Targeting Female Athletes’ Knee Injuries

Reprinted from Community Connections Newsletter, Summer 2008

An unfortunate upshot of the huge surge in participation in women’s college and high school athletics over the past several decades has been a corresponding increase in female athletes’ sports injuries.

The knee—specifically, the anterior cruciate ligament (ACL)—is an especially vulnerable area for young women involved in sports, particularly those who play soccer and basketball, according to David Chang, M.D., an orthopedic surgeon on staff at Alta Bates Summit Medical Center.

Young female soccer players “sustain ACL injuries on the order of four to eight times more often [than their male counterparts],” says Dr. Chang, who’s also a consulting physician for the Los Angeles Galaxy, a pro soccer team, and team physician for Contra Costa College athletics.

Among several possible explanations for this phenomenon are differences in women’s physiology and in their knees’ architecture and biomechanics, he adds. “Females are [typically] more knock-kneed, and [their knees undergo] different stresses that allow the ACL to be more taxed and [can] lead to tears. … And certain hormones, such as estrogen, allow ligaments and tendons to be relaxed, creating additional instability.”

To help prevent ACL injuries, Dr. Chang encourages teams to adopt the Prevent Injury and Enhance Performance (PEP) program—a 10- to 15-minute regimen, designed to be incorporated into regular soccer warm-ups, that focuses on flexibility, strengthening, plyometrics (powerful,
purposeful movements), and agility techniques. In one Southern California study, female soccer players who implemented the PEP program experienced 88 percent fewer ACL tears in noncontact episodes than did the control group that didn’t have PEP. Dr. Chang plans to take his campaign to promote the PEP program and injury prevention on the road—actually, into local stadiums and soccer fields. “My vision is to organize a collaboration with [local] soccer organizations to formally teach [the PEP program].”

Another key message Dr. Chang wants to get across to female athletes is the importance of thinking long-term. “You want to be a successful athlete over the course of many years, if not your [entire] lifetime. Pain is a warning signal … [and should] be heeded. Sometimes less is more, meaning rest and recuperation periods for the body [are] very important.”

To find out more about the PEP program, visit ACLprevent.com.