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.