Injuries to the anterior cruciate ligament (ACL) deserve attention because they are on the rise, especially among women and girls, said Dr. Freddie Fu, who was among the panelists discussing knee injuries in women at the recent American Academy of Orthopaedic Surgeons annual meeting in San Francisco.
The ACL is a diagonal piece of tissue in the middle of the knee connecting the upper and lower leg bones. It stabilizes and supports the knee. When the ACL is frayed or torn, the knee loses stability and becomes vulnerable to cartilage damage and arthritis.
What does a damaged ACL feel like? The knee feels unstable and sore as if it's ready to buckle. You lose leg flexibility and the knee feels stiff. Your knee may swell. Without physical activity over time, the leg will lose muscle.
Thankfully, many athletes recover from ACL injuries with good reconstructive surgery and disciplined rehab.
Nearly 1.4 million women have suffered ACL injuries in the past decade, twice as many as in the previous 10 years, according to a report from Sports Illustrated for Women last month.
Orthopedic surgeons perform about 100,000 ACL surgeries a year, Fu said. The actual number of ACL injuries is greater because some people do not have surgery. Although men still outnumber women in ACL surgeries, women and girls are catching up because more and more are playing sports.
Besides greater participation, another factor in the rise in women's knee injuries is the biomechanical differences between women and men.
In a study of female and male basketball players at the University of Pittsburgh, Fu found that women did not flex their knees as much as men when jumping and landing. Translation: Women did not use their muscles as efficiently as men did to absorb the load and shock, Fu said.
Other researchers suspect that at certain times of a menstrual cycle, women's ligaments may be looser, making the knee more vulnerable to injury. But the evidence is inconclusive, Fu said.
Studies also have shown that women tend to have weaker leg muscles than men, he said. Women can strengthen those muscles and reduce the risk of ACL injury through regular weight- and sports-specific training.
How to keep it from injury? Fortify the muscles around the knee with strength or resistance training. Strong muscles help absorb the load and shock when your knee is placed under stress.
Do resistance exercises on the muscles of all areas of the leg: quadriceps extensions, calf raises, hamstring curls, leg presses. Do single-leg squats and lunges.
Train your muscles to respond well to explosive or sudden stop-and-go movements. Practice jumping, hopping and landing with your legs flexed or knees bent. Ask a trainer to design a sports-specific conditioning program involving knee-friendly jumping, landing and lateral-movement techniques.
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