#physicatherapy

ACL injuries have been shown to be eight times more common in young girls than young boys, however all youth athletes are susceptible. Running into a hole, twisiting, and a direct blow to the knee are often causes of ACL injuries. 

There were a few explanations for why the incidence of ACL injuries has increased in children and pre adolescents. In the past, ACL injuries may have been mistaken and misdiagnosed.  However MRIs are now used as the gold standard for diagnosis, which increases accuracy.  Another reason for the increased incidence of ACL injures in youth is that the nature of youth sports has changed. Young children are playing year round on multiple teams  with increased frequency and intensity of play, therefore increasing their risk for injury.

ACL injuries in youth athletes are problematic because surgery is complicated for younger children whose bones are still growing.  During ACL surgery, the new ligament must be fixated to the tibia bone which is much more complicated in children and pre-adolesents.  This is because the location of the screw could affect their fragile growth plate leading to even more complications.

What can be done about it for youth?

Bracing was discussed as the safest method to be used to protect the knee while the child grows and the growth plate is protected before proceeding to surgery. Surgery was shown to be too risky as any damage to the growth plate can affect ability to return to sport. At the time this article was written, new surgery techniques were being developed to avoid possible permanent injury to the growth plate however long term effects were not yet researched.

Since this article was written in 2008 there has been more research to look at prevention of ACL injuries and specifically creating programs for young athletes to work on knee, hip and core strengthening as well as teaching proper knee positioning. There has also been research that looks at the practice of landing techniques to aid in the prevention of ACL injuries.

At Jaco rehab we treat and rehabilitate adolescent athletes and incorporate the recent evidence based practice patterns to train athletes to land correctly and practice correct mechanics before return to sport to decrease the incidence of re injury.

Amanda Witko, PT at Jaco Rehabilitation

article: http://www.nytimes.com/2008/02/18/health/18knee.html?pagewanted=2&_r=0