MD Mama

The Knee Injury That Can Change An Athlete's Life

Do you know what the ACL is? If you are the parent of an athlete, you should.

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The ACL is the anterior cruciate ligament, one of the four major ligaments that stabilize the knee--and injuries to this ligament are on the rise. They are particularly common in girls during the teenage years, in part because girls don't get that extra supportive and protective muscle boys get during their growth spurt. ACL injuries are most common in soccer, basketball, football, gymnastics and lacrosse.

Lots of sports injuries are on the rise in kids, as more kids play competitive sports--and play them more intensely and competitively. But this particular injury is more worrisome--because not only is it common, it can be life-changing.

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More than many other injuries, ACL injuries can be career-ending. While the majority of athletes return to sports after ACL surgery, only about half return to their previous level of performance. 

But here's what's more scary: more than half of people with ACL injuries end up with osteoarthritis 10-20 years after their injury. That means that a girl who gets an injury in high school could end up with arthritis, and all the pain and disability that brings, by the time she is 30. 

Surgery doesn't change that, either--in fact, surgery may increase the risk of arthritis. And when young people have surgery, it can interfere with the growth of the joint.

Scared yet? You should be. 

These injuries often happen when the legs get into a position called "dynamic knee valgus." That's when you come to a stop or quickly change position with your knee straight and turned inward, with your foot behind. It's a common position as players maneuver around a field or court, or in a gymnast's routine. (If you look carefully at the girl in the white and blue jersey in the picture, her right leg is just about in this position.)

Knowing about this can help prevent injuries, as can learning safe technique and doing plyometric (jumping), balancing and other strengthening exercises. Which is not stuff you'd expect your average volunteer (or other highly underpaid and possibly undertrained) coach to be doing with your child. That might be okay if your child plays a variety of different sports during the year, and isn't spending many hours a week at practice or competition. But if your child is specializing, and/or spending lots of hours practicing and competing, especially if your child is an adolescent girl...well, it might not be okay.

Not that it's all about the coaching. Being overweight, having loose joints and having a previous injury also increase the risk of ACL injury.

So if your child plays a sport, talk to the coach. Ask what he or she is doing to prevent sports injuries. Talk to your doctor, too. Make sure you are doing everything you can to help your young athlete stay healthy--not just now, but for the the rest of his or her life.

For more information, check out the American Academy of Pediatric's newly released clinical report on ACL injuries.