The sudden deceleration, shifting in the knee, popping sound and screaming from the intense pain that immediately follows is becoming increasingly common among our young athletes. Those who have witnessed or suffered a torn anterior cruciate ligament (ACL) are familiar with the pain, surgery and intense 6 to 8 month rehabilitation that accompanies the injury, not to mention the disappointment of ending a season. Nationwide, this will occur more than 500,000 times this year, and female athletes with ACL injuries outnumber males 5 to 7 to 1.
Why is this injury more common in female athletes, especially basketball and soccer players? What is it about young female athletes that puts them at such a high risk for this devastating injury?
Several factors contribute to this trend. ACL injuries in females and the biodynamics involved are among the most widely studied topics in sports medicine. Through this research, we have learned that boys and girls differ in many ways beyond those typically considered.
Anatomic Differences Females have wider hips than males, which increase the angle on the knee joint. The knee was designed as a hinge joint that is supposed to rock forward and back in the frontal plane. Females’ wider hips create an inward-directed inward angle on the knee, which causes it to roll side to side like a ball and socket joint. This increases stress on the ACL, especially during landing and cutting movements.
Females also have a narrower notch in the inside of the knee. The ACL travels through the middle of the knee joint through a notch called the intercondylar notch. Since it is narrower in females, the ACL may get pinched or frayed during cutting, increasing the risk of tear.
Muscle Imbalances Hamstrings (muscles in the back of the thigh) are protective of the ACL and the quadriceps (muscles in the front of the thigh or quads) are antagonists of the ACL. In other words, during landing or cutting, if the hamstrings contract first, the tibia (shinbone) is stabilized and the ACL is “protected.” On the other hand, if the quadriceps contract first, before the hamstrings can stabilize the ACL, then the stress on the ACL is increased, leaving it at risk for a tear. In general, the quadriceps of females are stronger than their hamstrings, putting the ACL at an even higher risk. In males, the hamstrings are stronger, thus protecting the ACL.
Additionally, biomechanical research shows that the gluteus muscles, or external rotators of the hip, fire differently in males and females. In males, the hip muscles fire a split second before landing, thus stabilizing the hips, or core. With females, the glutes don’t fire before or after landing, so the hips rotate in, the knees buckle inward, and the ACL is stressed.
Landing Patterns Sports typically involve some degree of running, jumping, landing, cutting, acceleration and/or deceleration. Females tend to perform these tasks with more of a straight leg than males. This straight leg landing pattern does not let the muscles of the thighs and calves absorb the shock, so the stress of landing is transferred to the ligaments of the joint, like the ACL.
The solution Now that these biomechanical differences have been identified, can we correct them? Some we can, but some we cannot. For example, we can’t change the shape of an athlete. If a child has wide hips and a stocky build, this may increase the inward angle on the knee, stressing the ACL.
On the other hand, through strength and proprioceptive (balance) training, we have been able to train female athletes to fire their hip muscles and glutes in ways similar to males, thus stabilizing their ACLs. We can also change the hamstring to quadricep strength ratio to make it more favorable for protection of the ACL. With proper training and conditioning, female athletes can avoid ACL injuries and stay in the game.
There is a wonderful site that just launched with the youth sports community in mind. The site is http://YouthSportTravel.com , a collaboration of youth sports coaches and a major online travel brand. They offer arguably the best prices on hotel and motel rooms anywhere. For proof, I tested a number of locations with www.hotel.com, Expedia and Travelocity incomparison with YouthSportTravel and in each case; YouthSportTravel was equal to or cheaper than the competition. But this is not all they offer.
YouthSportTravel offers a basic but effective free tournament bulletin board for tournament operators. There are categories for multiple sports with ample space to post all of the important information for an event. A clever feature in the Find a Tournament section is the ability to find a tournament by location, date, and sport then click a link posted with the information to make your reservations. This covers all bases for the tournament operators and participants.
Since youth coaches are collaborating partners in YouthSportTravel, they fully understand the vast majority of youth sports organizations struggle from year to year to raise money for operations. With this in mind, they developed an affiliate marketing program that offers a free and easy way for organizations to raise money with very little human resources and a very high return. As a registered affiliate, you receive a user code that can be passed around within the organization and the community. For each room that is booked via YouthSportTravel with the user code, the affiliate receives $2 per room. It would be safe to say, an organization of 200 families could book 500 rooms in a year with sport tournaments, vacations and business. That is $1000 to the league without the painstaking labor of selling over priced candy door to door, counting nickels and dimes at midnight in the concession stand or begging local businesses to buy outfield boards. Once the word is out, I see organizations flocking to sign-up to add to their coffers.
YouthSportTravel wants to engage the youth sports community. There is an extensive database of attractions available on the homepage to plan your trip or find something to do for the family when the games are not being played. Soon to be added will be a place to upload videos, affiliate social marketing tools plus a forum to recommend your favorite restaurant or events of the trip.
http://YouthSportTravel.com is sitting on the fastball in a hitters count so I would not be surprised if they hit out of the park or at least a booming double off the wall.