ACL Injuries in Athletes
ACL injuries are common in the athletic population. Just so you know, you don’t have to be a young kid in high school playing baseball to be considered an athlete. Athletes come in all ages, shapes, and sizes. If you routinely walk, exercise, go to the gym, hike, etc., then you can consider yourself an athlete. If you fall into this category, then I’d like to share a bit of information to help avoid an ACL injury and especially avoid reinjuring your ACL if you have injured yourself in the past.
In fact, Nessler, T, et al reported in 2017 in the journal Current Reviews in Musculoskeletal Medicine that there have been an estimated 350,000 ACL reconstruction surgeries every year. Risk factors for injuring your ACL include: previous injury, asymmetry (one side does not move like the other/ Or there is a strength difference from one side to the other), females are 4-6 times more likely to have an ACL injury compared to their male counterparts, having a valgus knee position especially combined with faulty movement patterns (where your knee deviates inward), knee hyperextended position, and quadriceps dominance over hamstring strength. Interestingly enough, most ACL injuries occur from non-contact sports. For example, a volleyball or basketball athlete may land incorrectly on his/her leg. Alternately, he or she may be running and will cut/pivot which creates enough shearing force to injure the ACL. Even if you’ve had an ACL injury and repair, you are still more likely to reinjure your knee or develop arthritis later in your life (this journal reported that 1 in 4 young athletes will re-injure their ACLs). The moral of the story is that if you prevent ACL injuries from happening in the first place, you are going to be better off in the end.
There are a few tests or screens I like to perform on individuals who wish to play sports or are looking to become more active in their lives. The first test is called the Functional Movement Screen. I like this screen because it looks at many of the risk factors listed above. It looks at symmetry, screens for knee valgus, and looks for faulty movement patterns. The second test I like to use is called the Y balance Test. As the name implies, this test looks for differences between the left and right leg during dynamic (movement-based) balancing tasks. With each of these tests, there are certain criteria that you should be able to meet. If you don’t meet the criteria, it guides us as physical therapists to further screen out the root source of the problem. The third screen I like to use is called the Fundamental Capacity Screen. This test is more specific to hopping and jumping. This test looks at symmetry, movement patterns, and your ability to load/unload your knee during dynamic tasks.
If you would like to do a simple screen at home, I would recommend a single leg balance reach. To do this test, stand next to a wall and measure two foot-lengths out from the wall. (Make sure there is a chair nearby to grab on to should you lose your balance). Stand and balance on one foot and reach your other foot to touch the trim on the wall. You should be able to do this equally on the left and right side. If you are unable to do this on one or both sides, it means you may be at risk for injuring your knee in the future. Let us know how you did, especially if you are unable to perform the test. We would love to help and give you some pointers.
Be sure to come to Chad Clark’s workshop on 6/18/2019 from 5:00 – 6:00 pm at PT-Connections. He will be going over how “athletes” can prevent knee injuries and ACL tears. Call 719-565-6678 to reserve your spot.