Olympic snowboarding gold medalist Maelle Ricker has travelled a long road from 8 knee operations, including multiple Anterior Cruciate Ligament (ACL) ruptures, becoming an Olympic Champion. She is one example of an alarming statistic showing that young female athletes are 4-6 times more likely to sustain a sports related ACL injury of the knee as compared to males in similar sports. This heightened risk for females has led the International Olympic Committee to release a position statement on the current causes and treatment and future areas for research related to ACL injuries in young females.

An ACL injury is a devastating injury requiring up to a year of rehabilitation, before a return to normal physical activity. There is also a very high risk of developing knee osteoarthritis 10-15 years following this type of injury. The good news is there is scientific proof that a specifically designed exercise program and preseason assessment by a physiotherapist can help reduce the risk of an ACL injury and its life changing consequences. As in Maelle Ricker’s case with the proper rehab you may be even able to continue to compete at a high level of physical activity.

What is the ACL?

The ACL is a ligament in the knee which runs from the shin bone (tibia) to the thigh bone (femur). Its job is to help stabilize the knee and to prevent excessive forward movement of the shin bone away from the thigh bone. Injuries range from minor overstretching to tearing or a complete rupture of the ligament. These injuries should be evaluated by a physiotherapist or an orthopaedic specialist to determine the severity and appropriate treatment. Depending on the severity, the knee can be more unstable and prone to repetitive trauma after these injuries.

Why are females more at risk than males for an ACL injury?

At this time the reasons why females are more at risk for theses injuries are not fully understood and are likely quite complex. However, factors such as bone size, bone shape and hormone differences have all been proposed to add to this risk. Research has also shown that females use different muscles and body positions when jumping and moving and these altered movement patterns may be what increases the risk of an ACL injury.

How can ACL injuries be reduced?

Risk factors such as bone size and hormone levels cannot be changed but how someone jumps and moves can be corrected and improved by a knowledgeable physiotherapist. Prevention is best achieved through learning how to land a jump properly and how to move quickly in ways which reduce the stress on the ACL. Incorporating exercises that focus on strengthening of the trunk and legs, balance training and agility drills are also beneficial. These programs can easily be incorporated into practices, training sessions or warm ups.

Who should participate in a prevention program?

The risk of ACL injury is particularly high for adolescent females, ages of 14-19 who are involved in sports with quick stopping and cutting movements such as soccer, basketball, downhill skiing, and snowboarding. These are the young female athletes who should be targeted to participate in an appropriately designed prevention program. It is also recommended that a physiotherapist performs a preseason screening examination to help identify risk factors such as poor muscle strength and flexibility which also can lead to injury. The bottom line is that with the proper evaluation and instruction young girls can reduce their risk of an ACL injury in sports and the devastating long term effects on their physical health.

For further information about ACL injuries, injury prevention programs or preseason screening evaluation please contact physiotherapists Gareth Sneath , Svetlana Marianer or Milad Bazaz Jazayeri, who have extensive experience in orthopaedic and sports injury rehabilitation.