The good thing about a torn ACL in a young person is they can repair it. The bad news is the cost, pain, anxiety and more importantly, the realization we would have prevented the injury from occurring in most girls who were going through puberty. While ACL injuries are not exclusive to girls, puberty is recognized to be a strange time in a maturing female. They are getting taller. The hips are getting wider and secondary sexual development is occurring with the explosion of hormones. This affects their agility, their balance and if they are built asymmetrically, those imbalances will be amplified as their bodies change. A recent NY Times article spoke about the fact that most of these injuries are preventable with the right exercises to improve core stability, leg flexibility and addressing many of the problems such as overpronated feet and asymmetrical gait that an off the shelf foot orthotic or for those in dance, an arch support that helps to stabilize the pelvis from the ground up and reduces the torsion on the knee. It only requires an unstable movement by planting the foot and rotating while the foot stays planted as the body twists. This places an undue stress on the knee which is supposed to be a stable joint. The pop occurs indicating an injury occurred along with swelling and a feeling of instability in the knee. According to the NY Times article referenced below, “young female athletes are three to six times more likely than boys to tear an A.C.L., and in a recent 15-year period, across a dozen sports in U.S. high schools, the rate of A.C.L. injuries among girls jumped 32 percent, more than double the increase among boys.” Ironically, ATC’s, the schools athletic trainers have learned that certain core stability exercises reduce the incidence of these injuries and in soccer or any other sport, the exercises that stabilize core should be part of the workouts all teams perform as a warmup before a game and even off the field. Many of them were using exercises devised a quarter-century ago by Holly Silvers-Granelli, a young, driven physical therapist, helped create a sequence of warm-up exercises designed to protect young athletes’ knees. In 2000, she and some colleagues had nearly 3,000 female teenage soccer players in Southern California take part in an experiment to test their regimen. The results were extraordinary. Performing their 20-minute workout three times a week cut the risk of A.C.L. tears by more than two-thirds. When the experiment was repeated a year later, the pattern held. Read the article below for more information. In our office, a history that makes us suspect an ACL tear includes a Lachman’s test which will show the ligament when compared to the other side is no longer stabilizing the knee in forward translation. The injury will also damage the meniscus as well as the medial collateral ligament. We also evaluate patients from the feet up to get a true clinical picture of the patient which is important to understand how the injury occurred and what we can do to prevent another similar injury. An MRI may confirm the injury, but will not prevent the first one of the next one. A thorough history and evaluation is valuable because it helps us understand the patient better. While these injuries are repairable, prevention is more desirable than reconstruction and our job is to use the best methods to prevent even the first injury. Many of the common ailments growing athletes develop playing soccer can include: Lower back pain Shin pain Foot pain Shoulder pain balance issues cramps in the legs. Plantar fasciitis Shin splints Unfortunately, we often look at these symptoms as the problem, when they may have greater meaning in how we move. Core stability involves a growing understanding of the fascial system and it involves how we move. When we move poorly as we are adapting, we have less stability which can impart forces to the knee joint coming from a restricted ankle and hip which are mobile joints, and secondary changes in the lower body including asymmetries. Some of these girls may be developing scoliosis although in my book, Cheating Mother Nature, what to know to beat chronic pain explains how common idiopathic scoliosis usually is a reflection of asymmetry from the feet up which causes secondary changes in the spine in a growing person. In other words, all patients I have personally seen with idiopathic scoliosis have flat feet. Recognizing this and addressing it with foot orthotics that are off the shelf in a growing girl can help mitigate ACL injuries along with core stability exercises and chiropractic care in combination with myofascial release and exercises. Why Are So Many Teen Girls Still Tearing Their A.C.L.s? Common exercises that may reduce the incidence of ACL injuries include Planks, including side, standard and reverse. Goal is for a 3 minute plank. Balancing on one leg, especially using a balance pad for 3-4 minutes. Situps and lower back extensions and side situps on a roman chair, Foot Drills to improve foot tone and dexterity. Hurdlers stretches. Common things all soccer players should consider include Proper shoe fit which allows movement of the foot. Half of our patients are wearing shoes that are a half size small and were unaware of how to properly fit a shoe. Soccer shoes are tight as a glove and our office has a half size off the shelf foot orthotic many soccer players can use to stabilize their hips, improve how their weight distribution is so whey they plant and twist, there is less force placed through the knees. This is some basic advice. Some of the common symptoms young athletes experience should be looked at with a functional holistic exam. A sports chiropractor is a natural choice. We understand movement. While proper care may not avoid every ACL injury, it can help reduce your Childs risk of injury markedly. Everyone is unique and often, customizing exercises and methods based on their unique body mechanics further reduces risk of injury. Need help today? Book online or call either of our offices for an appointment today.