For young athletes, knee injuries often mean time spent on the sidelines. Anterior cruciate ligament (ACL) injuries in children are on the rise, but a few tips will help your child avoid tearing it up on the field.

The knee is a joint where three bones join: the femur, or thigh bone; the tibia, or shin bone; and the patella, or knee cap. Four ligaments attach to the femur and tibia and give the joint strength and stability. One of these, the anterior cruciate ligament (ACL), is in the center of the knee and limits rotation and the forward movement of the tibia.

Each year, more than 100,000 Americans tear their ACL. ACL injury rates may be five times more common in teenage and young adult girls in comparable sports. In the younger ages, rates may be more equal.

Aggressive organized sports and year-round sports allow greater opportunities for the injury to occur. The ACL is most often stretched or torn by a rotation through the knee upon landing from a jump. The ACL also can be injured by quickly changing the direction of movement. Landing patterns characterized by a high or off-centered pelvic position, or relatively extended knees may place more stress on the ACL.

"The ACL tears or unravels like a braided rope when it's stressed beyond capacity and doesn't heal on its own," said Dr. Philip Wilson, an orthopedic specialist at Children's and assistant professor of Orthopedic Surgery at UT Southwestern Medical Center. "But reconstruction surgery can help most people recover full knee function after an ACL tear."

Prevention
Many ACL injuries can be prevented if the muscles that surround the knees are strong and flexible.

"Athletes of all ages should do drills that focus on balance, as well as those that link strength in the lower torso and thighs," said Dr. Wilson.

The following training tips can reduce the risk of an ACL injury:

• Train for activity, but be cautious of fatigue that may develop during year-round single sport play.
• Perform core body, hip and thigh strengthening exercises.
• Practice wide-based, flexed-knee jumping and landing techniques.

Children's is committed to educating coaches, parents and young athletes about safety on the field, court, mat or in the pool. The Children's Injury Prevention program and has created a handy booklet to provide essential information on sports injuries and first aid. You can check it out here.

Resources
Children's Medical Center
American Academy of Orthopaedic Surgeons