ACL Tears! What's going on.

[TheRealTruth]

Both fractures were the result of coming down on another girls foot. Her freshman year it happened against Maryville and her sophomore year she came down on a girls foot against Heritage. It was at the end of the season.

Through both injuries have a clear mechanism, we can still factor in the anatomy and hormonal changes as a predisposition. Again, lower extremity alignment (wider pelvis, knee valgus, foot pronation), muscle development, joint laxity and hormonal differences are factors. If joints are lax in the knee, it is reasonable to surmise the ankles are lax. The fact that it is unilateral may be simply due to having a dominate foot or leg. If the fracture were a 5th metatarsal fracture, was it surgically fixed? If the fracture were distal fibula, was it growth plate? If it was an avulsion fracture, that is an insignificant finding. 

[bigAsports]

I have often wondered about all the ACL injuries over the last several years. Yes, more likely for girls but boys injuries are up as-well. My personal opinion is this. Growing up many of us adults had one mode of transportation as a kid. We rode bicycles. We rode them for hours daily and put lots of miles on them from here to there etc. Even if it was just down to a friends house, it was done daily. I believe by riding so much while growing up, it strengthened & developed our lower bodies way more than the kids today. Not many kids ride & I mean RIDE like we used to. Video game, CPU, Smart phone era has kept kids less active on a daily basis. I was fortunate enough to play HS & college basketball without ever getting any major injuries. I look back & many of my friends or kids I competed with did not go down with these injuries either. And if anyone did it was almost unheard of. Today, it's very common to happen to many of these young athletes. I am not a bike rider now & not trying to down the technological era. or push an agenda just sharing my own thoughts.

Do you agree? Disagree?

[u2bballnow]

I think kids play too much aau ball , my daughter has played as many as 3 games in one day. Luckily no major injuries, thats too much for their bodies. I think parents get caught up in the more they play and push their kids, the better chance of college offers and so forth. The kids suffer, with acl, knee, shoulder and feet problems, might not even get to play college ball.  

[TheRealTruth]

I have often wondered about all the ACL injuries over the last several years. Yes, more likely for girls but boys injuries are up as-well. My personal opinion is this. Growing up many of us adults had one mode of transportation as a kid. We rode bicycles. We rode them for hours daily and put lots of miles on them from here to there etc. Even if it was just down to a friends house, it was done daily. I believe by riding so much while growing up, it strengthened & developed our lower bodies way more than the kids today. Not many kids ride & I mean RIDE like we used to. Video game, CPU, Smart phone era has kept kids less active on a daily basis. I was fortunate enough to play HS & college basketball without ever getting any major injuries. I look back & many of my friends or kids I competed with did not go down with these injuries either. And if anyone did it was almost unheard of. Today, it's very common to happen to many of these young athletes. I am not a bike rider now & not trying to down the technological era. or push an agenda just sharing my own thoughts.

Do you agree? Disagree?

Disagree, sure biking strengthens your legs but, as previously mentioned, those involved in sport are training with better designed weight programs and conditioning programs than ever. I am more than the median aged person on CoachT and I remember 2 ACL injuries to my classmates in which it typically said "they tore a ligament" as no one really understood what the ACL is or does. I believe we hear more in the media and have more information about these injuries than ever. If we look back even to the 70s, there were 2 million+ high school athletes to now 8 million+ high school athletes not to mention AAU/travel teams, etc.

 

The biggest factor is exposure. Second biggest factor is risk. Some are predisposed, some are trained, many are both. If we use the bike scenario as a cross training workout then reducing risk may be probable. Anyone that plays basketball or any sport year round dramatically increases risk. Anyone doing the same dynamic movement at a high rate of repetition and/or over time will experience fatigue in an area of the body. Most experience an overuse injury, some hit the break point of acute injury and some just happen regardless. example: overhead throwing in baseball, cutting/jumping and landing in basketball. This is why offseason is needed for the body to cycle off the same regiment and began off season training that should include some non sports specific training or better yet, play a different sport.    

[TheRealTruth]

I think kids play too much aau ball , my daughter has played as many as 3 games in one day. Luckily no major injuries, thats too much for their bodies. I think parents get caught up in the more they play and push their kids, the better chance of college offers and so forth. The kids suffer, with acl, knee, shoulder and feet problems, might not even get to play college ball.  

Maybe too much exposure but, definitely too much emphasis.

[WarriorFan]

Girls have to train much different than boys.  Very few people in this area know how to train to prevent ACL injuries.  Weights as a whole is not the answer.  My daughter is in high school now but has played a lot of AAU since the 4th grade, and pretty much plays year round, and has no knee injuries.  Her trainer is Ross Jordan who has been training girls for over 20 years.  He has also coached Memphis Elite and Tennessee Tigers.  He has a whole theory on training to prevent ACL tears.  The girls he trains has had very few ACL injuries.  He is not a member of CoachT.  I will see if I can get him to come on the forum.  I think he can best answer what you guys are talking about.  

Edited January 10, 2014 by WarriorFan

[WCG]

Praying for a healthy season for all the girls basketball players. Amen

[WCG]

I have often wondered about all the ACL injuries over the last several years. Yes, more likely for girls but boys injuries are up as-well. My personal opinion is this. Growing up many of us adults had one mode of transportation as a kid. We rode bicycles. We rode them for hours daily and put lots of miles on them from here to there etc. Even if it was just down to a friends house, it was done daily. I believe by riding so much while growing up, it strengthened & developed our lower bodies way more than the kids today. Not many kids ride & I mean RIDE like we used to. Video game, CPU, Smart phone era has kept kids less active on a daily basis. I was fortunate enough to play HS & college basketball without ever getting any major injuries. I look back & many of my friends or kids I competed with did not go down with these injuries either. And if anyone did it was almost unheard of. Today, it's very common to happen to many of these young athletes. I am not a bike rider now & not trying to down the technological era. or push an agenda just sharing my own thoughts.

Do you agree? Disagree?

I agree

[WCG]

I think kids play too much aau ball , my daughter has played as many as 3 games in one day. Luckily no major injuries, thats too much for their bodies. I think parents get caught up in the more they play and push their kids, the better chance of college offers and so forth. The kids suffer, with acl, knee, shoulder and feet problems, might not even get to play college ball.

I agree

[cbg]

Knee ligament and meniscal injuries have been too common for the past 20 years. I have often wondered why these injuries appear to be more common than years ago and especially why they seem to be more prevalent in girls. Well, according to UCSF Department of Orthopaedic Surgery, "Several factors are speculated to increase risk of ACL injury in females including lower extremity alignment (wider pelvis, knee valgus, foot pronation), joint laxity, hamstring flexibility, muscle development, hormonal differences, and ACL size." (Written by Jennifer Kim Reveiwed & Updated by Joe Smith, January 2009). I believe other factors are: 1) more girls are involved in sports now than ever before and 2) basketball (and other sports) is played essentially year round - because of this the body has little to no time to recover/heal/mend.  These are only speculations on my part as I am not a physician.    Regardless, I hate to see or hear of any young athlete that suffers this type of injury.  Hopefully, this young lady will recover quickly and be back on the court playing the sport she loves.

All of this is true.  Another problem that most people don't wish to discuss because it's young females is that some of these girls while strong are overweight and when carrying the extra pounds it places extra pressure & stress on the joints along with the MCL & ACL. 

[coachrlj]

i have trained bodybuilders,kids and adults for over 20 yrs and one thing i have learned is "not to try and reinvent the wheel. In adapting my training programs especially for females i consulted Dr Laura Ramus, P.T. A.T.C. Head Athletic Trainer S&C Coach for the WNBA's Detroit Shock-Manager of Sports Medicine @ St. John Hospital & Medical Center. here are  excerpts from her website"girls can jump" under plyometric training & ACL prevention; Females have wider hips and a naturally more knock-kneed stance. They have looser ligaments because of monthly hormone fluctuations(81% of acl tears happen during this time) Their muscles are smaller and weaker than males particularly hamstrings, certain muscle reflexes are slower or fire differently. To compensate females tend to play sports in a more erect stance than males causing more force on the knee with every landing. Lower body strength is important but improper training is at fault also "for yrs, we have trained girls just like boys and although experts bicker over training details, they have known for a few yrs that a combination of plyometrics(jump training) and reflex training, foot and ankle strength trng, and functional weight trng(that is do things that mimic the movements you actually would use in a sport or activity), can cut the risk to female athletes. Not enough trainers know these things or know how to train with these techniques. We need to reach girls when they are 11, 12, and 13 because that's when they are developing those neural pathways.Girls are being subjected to heavy weight trng programs by trainers, who if you ask them why they use a particular exercise they usually can't give you a reason and this is at the high school & middle school level. The trick is getting out the word at these levels and changing decades of ingrained training techniques by these coaches and trainers who resist change.Anatomy and biology can't be changed, But Dr Ramus urges players and parents to demand specific trng geared to females, based on the latest research. She urges players to find out if they are at risk, by having their running, footwork and jumping evaluated by proper personnel. Maintain proper weight as each extra pound puts four pounds extra pressure on knees. I pass out this information at every opportunity that i have where parents are present, and to many of these parents dismay, they are told when they confront their high school coaches and AD's that if they want their daughters to play on their team they WILL follow the training program in place(end of conversation).  For me using these training techniques, has led to State titles in volleyball and basketball @ FCS  and many young athletes i have trained have avoided acl injuries even those who started playing competitively as early as 8yrs old and many who play sports year round. I urge you to go to her website.

[TheRealTruth]

All of this is true.  Another problem that most people don't wish to discuss because it's young females is that some of these girls while strong are overweight and when carrying the extra pounds it places extra pressure & stress on the joints along with the MCL & ACL. 

Definately a factor. Building strength on dysfunction is an issue.