The anterior cruciate ligament (ACL) is a vital ligament involved in various sports activities, supporting pivotal movements, sprints, and landings. Certain sports, such as football, basketball, rugby, American football, and alpine skiing, pose a high risk for ACL rupture. However, recent statistics have revealed a concerning trend, with a significant number of athletes, particularly women, experiencing ACL injuries. This article delves into the reasons behind this trend and emphasizes the importance of muscle activation (Mbody) monitoring as preventive measurement to reduce ACL injuries.
Gender Differences and Structural Factors
Studies have shown that elite female footballers are six-to-seven times more likely to suffer ACL injuries compared to their male counterparts. The disparity can be attributed, in part, to differences in knee structure. Females tend to have a straighter or occasionally knock-knee alignment, with a smaller notch in the middle of the knee joint where the ACL resides. This structural difference reduces the room for ligament movement, increasing the likelihood of the ACL getting chopped by the femur. Other factors such as strength, weight-to-power ratio, and even the menstrual cycle may contribute to the higher prevalence of ACL injuries in women.
Intensification of Sports and Fatigue
The level of play, competition, and intensity in sports has significantly increased over time. Players often experience fatigue due to the demands of frequent matches and training sessions. This heightened stress can impact performance and increase the risk of ACL injuries especially in case of left-right muscle load imbalance or unequal muscle load distribution. Additionally, young athletes focusing on one or two sports at an early age without developing a diverse range of movements and loads may be more susceptible to ACL injuries.
Arsenal's Laura Wienroither tore her ACL during a Champions League semifinal in May 2023. (Richard Heathcote/Getty Images)
Lack of Injury Prevention Programs
One critical aspect contributing to the rise in ACL injuries is the absence of structured warm-up - or better to say muscle activation - programs and injury prevention initiatives. Several experts, including surgeons, doctors, physiotherapists, and academics, advocate for the implementation of comprehensive activation programs, which have shown the potential to reduce ACL injuries by up to 50% or even 70% globally. However, the compliance with these programs remains distressingly low among athletes. Monitoring the training load with Myontec Mbody shorts and MSleeves is made for this; showing objective data directly from muscle such as muscle load, load distribution, muscle stiffness, relaxation, fatigue or other indicators of injury risk level.
Insufficient Biofeedback and Data Gathering
Monitoring and gathering accurate biofeedback is crucial for identifying and addressing rising injury risks. Unfortunately, the current methods primarily rely on subjective feedback reports, GPS, location-based services (LBS), or video analyses, lacking direct feedback from muscles. The development of more sophisticated techniques like Myontec smart clothes to gather real-time data from muscles allow for early detection of potential injury risks and the strengthening of appropriate muscles and joints.
ACL Treatment and Rehabilitation
ACL injuries can be debilitating and often require a significant recovery period. It typically takes two years for athletes to regain their previous level of performance, and these injuries can significantly shorten professional careers. Researchers have discovered that focusing on regaining range of motion, rather than solely strength, in the early post-operative phase is crucial. New data highlights the connection between the brain, hip, and knee muscles, emphasizing the importance of managing hamstring muscle tension and implementing exercises, physical therapy, massage, and release techniques to restore motion. When range of motion is good enough, it's important to focus on improving the strength of leg muscles, especially Vastus Medialis. Monitoring muscle activation (EMG) is important in pre-operative and post-operative phases in order to avoid compensating Vastus Medialis with other muscles, like hamstring.
The Importance of Preventive Exercise Programs
Preventive exercise programs have shown considerable benefits in reducing ACL injuries among athletes and teams that commit to them before the start of the seasons. These programs involve not only quad and hamstring training but also focus on enhancing the brain-body connection, particularly in the hip, knee, and ankle positions during landings. Disruptions in this relationship, even momentary, can overload the knee ligaments. Despite the overwhelming evidence supporting the effectiveness of ACL injury prevention programs, the adherence to these programs remains disappointingly low and mainly due to lack of EMG level monitoring during the season.
Conclusion
The increasing prevalence of ACL injuries in sports, particularly among female athletes, is a cause for concern. Structural differences, intensification of sports, fatigue, lack of preventive programs, and insufficient biofeedback contribute to this trend. To combat this issue, it is crucial to implement comprehensive muscle activation programs, gather accurate EMG biofeedback, focus on range of motion in rehabilitation, and promote adherence to preventive exercise programs. Myontec Mbody has shown already significant benefit being objective monitoring tool in injury prevention, training load and intensity monitoring tool as well as in optimizing rehabilitation. By prioritizing injury prevention, athletes can mitigate the risk of ACL injuries and ensure their long-term well-being and performance in sports.
More to read
WTBU: Claire Guest, All About Women’s Sports: A Rise in ACL Injuries in Women’s Sports, https://sites.bu.edu/wtbu/2023/05/22/all-about-womens-sports-a-rise-in-acl-injuries-in-womens-sports/
Rinaldi V. et al. The influence of gluteal muscle strength deficits on dynamic knee valgus: a scoping review
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