The Anterior Cruciate Ligament (ACL) plays a vital role in stabilizing the knee joint, especially during activities that involve sudden changes in direction, jumping, or pivoting. ACL injuries often occur during sports like soccer, lacrosse, football, basketball, field hockey, and skiing. These injuries can range from partial tears to complete ruptures, depending on the severity.
Female athletes are more prone to ACL injuries than males, likely due to anatomical differences in knee structure and variations in how men and women jump, land, and move during sports. These factors can lead to greater stress on the ACL in women, increasing the risk of injury.
Why ACL Injuries Happen
In adults, ACL tears typically involve a rupture of the ligament itself, often resulting in immediate pain, swelling, and instability of the knee. However, in children, the ligament is often stronger than the surrounding bone. Instead of tearing in the middle, the ACL may pull away from its attachment to the tibia, bringing a small piece of bone with it. This condition is called a tibial spine fracture or tibial eminence fracture.
The good news is that most of these injuries in children can be repaired using minimally invasive techniques like arthroscopy. With proper treatment and rehabilitation, the ACL can often be restored to normal function, allowing children to return to their usual activities.
Case Example: Mia’s Soccer Injury
Mia, a 16-year-old high school soccer player, was sprinting down the field during a game when she suddenly pivoted to change direction. She felt a sharp pain in her knee and heard a “pop.” After falling to the ground and being unable to stand, Mia was taken to the emergency room. An MRI revealed a complete tear of her ACL.
Mia underwent arthroscopic surgery to reconstruct her ACL using a graft from her own hamstring tendon. Her surgeon also performed a meniscus repair to address additional damage found during the procedure. Following surgery, Mia committed to a rigorous rehabilitation program to strengthen her quadriceps and hamstrings. After six months of physical therapy, she was back on the field, feeling stronger and more confident than before.
Preventing ACL Injuries
While not all ACL injuries can be prevented, strengthening the muscles around the knee, particularly the quadriceps and hamstrings, can reduce the risk. Proper warm-ups, stretching, and conditioning are also crucial, especially for athletes who participate in high-risk sports. Training programs focused on balance, agility, and jumping mechanics can help athletes develop safer movement patterns, reducing the likelihood of injury.
To support this, we have developed an ACL Injury Prevention Tip Sheet that includes specific exercises and drills to help young athletes stay strong and minimize the risk of ACL injuries.