Steve Jordan, MD, a sports medicine specialist at Gulf Breeze, Fla.-based Andrews Institute for Orthopaedics & Sports Medicine, discussed anterior cruciate ligament injuries and how to prevent them as part of the Institute's new video series.
Note: Transcript was edited for style and clarity.
Dr. Steve Jordan: Orthopedic surgeons and sports medicine specialists look into the risk factors of anterior cruciate ligament injuries and how to prevent ACL injuries because of one big thing: If you injure an ACL, it could change your active life forever. We want to identify how we can prevent these injuries. Understanding the risk factors of ACL injuries is one way to do this.
Some risk factors we can't prevent, but some we can.
- The sport you play: We certainly do not see the frequency of ACL injuries in swimming that we see in soccer, lacrosse or football. These are "cutting sports." It used to be termed "contact sports," but I think a better term is "cutting sports." Cutting sports are any sport where you have to stop quickly and change direction.
- Age: Your age is a risk factor and while we're not really sure what that means, it sometimes just means that your muscles aren't as mature to help you control your body yet.
- Your family history or genetics: If you've had family members who have had ACL tears, you're more likely to have an ACL injury. But if you've had a prior ACL injury, you're 12 times more likely to have an ACL injury, so genetics play a role.
- Female gender: Being a female is also a risk factor because of certain anatomy differences in the hip and knee.
- Poor conditioning: Being poorly conditioned is a risk factor.
Question: How are ACL tears treated in youth athletes compared to adults?
SJ: Young athletes are different than adults after sustaining ACL injuries. Their ability to understand and realize how serious the injury is may not be as great as adult athletes. Their growth plates and their bones are still growing, and they have to be treated different because what we don't want to do is talk about an operation that will affect that growth. If you affect the growth on part of the knee or on one leg versus another, it could lead to some differences in length.
We also want to try to control them in their postoperative period. If we do an operation that fits their growth plates, which we can do, we still have to keep a close eye on the younger patient because they're more likely to run off when they feel good, as opposed to starting to run when they are fully healed.
Q: Can youth athletes prevent ACL tears? If not completely, are there ways for youth athletes to reduce risk?
SJ: Some of the best ways for youth athletes to prevent ACL injuries is to be properly conditioned. In other words, don't go out and play a really hard game or start a really hard practice without a little conditioning. We like to say six weeks of good conditioning before starting a new sport or a new season is ideal. Studies have shown that specific exercises — primarily those that look at your core, hip and knee mechanics (in other words, how do you land when you go to cut and change direction) can then bring the incidents or risk of ACL down.
View the video here.