Getting Your Athlete Back to the Field After ACL Injury Authors: Andrew Toce M. Ed., MBA, LPC, CMPC and Gianpaolo Rufo D.O. It's well known that physical activity has many benefits which last a lifetime. High School sports provide health, educational, financial, and psycho-so- cial benefits, but what happens when athletes are hurt? The negative health impacts of ACL injuries are significant. From 2007-2022, the average annual ACL injury rate grew 25.9%. ACL injuries now represent more than 14% of all injuries involving the knee amongst high school athletes. Among the most concerning long-term health issues is the develop- ment of osteoarthritis after ACL injury.1 It's import- ant for high school athletes,their parents, and coaches to understand the health and psychological issues related to ACL injuries, which can last a lifetime if not treated properly.11 The purpose of this article is to educate coaches, athletes, and parents about the physical and psychological impacts that ACL injuries have, discuss ACL prevention exercises to reduce the risks of injuries, and provide psychological tech- niques that a coaches can use to help their athletes return back to play sooner. What Is An ACL Injury And How Common Are They? The anterior cruciate ligament (ACL) is a strong band of fibrous tissue located inside the knee that acts as a strong rope to help keep the joint stable.1 It connects the thigh bone (femur) to the shin bone (tibia) (Figure 1) and prevents the tibia from sliding too far forward, or twisting too much.1 ACL injuries range from a minor sprain to a complete tear where the ACL is torn and is nonfunctional. Most ACL injuries happen without direct contact, in fact 40% of injuries occur from non-contact mechanisms. Common ways the ACL is injured includes: sudden changes in direction, cutting while running, landing awkwardly from a jump, pivoting with the foot planted, or stopping quickly. These movements can put too much stress on the ACL, causing it to tear.1 When an ACL is torn, athletes may experience a variety of symptoms. Some describe a sharp, intense pain, hear a loud "pop" or snap, or some athletes may just experience instability of the knee joint with or without pain. Walking may be difficult, and the knee will feel loose or unstable. Usually, the knee will swell immediate- ly, within minutes to a few hours. ACL injuries are very common, especially in people who play sports that involve running, jumping, and quick changes in direction, like soccer, basketball, and football. In the United States, more than 200,000 people have ACL injuries each year. Young athletes, especially those aged 16 to 18, are at higher risk. Female athletes are about three to eight times more likely to injure their ACL than male athletes in similar sports due to a difference in the skeletal anatomy. (Figure 1). What Can Coaches Do To Reduce The Likelihood Of Injury? There are many risk factors that can predispose athletes to an ACL injury. Some of these are out of the control of the athlete, such as gender, anatomy, hormone levels, and genetic risks. However, there are multiple risk factors that can be modified to reduce the risk of injury. These include quadricep & hamstring strengthening, jumping and landing mechanics, and recovery habits after training. It is recommended that coaches incorporate specific exercises into warm ups and workout routines throughout the season to reduce the risk of ACL injuries. These exercises include, but are not limited Figure 1. 23
View this content as a flipbook by clicking here.