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It’s back to school time and for parents of sports-minded kids that means it’s also time for sports injuries. But that doesn’t have to be the case according to Robert Pedowitz, M.D., Ph.D., Chief of Sports Medicine in UCSD’s Department of Orthopaedic Surgery.
Many sports injury problems occur at the anterior cruciate ligament (ACL), one of the key ligaments that connects the femur (thigh bone) to the tibia (leg bone) at the knee, says Pedowitz. This ligament runs down the middle of the knee joint and is most easily injured during sports.
“The ACL is commonly used in cutting and twisting sports such as soccer, basketball, football, and skiing,” says Pedowitz. “When ACL injuries occur they often require surgical reconstruction. Without treatment, athletes are likely to have buckling or shifting episodes and can damage other important structures over time, such as the meniscus or cartilage within the joint.”
Pedowitz says that in the last decade, physicians have come to realize that these injuries are four to ten times as likely to occur in females as in males, when they look at injury risk per hour of practice or competition. Much of this data comes from NCAA records for men's and women's intercollegiate soccer and basketball. Similar differences in injury rates have also been noted in teenagers, with girls much more likely to tear the ACL than boys.
“We still don't know the exact reason for these differences in injury rates, though many theories exist, Pedowitz suggests. “However, the most likely explanation is that there are subtle differences in the way females run, jump and land compared to males and that there are some differences in the strength balance between the muscles on the front of the thigh versus the back of the thigh.”
Pedowitz notes that in the last few years, several large studies in the United States and in Europe have shown a significant drop in injury rate, about a 50% decrease, when athletes engage in pre-season programs that focus on strength, agility, and sports-specific technique.
“These programs are simple and can be instituted by sports coaches and athletic trainers,” says Pedowitz. “If more kids enrolled in these programs I’d see a lot few injuries in my clinc.”
As for the future Pedowitz remarks that it will be interesting to see if the risk of ACL injuries changes since very young girls are starting with cutting sports at a much younger age than in the past. Pedowitz surmises that earlier exposure and training could lead to a long change in the risk of these injuries.
For student athletes who do tear an ACL, doctors such as Pedowitz commonly perform an ACL reconstruction, an outpatient arthroscopic procedure that takes about two hours. The procedure involves replacement of the ACL with a graft, typically taken from tissue elsewhere in the knee. Although the surgery is usually successful, it takes about six months to a year to return to sports.
Pedowitz says that with proper pre-season conditioning such injuries and surgery can be avoided.
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