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Dr. Christian Balldin on Preventing ACL Tears in Athletes

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The anterior cruciate ligament (ACL) is one of the four major ligaments of the knee.  ACL tears are very common in sports where athletes are expected to change direction and pivot frequently such as in football, basketball and soccer. 

There are a high number of sports-related ACL injuries across the board, but this seems to be especially true in women’s basketball and women’s soccer.  Numerous studies have tried to explain this phenomenon and, though there is no complete consensus, some proposed explanations include:

  • Women have slightly different and narrower anatomy in the area of the knee where the ACL runs making it prone to impingement and thus injury.
  • There is difference in the balance of the musculature surrounding the knee between male and female athletes.
  • Female athletes show different landing dynamics of the knee when jumping and cutting.
  • Hormonal differences may make the ACL more prone to rupture in women.

Another contributing factor to ACL injury is overuse.  Year round play, which is becoming more and more common in today’s environment, makes athletes more prone to ACL tears and to sports injuries in general.  In baseball, we see elbow or shoulder injuries because of too many pitches as early as little league.  In football, basketball, and soccer, we see a high number of ACL injuries. During the season, it is crucial to get the all important rest that allows the body to rejuvenate and avoid overuse injuries.

Athletes need to make sure they are in good physical condition prior to starting the season, engage in proper warm-up and cool-down activities and implement certain exercises within their training regimen to decrease their chances of ACL tears.  Multiple studies have looked at implementing exercise programs to make the body more aware of how to land and change direction safely. While in use, these programs showed a decrease in number of ACL tears, but the effect appeared to dissipate when the exercises were not performed any longer.

Due to the nature of certain sports, we will never be able to prevent all sports-related ACL tears, but following these guidelines may help you sidestep an injury.


Dr. B. Christian Balldin is an orthopaedic surgeon, specializing in sports medicine, at The San Antonio Orthopaedic Group.  To learn more about Dr. Balldin, please visit his web page here. To schedule an appointment with Dr. Balldin, please call 210.281.9595.


NOTE: We cannot provide medical advice or diagnoses without seeing a patient in person.

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