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The 411 on ACL Tears

April 28, 2020

If you’ve ever watched any type of sporting event, you are probably familiar with the term “ACL Injury.” But do you know what that actually means?

According to the Centers for Disease Control and Prevention, around 250,000 ACL injuries occur in the United States each year. The injury is incredibly common, but not necessarily well understood.

That’s why Jeff Lansdale, PT, OCS, Program Manager at Humboldt Sports Plus, wants to shed some light on the anterior cruciate ligament and how we might lower the risk of ACL injury.

Jeff Lansdale, PT, program manager
Jeff Lansdale, PT, OCS, program manager

What Is the ACL?
First—what is a ligament? Basically, a ligament is strong connective tissue that connects bones  one to another. The ligaments keep the bones and joints in proper alignment so that they can function correctly.  

Generally speaking, the anterior cruciate ligament functions to prevent the leg bone, which is below the knee, from moving too far forward on the thigh bone, which is above the knee. The anterior cruciate ligament also controls rotational forces at the knee joint.  

What Happens in ACL Injury?
The anterior cruciate ligament or “ACL” is one of the primary stabilizers of the knee joint, and we often hear about the ACL when someone injures their knee. If someone says, “I blew out my knee,” he or she is most often talking about an anterior cruciate injury. 

Tearing the ACL is a severe injury and usually requires surgical reconstruction and prolonged recovery before a person can return to his or her previous level of activity. The prolonged timeline is especially true in the athletic population, particularly in high-demand sports such as football, soccer, basketball and volleyball. 

As the father of two athletic daughters, it was very interesting to me that young female athletes injure the ACL a rate of four to six times greater than their male counterparts.  A great deal of research has been undertaken to determine why the female athlete, particularly in her adolescent years, is more prone to injuring the ACL.  

As is often the case, there seem to be multiple factors—some we think we understand and then some maybe not so much. 

There are anatomical, biomechanical and hormonal differences between male and female athletes that have been studied and likely play a role in the increased injury rates noted in the adolescent female. Those hard biological factors can’t be changed. They are what they are.

But there are some factors that can be changed.

Most ACL injuries are non-contact in nature and often result during planting, cutting and pivoting activities. Landing from a jump can also be a time of concern. Researches discovered that female athletes tend to stand more erect with straighter knees during these tasks. 

Girls also let the knees slant in or come together to a greater degree during these same planting, cutting, and landing activities. These positions and movements have been shown to increase stress on the ACL. The good news is that these “neuromuscular” tendencies can be mitigated by simple training regimens.

Taking Steps to Prevent ACL Injury

The neuromuscular risk factors can be impacted through nothing more complicated than a regular exercise program. The program should include certain balance, strengthening and jump training components, along with proper education and coaching “feedback” regarding correct technique.

The program needs to be performed at least three to four times per week for a minimum of six weeks to begin showing results. With regular performance of a good ACL Injury Prevention Program, the injury rates in females can be decreased up to 72%. That’s a huge impact!

The great news is that you do not have to be a healthcare professional to start a program.  A typical regimen is about 20 minutes in length and can be implemented by a coach or even a player after a short bit of instruction. 

I know a local basketball coach that has her captains run an ACL Injury Prevention Program as her warm-up. The process works beautifully with great results. It really is easy and just takes a little dedication. 

Quality programs are readily available in step-by-step format from multiple sources, including the internet, but it is a good idea to check with a rehabilitation or athletic training professional to make sure you are using a program that includes all the needed components and that you understand the particular points of technique critical to program success.

Despite all the advances in medicine, surgery and rehabilitation, up to 20 percent of ACL reconstruction patients suffer re-injury within two years. Ten to 12 years after ACL reconstruction, up to 79% of patients begin to demonstrate early signs of osteoarthritis. There are downstream consequences and costs for this injury. That’s why preventive action is so important.

We owe it to our girls, and boys as well, to step in and do what we can to protect them as best we can from ACL injury. As a father of daughters and a physical therapist, I would like to see injury prevention programs implemented throughout our youth sports leagues worldwide. 

Amateur sports organizations, including FIFA, AAU and YVBA, need to lead the way by adopting ACL Injury Prevention Programs. As more and more girls step forward into competitive athletics and experience all the good life lessons sports provide, let us make sure they stay healthy and finish strong. 

There is no reason it can’t start right here. Let’s lead the way.

If you’re looking into ways to prevent ACL tears and other injuries, Sports Plus Rehab Centers offer comprehensive guidance. With 14 clinics across west Tennessee, SportsPlus is conveniently located close to you.