Why young athletes are getting ACL injuries
An expert lists six ways to prevent anterior cruciate ligament (ACL) damage
As a parent of an athlete, you probably know the term anterior cruciate ligament or ACL. But if you’ve heard it, it’s probably been in a negative context – either you saw a player on TV with an ACL injury or maybe your child has been injured with one. Unfortunately, these injuries occur to younger children than we ever thought possible. At Cook Children’s, we’ve seen ACL injuries in children as early as 5 years old.
One of the tops reasons is that younger kids are doing more than their growing bodies can withstand. Children are no longer just playing outside for fun. They are playing at a higher skill set than in the past, often times with parent coaches who aren’t formally trained to stretch their players in the correct manner. Make sure your young athlete stretches for his or her game.
Other causes of injury include weakness to the gluteus medius, loose joints, tight muscles, decreased balance and motor control and coordination.
I’ve spent the first two paragraphs talking about the injuries, but I actually feel the ACL has gotten a bad reputation because it’s a very important ligament that allows an athlete to run, jump and cut. Many non-contact ACL injuries can be avoided if athletes understand the issues that lead to ACL tears.
If you have a child who is an athlete, it’s important to know the proper way to stay safe during athletics and preventing ACL injuries. Below are 6 steps to preventing an ACL injury.
1.Strengthen your gluteus medius - The gluteus medius (located in the buttocks) weakness are common culprits in ACL injuries. This is one of the muscles that stabilizes your hips and in terms of ACL injuries prevents the knee from pointing too far inward when landing during jogging, hopping or cutting. A good way to know if this muscle is working the correct way is to watch the knees while performing squats or single leg squats. If the knees point inward past the inside of the ankle, the athlete may have weakness in his or her gluteus medius. To strengthen the gluteus medius, the athlete should perform exercises that cause his or her hip to come away from the body such as side steps, clamshells, or side lying leg raises.
2.Strengthen your hamstrings- Another important thing that should be looked at is the strength of the hamstrings (large muscles at the back of your thigh) in relation to the quadriceps (large muscles at the front of your thigh). When the quadriceps are significantly stronger than the hamstrings it can pull your tibia (shin bone) too far forward causing stress on the ACL. This is common with female athletes.
3.Stretch your quadriceps- When the quadriceps (large muscle on the front of the thigh) is too tight, it is similar to them being stronger than the hamstrings. It creates a forward pull on the tibia (shin bone). To stretch this muscle, grab the shin to bend the knee and hold it for 30 seconds repeat this 3 to 5 times. Make sure your young athlete stretches when he or she has been active. Stretching when not warmed up, is not as effective.
4.Work on your balance- Balance is another important part of any injury prevention program. People often think that their balance is poor but do not realize that it can be improved. Children who can’t stand on one leg for 1 minute without placing their toe to the ground, need to work on their balance. Have your child practice standing on one leg for a minute. Once this becomes easy, have your child try doing this with his or her eyes closed. For safety, always make sure your child has something steady to grab onto if he or she starts to lose balance.
5.Strengthen your core- Like the gluteus medius, the core assists with control of legs when athletes are active. It is important to have good control if you are an athlete. There are many ways to strengthen the core but some examples are planks, side planks and/or exercises on a stability ball.
6.Wear good shoes- Proper shoes are especially important if your child has flat feet. Shoes that are too flexible or without arch support may cause an increased risk of injury. If your child has flat feet ask the shoe salesman for shoes that help with control to help prevent injuries.
Following surgical repair, ACL injuries require 6 to 9 months of rehabilitation. However, athletes can prevent non-contact ACL injuries by strengthening their muscles properly, having a good stretching routine, working on balance, and wearing supportive shoes. Although it is important to properly maintain all leg muscles these are six of the most important ways to prevent an ACL injury.
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Kyle Tatum, PT, DPT is a SPORTS physical therapist at Cook Children's. Cook Children’s SPORTS Rehab is a leader in the community in sports injury. Additional information and helpful tips can be found on the Cook Children’s SPORTS Rehabwebsite. Cook Children’s SPORTS Rehab is a leader in the community in sports injury prevention.