ACL INJURIES IN WOMEN By Dr. Mir Jawad Zar Khan, Sr Joint Replacement Surgeon
Edited Version | Hyderabad | 2 Dec 2019
Dr Mir Jawad Zar Khan Sir educated Most of his joint pain patients and Athletes, Saying that “ The slightest mention of an ACL tear strikes fear in the hearts of even the toughest athletes, and for a good reason. The career-ending injury occurs in 1 of every 3,000 individuals each year, and it has been reported to occur upwards of 9 times more often in women than men. “
Further, he said that “ ACL injuries are more common in females than males, but why exactly is that the case?
Not surprisingly, female anatomy has been called into question as the culprit of increased rates of knee injuries. Women have a wider pelvis, which causes the femur to descend at a much sharper angle inwardly than men. Medically, the angle of the femur is called the “Q- angle”, and a greater Q-angle can give what is often known as a knock-knee appearance. This alignment of the female femur puts more pressure on the inside part of the knee, which is thought to contribute to ACL tears.
Besides the width of the pelvis, another contributing factor is an imbalance in the strength of female leg muscles. Women tend to have stronger quadriceps muscles (located in the front of the thigh), and relatively weaker hamstring muscles (located in the back of the thigh). This imbalance causes additional stress to be placed on the ACL, leading to an increased risk of tear.
The construct of the ACL itself may be a cause of increased tears in women. Females generally have smaller ligaments compared to men, which makes even the smallest tears detrimental to their physicality. On top of that, women have more lax ligaments, meaning they have more give. This increased laxity allows for more joint mobility, which predisposes women to ACL tears.
More recently the contribution of neuromuscular control and biomechanics as predisposing factors has been studied. To explain, researchers have looked at the way females jump, cut, land, and rotate during sporting events. Compared to men it was found that women tend to bend their knees less upon landing, meaning they allow their joints to take on most of the force of impact. Women also buckle their knees inward when landing and making cuts, which puts even more stress on the inside part of their knees. Furthermore, women’s feet flatten out upon impact which adds to the mounting stress on their ACLs.
Is surgery always necessary after an ACL tear?
Dr Mir Jawad Zar Khan Sir Said at GERMANTEN HOSPITAL as Not necessarily. The decision to repair an ACL tear with surgery should factor in age, current activity level and desired activity level. Women who are older and/or don’t participate in many high-intensity sport or leisure activities might get good results from physical therapy alone. Meanwhile, women who play sports or have knee-straining jobs or hobbies, such as dancing, may benefit from surgery to recover as much function as possible and continue their active lifestyle. A sports medicine specialist can help decide which option is best.
What can female athletes do to prevent ACL tears?
Sports injuries are always a possibility, even if you do everything right. But there are steps you can take to minimize risk factors related to your technique, training and lifestyle. The following recommendations are all equally important in preventing ACL tears and other sports injuries:
✔ Practice good technique.
While not a guarantee, proper technique when training and playing a sport can help ward off sports injuries. Work with your coach and/or your sports physical therapist to identify improper form and correct it.
✔ Avoid working out while overly fatigued.
When you’re tired, it’s easier to make mistakes or forget about good technique. Getting enough sleep and stopping a workout before exhaustion sets in help to prevent injury.
✔ Work to develop muscle groups evenly.
Core and extremity strength are equally important. Focusing on one while ignoring the other increases your risk of injury.
✔ Create a balance between strength and flexibility.
Both tight and overstretched muscles are more prone to injury. Working on strength and flexibility in moderation is key.
✔ Eat a balanced diet.
Poor nutrition leads to decreased strength, endurance, and attention. Eating well can help improve your focus and performance.