Girls are more prone to knee injuries. Specific exercises can significantly decrease risk.

Girls are especially prone to knee injuries.

James Hubbard, MD, MPH

Question. What do adolescent girl athletes and the rest of us have in common? Answer. Knee injuries, of course :).

In fact, anyone who gets in a little too much of a hurry or doesn’t watch what they’re doing is susceptible. Add jumping or a quick pivot for whatever reason and your risk increased greatly.

A while back, I jumped off a porch with such a jar I thought I’d shaken my teeth out. The reason was I landed without bending my knees and it’s a wonder I didn’t injure one of them.

You can be in tiptop shape (unlike me), and have the strongest of legs and still get hurt—just because you land or pivot wrong.

Fortunately, there’s been a lot of recent research in knee injury prevention triggered by the growing amount of injuries in girls’ sports. It seems they are particularly prone to ACL tears. The keys are not only strength but balance, and training our brain to make our legs land in the correct position. A little preparation can go a long way to prevent a debilitating injury.

Why Girls?

It’s always been a problem in boys playing football, but more and more teens are playing soccer, volleyball, and basketball. And, given the same sport, girls are estimated to be 4–8 times more likely to tear the anterior cruciate ligament, or ACL (Click here for a photo of a knee model, including the ACL).

Girls are more prone because their knees tend to turn inward a little too much when they pivot or jump, and for other reasons not fully understood. Interestingly it’s not so much of a problem in preadolescents because their ligaments are still so lax, but in the teen years, they start to tighten.

Why Adults Are At Risk Too

As we age, our ligaments get even tighter and a little more—maybe a lot more—worn down, making them easier to snap. We get in a hurry for any reason, have to jump off something when we’re not use to it, or just make a quick pivot and, pop, pain, we have debilitating knee injury.

ACL tears don’t occur only if someone or something hits you in the knee. More often, we’re jumping and come down wrong, or turn quickly. The knee, being a hinge joint, only bends and straightens in one direction and momentum is not our friend. If our upper body’s going one way, and our lower leg can’t move quickly enough to keep up with it, something’s got to give. Sometimes that results in a torn ligament.

Knee Injury Prevention

Strengthening the muscles above and below the knee can help, but only to a degree. Recent research has suggested there’s much more we can do. In fact, several groups have come up with specific neuromuscular exercise programs that have proven to decrease ACL injuries significantly, at least in teen girls, who have been studied the most. And I’m guessing us older folks can benefit also.

It takes only about 15–20 minutes but they must be done in the proper order and done correctly. A good coach or trainer is essential. Speed is not important. The Santa Monica Sports Medicine Research Foundation’s Prevention and Enhance Performance (PEP) program teaches one of the more popular regimens. Yes, it’s supposed to enhance performance also. Here’s a video of some of the exercises.

In general the program consists of five essential parts.

  1. Warmup (2–3 minutes)
  2. Strengthening specific muscles without weights (3 minutes)
  3. Plyometrics—basically how to land correctly after a jump (2.5 minutes)
  4. Agilities (3 minutes)
  5. Stretching (5 minutes)

The times are approximate. It’s better to take a little longer and do the exercises correctly. Yes, these are especially geared to teen girls, but I think anyone could benefit by joining in.

What about you? Have you ever heard exercises like this? Have you ever hurt your knee? Which would you rather do?

Here’s a couple of links for more information:

http://contemporarypediatrics.modernmedicine.com/contemporary-pediatrics/news/prevention-acl-injuries-adolescent-female-athletes?page=full

http://www.usyouthsoccer.org/news/acl_injury_and_the_female_soccer_player/

Here’s a link to videos of more exercises:

https://www.youtube.com/playlist?list=PL-W9Gn-XDQ_pIeE4mo1mgBb4OwyGc0UGU

And a link to my posts on knee injuries.

Soccer Photo: Flickr/KG SAND SOCCER shared under CC BY-NC 2.0.