society for Sports Medicine’s (AOSSM) Annual Meeting in Providence, Rhode Island. Additionally, more than 7,300 tears to the meniscus and 7,800 cartilage tears in children could be avoided each year in the U.S. by early ACL surgery.

For more:    http://www.physorg.com/news198571823.html

Lacrosse Injuries: Studies Show That Injuries To Female Athletes Are Higher Due To Conditioning Programs Being Designed For Males

(From a Telegraph article) Sportswomen experience “dramatically” higher rates of injury than men because programmes designed for “young adult while males” fail to take into account “intrinsic biological differences” between the sexes, according to the Canadian study.

Consequently women are more likely to get injured while competing because their bodies are not able to cope with the demands, said Dr Vicki Harber, of Alberta University’s Faculty of Physical Education and Recreation, who led the study.

Comparing adolescents, she reported: “Girls suffer higher injury incidence rates compared to boys, particularly in sports such as cross-country running, gymnastics and soccer.

“Injuries to the knee are greater in girls compared to boys with soccer having the highest injury rate, followed by basketball, field hockey, softball and volleyball.”

In particular, females have more flexible ligaments and lower muscular strength. As a result women are two to six times more likely than men to sustain anterior cruciate ligament (ACL) injuries, which are mainly caused by rapid deceleration or changes in direction.

Women should be taught “sports-specific movement patterns, flexibility and strengthening of muscle groups at multiple joints” to prevent such injuries, she suggested.

She advised: “Many of the injuries women suffer because of this are preventable. Women are not men, just like children are not small adults.

“Training programmes are not a ‘one size fits all’.”

Dr Harber also said that the rate of eating disorders among sportswomen was “much higher” than among other women, particularly in endurance sports like long distance running and “aesthetic” sports like ice skating and gymnastics.

This can also lead to periods temporarily stopping, she warned. She has written a guide called The Female Athlete Perspective to address the issues.


Lacrosse Injuries: Medical Studies Show That “Knee Injury Prevention Training Programs” Are Effective If They Follow Several Critical Elements

“It is important to note that several knee injury prevention training programs have been published and shown to be effective in improving neuromuscular deficits and reducing the risk of knee injuries, particularly in the female at-risk athlete. All successful programs incorporate the following key elements: a dynamic warm-up period that is high energy and efficient; plyometric/jump training with emphasis placed on body posture and control, trunk positioning, dynamic core balance, and entire-body control through a specific task; strength training for the core and lower extremity; sports-specific aerobic and skill components; and pre-season and in-season training programs that are strictly followed. Pre-season training program may be 6 to 8 weeks in duration, 3 days a week for up to 1.5 hours per day. In-season maintenance programs can be done in 15 minutes during pre-game warm-up 3 times per week.24″

January 2010

Neuromuscular training has a significant effect on reducing relative ACL injury risk in female athletes in high-risk landing and cutting sports like soccer, basketball, volleyball, and team handball.

As many as 1 in 20 collegiate-level and 1 in 50 to 100 high school-level female athletes sustain an anterior cruciate ligament (ACL) injury during any given year of varsity sports.1,2 The answer to the posed rhetorical question “do ACL prevention programs actually reduce risk?” is neuromuscular training has a significant effect, from 24% to 82% reduction of relative ACL injury risk in female athletes in high-risk landing and cutting sports like soccer, basketball, volleyball, and team handball.

Growth in female sports participation at a two- to ten-fold higher rate has led to a great gender inequity in ACL injury. The National Collegiate Athletic Association (NCAA) reported >150,000 female participants in varsity sports each year.3 The National Federation of State High School Associations (NFSHSA) reported >3.2 million female participants annually in high school sports programs.4 Based on these figures, >50,000 debilitating ACL injuries likely occur in female athletes at the high school and intercollegiate varsity levels during an average year.

Most ACL injuries occur by noncontact mechanisms, during deceleration from a landing or making a lateral pivot.5 Neuromuscular training is effective in the reduction of ACL injury risk in females because females demonstrate 4 neuromuscular imbalances that may put them at greater risk of ACL injury than males and that may be ameliorated with neuromuscular training. These potentially correctable neuromuscular imbalances—ligament dominance (increased load on the knee joint), quadriceps dominance (decreased knee flexor recruitment and strength), leg dominance (increased leg-to-leg differences in muscle coordination and strength), and trunk dominance (increased motion of the body’s center of mass)—may decrease dynamic knee stability in females and lead to the gender bias in ACL injury risk.6,7

Are Female Athletes Really at Higher Risk for ACL Injuries?

Female athletes are 2 to 10 times more likely to sustain an ACL injury compared to male athletes playing the same landing and cutting sports.5-11 Since the enactment of Title IX, male participation at the high school level has remained steady, while female participation has increased approximately ten-fold (from <0.3 to >3.2 million).4

High school and collegiate athletics contributes to >50,000 ACL injuries in female athletes each year. An estimated 1 in every 100 high school female athletes will sustain an ACL tear. At an estimated cost of $17,000 per patient2 to reconstruct and rehabilitate the ACL in these athletes, overall costs would exceed $680 million annually. Of additional concern is the fact that successful ACL reconstruction in 2009 has shown the ability to return the athlete to the playing field at his or her previous level of performance in the majority of cases.

More than 50% of the patients show early signs of irreversible osteoarthritis within 10 years of ACL reconstruction, particularly female athletes. This is in addition to the traumatic effect to these individuals of the potential loss of entire seasons of sports participation, possible scholarship funding, and potential decreased performance in the academic arena.12

A major theory to account for higher knee injury incidence in female athletes is that neuromuscular imbalances, due to training deficiencies, developmental differences, or perhaps hormonal influences, lead to higher injury rates. Other variables that may be contributory include lower limb alignment as well as biomechanics and kinematics, overall ligament size and strength, and muscular fatigue over a given length of time.

This article focuses on the neuromuscular theory for 2 reasons. First, if neuromuscular training can alter observed neuromuscular imbalances in the laboratory and if the same neuromuscular training can decrease ACL injury risk on the field and court, then neuromuscular control must be a primary underlying factor for increased risk.5-11 Second, intervention and prevention are likely to have the greatest impact on neuromuscular control, where adaptation readily occurs, if properly guided by trained health care professionals.

Does Neuromuscular Training Decrease the Incidence of ACL Injury?

The majority of published studies demonstrate that neuromuscular training has an approximately 50% efficacy rate for decreasing relative ACL injury risk in female athletes in landing and cutting sports like soccer, basketball, volleyball, and team handball. Neuromuscular training alters active knee joint stabilization in the laboratory and aids in decreasing ACL injury rates in female athletes in the field.

Hewett et al2 reported the first prospective study of the effects of a neuromuscular training program on ACL injury in the high-risk female sports population. The rate of ACL injury was decreased 45% in the trained group relative to the untrained group. The findings of Hewett et al6 have been subsequently confirmed by several studies that used similar neuromuscular training protocols in young female athletes.13,14 Considered together, these studies provide strong evidence demonstrating that neuromuscular training is likely to prove an effective solution to the problem of sex bias in ACL injury risk.

In a prospective study by Hewett et al,2 trained females were no different than untrained males. Training resulted in great differences in noncontact ACL injuries between the female groups. These results indicate that neuromuscular training decreases injury risk in female athletes. Although the study by Hewett et al2 was the first to demonstrate significant decreases with neuromuscular training specifically in the female athlete, other studies have demonstrated similar significant decreases or trends toward significant changes in female, male, and mixed gender populations. Figure 1 shows the relative percentage decreases in relative injury rates following various training programs.

Figure 1: Percent decrease in ACL injuries
Figure 1: Percent decrease in ACL injuries in 7 ACL injury prevention neuromuscular training studies. The range of effect sizes of these studies was 24% to 82% reduction, and the average decrease in risk was approximately one-half (mean, 48%) reduction in ACL injury risk with neuromuscular training. (Hewett TE et al,2 Heidt RS Jr et al,13 Mandelbaum B,14 Söderman K et al,15 Myklebust G et al,16 Petersen W et al,17 Gilchrist J et al.18)

How Does Neuromuscular Training Decrease Incidence of ACL Injury?

Four neuromuscular imbalances are observed more often in female than male athletes. The first observed neuromuscular imbalance is the tendency for females to be ligament dominant. Females demonstrate a tendency to allow stress on ligaments prior to muscular activation to absorb ground reaction forces. Typically during single-leg landing, pivoting, or deceleration, as often occurs during ACL injury, the female athlete allows the ground reaction force to control the direction of motion of the lower extremity joints, especially the knee joint. The lack of dynamic muscular control of the joint leads to increased valgus motion, increased force, and high torque at the knee and ACL.

Another imbalance is termed quadriceps dominance. With quadriceps dominance, female athletes activate their knee extensors preferentially over their knee flexors during sports movements to stabilize their knee joint, which accentuates and perpetuates strength and coordination imbalances between these muscles.

A third imbalance is leg dominance. Leg dominance is the imbalance between muscular strength and coordination on opposite limbs, with 1 limb often demonstrating greater strength and coordination. Limb dominance may place both the weaker, less-coordinated limb and the stronger limb at increased risk of ACL injury. The weaker limb is compromised in its ability to dissipate forces and torques, while the stronger limb may be subject to high forces and torques due to increased dependence and increased loading on that side in high-force situations.

The final imbalance often observed in female athletes is trunk dominance. Trunk dominance is characterized by increased motion of the body’s center of mass due to the absence of neuromuscular control of approximately two-thirds of the body mass during single-leg landing, pivoting, or deceleration.19-21

Ligament Dominance—High Torques at the Knee and High Impact Forces

Typically during single-leg landing, pivoting, or deceleration, the motion of the female athlete’s knee joint is directed by the ground reaction forces, rather than by the athlete’s musculature. This results in high knee valgus motion and high ground reaction forces. Figure 2 shows the gender disparity in knee abduction motion and load between female and male athletes when dropping off of a box and progressing into a maximum vertical jump.

Figure 2A: Decreased dynamic valgus motion Figure 2B: Increased dynamic valgus motion Figure 2C: Decreased dynamic valgus motion in a male athlete
Figure 2: Differences in valgus knee motion between female and male athletes when dropping off a box and progressing into a maximum vertical jump (performing a drop vertical jump maneuver). Decreased dynamic valgus motion during landing in a trained or preadolescent female (A). Increased dynamic valgus motion during landing in an untrained or mature adolescent female (B). Decreased dynamic valgus motion in a male athlete (C).

Quadriceps Dominance—Decreased Posterior Kinetic Chain Torques

The problem of quadriceps dominance has been documented in the literature.6,7 With quadriceps dominance, female athletes tend to activate their knee extensors preferentially over their knee flexors to control knee stability. This over-reliance on the quadriceps muscles leads to imbalances in strength and coordination between the quadriceps and the knee flexor musculature. Quadriceps dominance must be addressed and overcome with dynamic neuromuscular training.

Leg Dominance—Leg-to-Leg Imbalances in Muscle Recruitment, Strength, and Stability

Female athletes have been reported to generate lower knee flexor torques on the nondominant than in the dominant leg.6 Side-to-side imbalances in neuromuscular strength, flexibility, and coordination have been shown to be important predictors of increased ACL injury risk.2,6,22 Knapik et al22 demonstrated that side-to-side balance in strength and flexibility is important for the prevention of injuries, and when imbalances are present, the athlete is more injury prone. Baumhauer et al23 also found that individuals with neuromuscular (muscle strength) imbalances exhibited a higher incidence of injury.

Trunk Dominance—Excessive Motion of the Body’s Center of Mass

During landing, pivoting, or deceleration, the motion of the female athlete’s trunk is often excessive and directed by that body segment’s inertia, rather than by the athlete’s core muscle contraction patterns. This results in excessive trunk motion, especially in the frontal or coronal plane, and high ground reaction forces and knee joint abduction torques (knee load).

It is important to note that several knee injury prevention training programs have been published and shown to be effective in improving neuromuscular deficits and reducing the risk of knee injuries, particularly in the female at-risk athlete. All successful programs incorporate the following key elements: a dynamic warm-up period that is high energy and efficient; plyometric/jump training with emphasis placed on body posture and control, trunk positioning, dynamic core balance, and entire-body control through a specific task; strength training for the core and lower extremity; sports-specific aerobic and skill components; and pre-season and in-season training programs that are strictly followed. Pre-season training program may be 6 to 8 weeks in duration, 3 days a week for up to 1.5 hours per day. In-season maintenance programs can be done in 15 minutes during pre-game warm-up 3 times per week.24

The goal of this program is to avoid injury by teaching athletes strategies to avoid vulnerable positions, improve strength and flexibility, and improve proprioception. Those of us fortunate enough to be involved in youth, high school, and collegiate athletics should pass this information on to our sports medicine team colleagues whenever possible. If we are able to prevent just 1 ACL injury, it is worth the effort. Only with education will we hopefully see a decrease in this dreaded injury, which is often season- and career-ending to some.

Lacrosse Injuries: Women Lacrosse Players At Higher Risk Of ACL Injuries Due To Mechanics Of Jumping And Landing (Video)

Dr. Kathy Weber, M.D.,  a team physician for the Chicago White Sox and Chicago Bulls, discusses why women are more prone to ACL injuries.

Lacrosse ACL Injuries: “Movement Errors” Are Identified By “Landing Error Scoring System” (LESS) Developed By University Of North Carolina, Which Can Accurately Predict Potential For ACL Injuries

ACL support for the knee(From Kansas City Star article)    When it comes to preventing ACL injuries, LESS may be more.

The Landing Error Scoring System (LESS) has been by developed by Darin Padua, director of the Sports Medicine Research Laboratory at University of North Carolina, as a predictive tool in the prevention of ACL injuries.

“The purpose of the project was to figure out what were risk factors for ACL injuries,” Padua said in a phone interview. “We wanted to focus on what we call modifiable risk factors, things we can hopefully change through exercise.”

Over the past five years, Padua and five colleagues studied 2,691 incoming freshmen at the military academies. A motion analysis was performed on the subjects.

Each had to jump off a box that was 30 centimeters high. A square was marked off on the floor so they had a visual target area to land on in front of them. The subjects had to jump off the box, and then jump forward a height that was 50 percent of their body height.

The researchers looked for a number of potential “errors” in the mechanics of the jump. Problems included landing with the knees too straight, allowing the knees to collapse in knock-kneed appearance, allowing the toes to rotate in or out, not bending enough at the knees and hips when a subject landed from a jump or landing asymmetrically (one leg before the other).

“The notion is that the individuals who have the higher number of movement errors or a certain pattern of errors are going to be at risk for ACL injuries,” Padua said.

Padua added that the test should take less than five minutes.

“The ultimate goal,” Padua said, “is to create a quick and simple screening tool. Community soccer leagues, high school teams, colleges, recreational athletes can order a quick three- or four-minute assessment and then identify those individuals who may be at risk of injury. Ultimately, what we’d like to do is not say you shouldn’t play sports, but here are some things you can do to move better and reduce your risk of injury.”