Preventing ACL Injuries in Athletes

Female athletes are two to nine times more likely to suffer from anterior cruciate ligament (ACL) injuries than males. New research suggests that gender disparity is likely the result of body type and landing techniques.

ACL injuries are an extremely common sports injury, resulting in an estimated 80-100,000 ACL repairs in the US every year. Although most athletes are able to bounce back from these injuries, they can be a source of significant disability, lost playing time, and put you at an increased risk of arthritis later in life. Sports with jumping or quick starts and stops are tied to an increased risk of ACL injuries, such as basketball, soccer, volleyball, and lacrosse. Gender also plays a role in the risk of ACL injuries, but it was previously not understood why.

A new study from Oregon State University shows women are more likely to land in way associated with a higher risk of ACL injuries.

Using motion analysis software, researchers examined men and women's body movements while performing various jumping exercises. Both men and women utilized their quad regions similarly, and they also landed stiffly, which has which has been tied to an elevated risk of ACL injuries. However, women were 3.6 times more likely to land in a "knock-kneed" position, with their thighs slightly inward. This inability to control frontal-plane knee loading may put the knee ligaments at risk.

Further research is needed to understand why women land in this way, but lead author Marcus Norcross speculated it may be related to women's wider hips and body shape. It's possible that preventive training could help to mitigate that risk however. Norcross said in a press release that his next research project will investigate the effects of integrating prevention strategies into high-school athletes' warm ups with better landing techniques.

Chiropractors often treat athletes recovering from torn ACLs and other lower-limb complaints. One study of Australian football players showed that showed that players under chiropractic care had a reduced incidence of lower-limb injuries compared to players not receiving chiropractic care.

Exercise therapies have been shown to be effective for healing one of the most common types of knee injuries, meniscal tears. In one study, exercise therapies were as effective as surgery for alleviating symptoms in patients with knee arthritis and meniscal tears. Chiropractors frequently provide such therapies, often as a part of an integrated approach.

Primary References:

Norcross MF, et al. Lower Extremity Energy Absorption and Biomechanics During Landing, Part I: Sagittal-Plane Energy Absorption Analyses. Journal of Athletic Training 2013.

Norcross MF, et al. Lower Extremity Energy Absorption and Biomechanics During Landing, Part II: Frontal-Plane Energy Analyses and Interplanar Relationships. Journal of Athletic Training 2013.

Secondary References:

Hoskins W, Pollard H. The effect of a sports chiropractic manual therapy intervention on the prevention of back pain, hamstring and lower limb injuries in semi-elite Australian Rules footballers: a randomized control trial. BMC Musculoskeletal Disorders 2010;11:64.

Cimino F, et al. Anterior cruciate ligament injury: diagnosis, management, and prevention. American Family Physician 2010; 82(8):917-922.