One of the worst things for a coach to hear is the following phrase:
“Coach I’ve gotten hurt.”
I got that phone call a couple weeks ago from the parent of an athlete.
This athlete is starting her senior year of high school soccer, and had verbally committed to a major Division I school.
While scrimmaging another boys club team, she felt a pop in her knee when another other player tackled her while going for the ball.
For soccer players this is their worst nightmare.
With an injury like this the first thing you worry about is damage to the ACL.
The ACL (Anterior Cruciate Ligament) is one of 4 ligaments in the knee, and is most commonly damaged in contact sports when knee receives a direct impact from the front of the thigh while the leg is in a stable position, for example a player is tackled sideways when his feet are firmly planted.
An estimated 150,000 suffer an injury to their ACL every year and a growing % are female athletes. It has been reported that female athletes are two to eight times more likely to injure their ACL than male athletes (Arendt, 1995).
Causes are still unknown but a number of reputable studies have been presented.
One study suggest causes include increased valgus movements during landing, pre-menstrual hormone levels, narrower intercondylar notch width and smaller AC ligaments are a contributing factor (Griffin, L. Y., 2000).
Another documented difference may be the firing sequences of leg muscles in male and female athletes. These firing differences help explain some of the different responses that females exhibit to athletic movements and thereby expose themselves to higher risk during those movements. As a result, females find themselves at a biomechanical disadvantage to males when it comes to ACL strength and stability (Ireland, 2002).
It has also been suggested that the lack of a quality conditioning program for female athletes in the middle school and high school levels are a contributing factor.
According to Stephanie L. Silberberg, MD, “ Traditionally, male athletes participate in twisting sports, like soccer, at an earlier age than women. This helps them develop muscle coordination and reflexes that can protect the knee once they reach the high school and collegiate competitive level. These knee reflexes allow strong muscles to control the knee, thereby maintaining its stability. Most female athletes do not participate in the same sports until a later age. Therefore, their muscle strength and coordination, as well as their reflexes, may not be as fully developed when they reach higher levels of competition.”
So what can be done to prevent these injures?
While there is always the risk of injury in any sport, we can definitely take steps to minimize the risk.
A meta-analysis of published ACL injury prevention programs determined that plyometric and strengthening components were more important than balance training and that the favorable effects of training were most pronounced in female soccer players younger than 18 years (Yoo JH, Lim BO, Ha M, et. Al., 2010).
Additionally neuromuscular training has been shown to reduce the incidence of ACL injuries. This training helps the female athlete reduce valgus movements when landing, incorporate more muscular control and experience less ligament dependence during cutting, landing, jumping and rapid deceleration (Roniger, L. R., 2007 and Foster, J. B., 2007).
Finally anecdotal evidence supports incorporating an integrated strength & conditioning program for the high school female athlete will help reduce injuries. Not only will the increase the strength in the muscles surrounding the knee, but will also improve muscle reflex thus increasing the stability of the knee and reducing injures.
So what is the status of my athlete?
After an MRI, and consulting with two separate Orthopedic physicians, I am happy to report her ACL is in tact. She did suffer an injury to her MCL, but with physical therapy and rest, hopefully she will make a full recovery in 4-6 weeks.
So did all the work she did this summer help prevent an ACL tear?
Maybe or maybe not, who knows.
But what I can say is all the unilateral leg training (Split squats, Bulgarian squats, One-Legged squats, Single leg press, etc), the power moves (Hang Cleans and Deadlifts), and Posterior Chain Movements (KB swings, Kb snatch, Glute/Hamstring, etc) definitely helped to save the ACL.
One other thing, she has an remained amazingly positive and is extremely optimistic . Her friends and family have kept her spirits up, and her coaches (including yours truly) will be there to get her back on track when medical team releases her to start training again.
Stay positive and stay strong
PS: If your high school program does NOT have a comprehensive strength and conditioning program for your athlete, I would suggest you consult with a qualified strength and conditioning coach in your area. Look for someone who has a degree in exercise science, kinesiology, or exercise physiology, and they should also be credentialed from the National Strength and Conditioning Association or the National Academy of Sports Medicine.