2018-09-01 / OnCall

Staying Off the DL

Lessening the risk of ACL injury for high school athletes

It’s not an uncommon scenario. An athlete is sailing through the air or making a quick turn when all of a sudden he or she hears a “pop” in the knee. An athlete who experiences this followed by sudden pain and swelling often receives the much-feared diagnosis of an anterior cruciate ligament (ACL) tear.

“Young, growing athletes are at high risk for ACL injuries, so it is important to work with coaches, trainers and medical professionals to minimize the risk of injury today, as well as the likelihood of re-injury or arthritis many years from now,” says Dr. Paul Sherbondy, an orthopedic surgeon at Penn State Health Medical Group in State College.

The ACL is one of the four major ligaments in the knee and the most commonly injured. It connects the thigh bone to the shin bone and helps stabilize the knee joint. ACL injuries range from a mild overextension to a full tear, according to Sherbondy.

Although an athlete can injure the ACL during a collision with another player, most tears of the ligament are noncontact injuries. Primary causes of ACL damage during sports or fitness activities include: pivoting on one firmly planted foot; suddenly changing direction; landing from a jump; and quickly stopping and starting.

ACL injuries are most common in sports that involve these maneuvers like basketball, football, soccer and lacrosse.

Female athletes are more likely to suffer ACL injuries. “The reasons are not completely understood, but may be because females are more likely to have quadriceps and hamstring muscle imbalances and to land from jumps in a way that increases knee stress,” Sherbondy says.

Treatment for an ACL injury depends on the severity and type of damage, as well as on the patient’s long-term goals. Minor ACL injuries often can be treated with several months of physical therapy plus a knee brace and crutches to support healing while some ACL injuries require surgery. After surgery, the focus is not on a quick return to play, but rather on effective rehabilitation for long-term stability and avoidance of re-injury. Proper rehabilitation can take eight to 12 months.

To avoid an ACL injury, Sherbondy suggests that athletes should always wear the proper protective gear for their sports, including sport-specific footwear. In addition, he suggests always taking knee pain seriously.

 “Athletes also should seek evaluation and treatment, where needed, for minor knee pain to prevent a small injury from advancing to a full ACL tear,” Sherbondy says.
—Penn State News

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