Health & Safety Resources

ACL INJURY AND ITS PREVENTION

Injury to the anterior cruciate ligament (ACL) is a relatively common and significant knee injury in athletics today.  In this article, we will explore the injury and its importance to those involved in coaching and training our young athletes.

The ACL is a ligament which crosses the center of the knee.  It holds the tibia (shin bone) from sliding forward on the femur (thigh bone).  It also helps with rotational stability (twisting, turning, & changing directions) of the knee.

Injury to the ACL most commonly occurs as a result of a non-contact mechanism, although collision can also result in injury.  Frequently, the injury is seen when an athlete twists or changes direction (cut and pivot).  Athletes’ experience pain and frequently hear or feel a “pop”.  Most are initially unable to bear weight; the knee usually swells immediately after injury.

In order to return to competitive play, the athlete requires surgical reconstruction of the ligament.  More importantly, an ACL rupture requires significant rehabilitative effort for post-operative recovery, but athletes commonly return to their pre-injury level of play.

Female athletes are at a higher risk of ACL injury with some estimates as high as 4-8 times greater than males.  While the reasons for this are complex, some research suggests that inherent anatomic factors (body mechanics) of female athletes may contribute to their risk.  Gender specific movement patterns of running, jumping, and landing due to anatomic factors may be responsible.  Research, led by the senior author Dr. Henry Goitz, of the Henry Ford Center for Athletic Medicine, has identified gender specific proprioception or ‘position sense’ differences in the legs of elite female athletes.  Current training programs are available that have documented a decreased risk of injury to female athletes when specific muscles are retrained.  Research is ongoing as to the mechanisms of the effectiveness.

Another possible risk factor for ACL injury is improper and/or inadequate conditioning.  ACL injuries are more common in later stages of games or sports participation.  This may be due to fatigue of the leg muscles or generalized mental and physical fatigue.  Our researchers are presently trying to determine how fatigue affects ALL injuries in order to create test exercises and training strategies to prevent ACL injury.

Coaches, trainers, and parents can help their athletes by being involved in pre-season conditioning programs and supporting research programs for ACL injury prevention.  A proper ACL injury prevention program should develop lower extremity and core flexibility, strength, power and coordination.  Studies have indicated that a quality program with these components can reduce the incidence of ACL injury.  There are a number of ACL injury prevention or jump training programs on the market.  Be sure to choose a program that is research based and developed by a team of health care professionals (physicians, athletic trainers and physical therapists).  While not all ACL injuries can be prevented, it is our responsibility to educate and condition our athletic youth to prevent as many injuries as we can.  To enhance your athlete’s preseason conditioning and minimize the risk of injury, contact Henry Ford Center for Athletic Medicine and enroll your athletes in one of its performance enhancement programs.

If you are considering ACL reconstruction, be sure to consult with an orthopaedic surgeon whose specialty is sports medicine surgery such as the physicians at Henry Ford Center for Athletic Medicine. 

For further information on this article, our ACL injury prevention program, or for priority appointments for sports injuries please contact Henry Ford Center for Athletic Medicine at 313-972-4216.

Written by: Henry T. Goitz, M.D. and Kip Wilkens, M.D., Henry Ford Center for Athletic Medicine, Department of Orthopedic Surgery, Detroit, Michigan 48202

Henry Ford Health System’s Center for Athletic Medicine offers a comprehensive approach to sports medicine, including surgical and non-surgical care, sports rehabilitation, injury prevention, and performance enhancement programs.  The HFHS treatment team includes sports medicine fellowship trained orthopedic surgeons, sports medicine fellowship trained primary care physicians, as well as certified athletic trainers and physical therapists.  These health care professionals are supported by the HFHS nationally recognized bone and joint research facility, including the prestigious Herrick Davis Motion Analysis Lab.  HFHS is proud to be health care providers to the Detroit area’s premier sports programs including professional, collegiate, and high school athletes.