The majority of anterior cruciate ligament (ACL) tears each year occur in young and female athletes, as those on travel physical therapist assignments may know. To reduce these occurrences, the American Physical Therapy Association urges children and women to stretch and educate themselves on warm-up routines to lower their risk of ACL tears.
Doctors said that they are seeing more torn ACL cases in elementary schools, from simple activities like children doing gymnastics or playing tackle football. In fact, the numbers are growing so large that some therapists are calling it an epidemic.
“We recently looked at the database in New York and found a five- to six-fold increase over the last 20 years of ACL surgeries in children,” Dr. Daniel Green, at New York’s Hospital for Special Surgery, told ABC.
The ACL is the main stabilizing ligament of the knee. The fibrous bands attach bone to bone and help control excessive motion of the knee joint while preventing the lower leg from sliding too far forward. However, it’s not strong enough to endure the strain of repeated movements by itself. Rather, the whole knee must be strong.
Educating children and women on ACL tears
Children who do the same movements repeatedly while playing a sport – like kicking a soccer ball or pivoting on the basketball court – are at risk of ACL injuries. Girls run even a higher risk, being six times more likely to tear their ACL than boys, according to the Prevent Injury and Enhance Performance Program. Women are more vulnerable to ACL injuries because of either improper technique, hormones or alignment issues specifically related to females; wider hips result in a different angle between the hip and the knee.
“Women perform athletic tasks in a more upright position, putting added stress on parts of the knee such as the ACL, resulting in less controlled rotation of the joint,” Mark Paterno, sports physical therapy at Cincinnati Children’s Hospital Medical Center, said in a news release. “While men use their hamstring muscles more often, women rely more on their quadriceps, which puts the knee at constant risk.”
Most of the time, ACL injuries are not even on the radar of parents as something that could happen to their kids, since they are typically associated with professional sports, such as football, soccer and basketball. This injury was the reason Chicago Bulls point guard and MVP Derrick Rose missed the 2012 season, and it cost Lindsey Vonn her participation in the Sochi Olympics.
As those on travel physical therapy jobs should know, plyometric and strengthening exercises performed before sports activities have proven to be effective in reducing the risk of an ACL tear, in particular with young female soccer players, according to Move Forward, sponsored by APTA. Research has also shown that a simple solution is warm-up routines that involve jumping, stretching and flexing, which simulates the movements that children and older athletes do on the field, court or playground.
You can help design programs that teach athletes how to avoid abnormal movement patterns and lessen stress on the knees, which may include exercises to boost strength in the hamstring and core muscles.
“Whether patients are athletes or not, physical therapist expertise includes not only rehabilitation and restoration of normal levels of function, but also education regarding how to prevent further injury,” Physical therapist and APTA spokesperson Holly Silvers said in a news release.
With a combination of exercises that will improve strength, balance and coordination, travel physical therapists can help patients enhance the performance of their knee joints and keep them in the game.