Female athletes are much more likely than males to endure serious anterior cruciate ligament (ACL) knee injuries, according to Loyola University Medical Center orthopedic surgeon Dr. Pietro Tonino.

Dr. Tonino believes these injuries could be prevented by completing preseason conditioning, as well as learning and practicing landing techniques after jumping.

Tonino and several other orthopedic surgeons are seeing an unusual number of knee injuries in women athletes, spanning from middle school age to professional athletes. Tonino, a sports medicine specialist, had operated on thousands of knees.

Currently, doctors are not clear on why women athletes are more prone than males to ACL injuries. A theory is how women jump. Due to the shape of their pelvis, when jumping, girls generally land with their knees locked. This puts excess pressure on the knee. Women are also more prone to be “knock-kneed”, when their knees are close together and ankles are far apart.

Tonino recommends that athletes bend their knees and hips slightly when landing, in order to prevent the risk of an ACL injury.

Instead of standing upright while preparing to land, you must position the buttocks as if you were going to sit down. It is important to land on the forefoot, not the heel, and to also strengthen hamstrings by weight training.

Sports medicine physicians, including Tonino, suggest that athletes take part in summer programs that educate on injury-prevention techniques and conditioning. Team physicians and athletic trainers should be knowledgable about such programs.

In order to prevent basketball specific injuries Tonino recommends these tips by the American Orthopedic Society:

  • Pre-season physical exam, as well as following physician’s instructions for preventing injuries.
  • Maintain proper fitness. Injury rates are are higher in athletes who are not in shape.
  • Following a period of inactivity, gradually work back to full contact basketball via strength training and aerobic conditioning.
  • An athlete should return to playing when cleared by a medical professional.

The anterior cruciate ligament is one of the four major ligaments located in the knee. It connects the back of the thighbone (femur) with the front of the tibia (shinbone). It gives the knee joint its stability and ability to pivot.

Patients who suffer a torn ACL report of a “giving out” feeling. Non contact ruptures and tears appear to be the most common cause of ACL injury.

Once the injury occurs, patients often experience swelling and severe pain when bending the knee. When movement is attempted, the knee buckles, or when standing still and bearing weight on the inured knee, it can give way.

Torn ACLs are more often associated with high impact sports where the knee is required to make abrupt stops from high speed and sharp changes in movement. ACL injuries are most common in soccer, basketball and football athletes.

Slight tears in the ACL can be treated non-surgically, however complete tears need surgery. During this surgery, an orthopedic surgeon removes a tendon from the patient’s body or that of a cadaver, and uses it to replace the torn ligament.

As time goes on, surgical techniques and instruments are becoming more advanced and less invasive. ACL surgery still requires six months of rehab post operation. Frequently, ACL injuries also involve torn cartilage, limiting motion and leading to arthritis.

A previous study done earlier this year, suggests geometry, or the shape of a patient’s knee bone, is the reason for women being more susceptible to ACL injuries than men. The study found that most women and only ACL-injured men had a common geometry on the outside of their knee joint. The upper part of the shin bone at the joint, was much shorter and rounded. This could be an explanation why women are significantly more likely to have ACL injuries than men.

Tonino concludes, “Unfortunately, a reconstructed knee will never be as good as the God-given knee. So we should be doing all we can to prevent these injuries in the first place.”

Written by Kelly Fitzgerald