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How the ACL works and why female athletes are at high risk of injury

by Dave Lery on November 25, 2019

 

The crackling, snapping and popping sound before tearing the anterior cruciate ligament (ACL) is palpable. Knee injuries are disastrous. If they don’t end in expensive surgeries, they’ll keep you off the pitch for a generous part of the season. Knee injuries often see athletes spend more time in the therapy room and on the bench than on the field. Proper form is paramount: Especially when you’re in contact sports. Basketball, volleyball and soccer players should be careful about how they take hard steps. Quickly accelerating in a different direction (“cutting”) and landing after a jump (“planting”) should be performed carefully too. In fact, 80% of all torn ACL injuries in sports occur during lading, according to this report by Myer. Athletes stress the knee joint when they land, cut and pivot. The knee joint is designed to resist rotational movements. The anterior, posterior and anterior ligaments collectively restrain the joint from rotating. Incorre3ct form when planting can put too much force on these tendons and they may tear.  

Female athletes at high risk

“Research has shown that female athletes have a higher risk of noncontact ACL ruptures than male athletes, with data from the 2004-2014 NCAA ISP cohort indicating that 60% of ACL ruptures in female athletes were caused by a noncontact injury, versus 41% in male athletes” This journal reports   The ACLs are solely responsible for stabilizing the legs as we jump. They ensure that the tibia(shinbone) doesn’t slide under the femur (thigh bone). Why are female athletes at higher risk of injury? They tend to activate the quadriceps first while jumping while their male counterparts use the hamstrings predominantly. This difference in activation may alter how the jumping strain is distributed to the ACL and the other ligaments in the knee. Again, women tend to land with their knees closer in general compared to men. Henning suggested that athletes should land with their knees apart to reduce the risk of ACL injuries in his report on Rationale and Clinical Techniques for Anterior Cruciate Ligament Injury Prevention Among Female Athletes

Fatigue

Naturally, tired athletes tend to land with poor mechanics. This often results in them landing with their knees close. Elite-level athletes are expected to make split-second decisions and to make impressive reflexes but they may forget to maintain proper form when reacting on “auto-pilot” The ACL is made of somewhat elastic, fibrous tissues that sometimes tear on excessive strain. Total ACL raptures aren’t a rare occurrence either.

Can knee sleeves prevent ACL injuries?

This study on the immediate effect knee sleeves had on osteoarthritis patients came up with rather interesting findings. 80 patients showed up for the test. Seventy-four participants were able to complete the Stair Climb Power test (SCPT), Timed up and Go (TUG) and 8-meter walk tests. The tests were performed with and without knee sleeves. The knee sleeves were covered and the investigator blinded to mitigate the Observer-expectancy psychological fallacy. The compressive knee sleeve was found to be effective as it enhanced physical performance during the tests. It was practical, useful and proved a great aid when performing therapeutic exercises.

FOR THE GEEKS: There was a significant statistical reduction in pain with the knee sleeve worn with a (P < 0.05) reduction in the TUG test.

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