Human Performance and Rehabilitation Centers, Inc.

Are young female athletes at greater risk for ACL injuries?

Young female athletes are five times more likely to sustain an ACL tear than their male counterparts. This is especially common in explosive multidirectional sports like soccer or basketball. It’s important for girls to learn how to jump and land properly in order to prevent an ACL injury from occurring.

Female athletes from about 14-18 years of age are at greater risk than boys of injuring the anterior cruciate ligament (ACL). This is largely due hormonal changes. An increase in estrogen during puberty causes relaxation of the ligaments and the natural widening of the hips causes changes in biomechanics. A female athlete is likely not conscious of these new structural changes as she continues to snag rebounds or bolt across the soccer field. She may inadvertently land or stop stiff-kneed or in a locked position, and she might have a greater tendency to internally rotate the knee due to weakness of the developing outer hip.

In addition, a female athlete may be accustomed to using only the quadriceps instead of her developing hamstrings to control movements. All of these factors can put the ACL at risk.

It’s important to teach young women early on how to adjust the way they run and jump in competition in order to prevent an ACL tear. A physical therapist can screen an athlete to evaluate body mechanics, potential weakness and faulty movement patterns. Prevention is key. And it’s time well spent since a young athlete who has suffered an ACL tear is 70% more likely to suffer a re-injury.

Here are some strategies:

  • Young athletes should be in shape for the demands of their chosen sport. This includes both cardiovascular capacity and muscular strength. During fatigue or exhaustion, even a small weakness or poor body mechanics can become a bigger problem.
  • A good strengthening program will encourage better hamstring-to-quad strength ratio, which will help reduce reliance on quads only.
  • Good lateral hip strength and hip abduction control will help maintain proper knee position so that a girl doesn’t experience what we call a valgus collapse, or the extra internal rotation of the femur and the knee falling inward.
  • Proper proprioception is key. When the foot hits the ground, the knee should be properly positioned over it. This allows for strong core-hip stability during lunges, running and multidirectional activities.

Physical therapists don’t just treat patients after an injury. They also work with patients to prevent one from occurring.

Treating Achilles Tendonitis

Overview of Achilles tendonitis

Achilles tendonitis is a condition in which the Achilles tendon becomes painful or inflamed because of overuse. It’s often experienced by runners who make an abrupt change in their routine, such as an increase in mileage, hills or speed work without building up adequately. Weekend athletes who are sedentary during the week can also experience the condition. It’s easy to assume that Achilles tendonitis will improve on its own, but that’s usually not the case. Untreated, it almost always gets worse.

How to recognize Achilles tendonitis

Achilles tendonitis comes on slowly. Overuse causes the tendon to become tight and inflamed. Pain and swelling can occur anywhere along the Achilles tendon, which spans from the heel bone to the calf. When the condition first appears, the patient might notice some discomfort above the heel when running, walking, getting out of bed or standing for long periods. The pain and stiffness will usually worsen over time.

How physical therapy can help

Reducing inflammation in the Achilles tendon is the main goal of therapy. Depending on the patient’s level of mobility, treatment can include modalities like therapeutic ultrasound, dry needling and Astym. These modalities reduce inflammation and decrease the chances of the tendonitis from returning.

  • Therapeutic ultrasound is a highly effective treatment for Achilles tendonitis. It is used in conjunction with an anti-inflammatory gel applied to the surface of the skin. The ultrasonic waves help the gel to penetrate the tissue faster and bring relief to the inflamed area.
  • Dry needling is a form of manual therapy in which small needles are inserted into “knots” or trigger points. In Achilles tendonitis patients, it is used to address the referred pain that a patient can experience in the calf muscles. Dry needles are applied in a relatively painless manner and coax the muscle to release tension and “reset.”
  • Astym is a soft tissue therapy in which a clinician performs certain protocols of manual therapy using a small hard plastic instrument. This is an effective strategy for breaking down scar tissue and stimulating the growth of healthy soft tissue.

Patients with Achilles tendonitis usually see good results between 8-12 weeks.