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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.


David Marshal, M.D.

Medical Director, Sports Medicine Program

Children's Heathcare of Atlanta

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526 Views 0 Comments Permalink Tags: soccer, volleyball, softball, lacrosse, injuries, acl

There is a wonderful site that just launched with the youth sports community in mind. The site is , 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, 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. 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.

640 Views 0 Comments Permalink Tags: sports, basketball, football, baseball, travel, softball, lacrosse, youth



Member since: May 30, 2007

Covering youth sports ages 5-15 including baseball, football, lacrosse, softball, volleyball, basketball, golf and soccer.

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