Oct 8, 2019, 3:04:38 PM CDT Oct 8, 2019, 3:38:51 PM CDT

How to prevent ACL tears

Training tips and exercises for ACL injury prevention

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ACL injuries affect as many as 250,000 Americans each year. These injuries are more common among teen athletes, especially females, and the rates are on the rise.

"The number of kids in sports today, especially sports that are high risk for ACL injuries, is growing," says Dustin Loveland, M.D., an orthopedic surgeon with Children's Health℠ Andrews Institute for Orthopaedics & Sports Medicine. "Kids are also playing sports year-round, which increases their risk for injuries."

ACL tears can require surgery and a long recovery. They also increase a young person's risk for early-onset arthritis. That's why it is vital that parents, coaches and athletes work together to reduce the risk of ACL injury. See four ways athletes can reduce their risk of ACL tears and injuries by making smart training choices and building a foundation with injury prevention exercises.

What is an ACL injury?

KneeThe anterior cruciate ligament (ACL) is a small, but major ligament in the knee that connects the thigh bone (femur) to the tibia (shin bone). It takes on a lot of strain and pressure when jumping, landing and quickly shifting position. An ACL injury occurs when there is over-stretching, a tear or a sprain of the anterior cruciate ligament. A tear can be a partial or complete tear. Athletes may hear or feel a pop in the knee when an ACL injury takes place.

Which sports and players are at highest risk for ACL tears?

ACL tears are most common in girls who play basketball and soccer, and athletes who play football and volleyball. These players tend to jump and land more often and, in the case of football, might undergo a lot of twisting forces or blows to the knee.

Females are at a higher risk for ACL tears for a variety of reasons. Their anatomy is different than males – they have a smaller ACL, weaker hip muscles and different hip-knee alignment. Female hormone cycles might also play a role in risk.

"It's hard to pinpoint the cause in one person," says Dr. Loveland. "A lot of things can lead to an ACL tear, not just one cause."

How can athletes prevent an ACL tear?

While it's not always possible to prevent an ACL tear or injury, athletes can lower their risk by taking a few precautions. Participating in training programs, building a strong foundation, avoiding year-round play and preventing fatigue are key components to ACL injury prevention.

1. Engage in an off-season training program

"Athletes and parents should think about their routine during off-season and develop a comprehensive training program for when they aren't playing their sport," says Stephen LaPlante, MS, PT, ATC, team lead Physical Therapist at the Children's Health℠ Andrews Institute for Orthopaedics & Sports Medicine. Athletes should work with a certified strength coach during the off-season to design an age-appropriate strength training program.

The training program should focus on:

  • Body mechanics and teaching balance and reteaching how to jump and land correctly
  • Core and trunk stability training that includes planks and bridges
  • Strengthening exercises and use of resistance bands especially for hips

2. Develop a strong foundation

LaPlante says sports have become too focused on specific skills instead of developing a good foundation for athletic play. Many athletes skip conditioning or strength training, putting them at a greater risk for injury.

Both Dr. Loveland and LaPlante emphasize that injury prevention programs and performance-training programs go hand-in-hand. "All of the things we do to prevent an injury also makes young athletes better at their sport," says Dr. Loveland.

3. Take a break from the sport

It's important to take a rest from your sports. During the off-season, stick with conditioning and try a low impact sport. Year-round play of the same sport can overstress athletes both mentally and physically. "Athletes should take two to three months off per year to work on foundational strength," says LaPlante. "That's our number one priority."

4. Be aware of the athlete's performance during play

During games or practices, it's also important to look out for signs of fatigue. Players are more likely to be injured if they are experiencing fatigue. "You'll notice an athlete is moving at a slower pace, taking more rest breaks and putting their hands on their knees," says LaPlante. "It happens a lot at weekend tournaments when kids are playing more games." If you notice your athlete is fatigued, request they be taken out of the game briefly to rest.

"If I have an athlete returning from an ACL injury, I tell them to come on as a sub when other players are fatigued," says Dr. Loveland. "Even when they are theoretically safe to return to play, even if they are still strong, their supporting muscles will still fatigue faster. I like them out there fresh when other kids are already a little bit tired."

Preventing injuries takes a comprehensive effort from athletes, parents and coaches. By helping athletes build a foundation and recognizing when athletes have hit their limits, parents and coaches can help them stay safe so even if they can't finish the game, they can finish the season.

Learn more

The only pediatric institute of its kind in Texas, the Children's Health Andrews Institute for Orthopaedics and Sports Medicine aims at reducing the number of children being sidelined from injury. Learn more about our wide range of services available to help athletes stay healthy and improve their game.

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