It happened in a matter of seconds. “I was playing for my high school soccer team,” explains 18-year-old Laura Soto. “I twisted on my leg, and just then I was pushed down. I heard three quick pops and suddenly felt a lot of pain. An ambulance took me to the emergency room.”
Laura had torn her ACL, the anterior cruciate ligament, and her meniscus. The ACL is a ligament that runs through the middle of the knee joint and connects the femur (thighbone) to the tibia (shinbone). It allows a person to twist and turn. The meniscus is cartilage that sits between the leg bones to act as a shock absorber.
“I had to have surgery,” Laura says, “and the doctor had to make a new ACL for me out of a graft from my hamstring. I also have two biodegradable screws my knee.”
Recovery has been difficult. The brace she had to wear reached from her upper thigh to her ankle and she dealt with a lot of pain. “For eight hours each day, I had to put my leg in a Continuous Passive Machine, which would bend my leg a little more each day. I would do it for four hours, rest, then do if another four,” she says.
“It has been hard,” she admits. “Soccer was my life, and I’d had a scholarship to Northern Michigan University.” Laura still goes to physical therapy once a week and works with weights to strengthen her new knee and the muscles around it.
Is It an Epidemic?
Laura’s story isn’t unusual. According to recent statistics, there are thousands of knee injuries like Laura’s annually. Doctors and researchers are beginning to call these injuries the new epidemic in the sports world. Girls are four to six times more likely to have a knee injury. Just ask 16-year-old Megan Okui.
“I was a guard for my high school basketball team,” she says. “I was at practice and went up for a shot. When I came down, I felt like I’d landed funny. I twisted sideways and couldn’t get up for about 15 minutes. It felt like my leg weighed a million pounds, and it didn’t want to work. I finally got up and walked on it a little. I iced it overnight, but in the morning it still hurt, so I went to the hospital. They said it was a sprain and to stay off of it. I went back to playing basketball, but it kept hurting. Sometimes it would give out.” Three months after the injury, Megan found out why. “The doctor told me I’d torn my ACL. I had surgery, followed by six months of physical therapy. Now I’m back on the team and feeling strong.”
“The sports that can cause the most damage,” states Dr. Ronald Navarro, chief of orthopedics at Kaiser Permanente in California, “are soccer, basketball, and football.” The primary causes are direct blows, falls, jumps, and twisting on one foot.
Why So Many Girls?
Reasons vary, but one of the main theories is a simple one: Girls and boys are put together differently. Girls have wider hips and smaller ligaments, first of all. After jumping, girls tend to land on their feet, rather than their toes, putting the knee at greater risk. Also, to stabilize themselves, they seem to use their quadriceps (muscles on the front of the thigh), which are weaker muscles, while boys use their hamstrings (muscles in the back of the thigh) and calf muscles, which are stronger. Another factor is something called the Q Angle, which means that girls’ thighbones angle inward more than boys, stressing the knee joint. Also an increasing number of girls are getting involved in sports.
Whatever the reason, it’s obvious that knee injuries are becoming a real problem. The answer is twofold. First, there’s prevention. “Proper prevention is a combination of building endurance and strength through training, plus stretching and warming up the muscles,” says Dr. Navarro.
Dr. Kevin Stone, an orthopedic surgeon and founder of The Stone Foundation for Sports Medicine and Arthritis Research, agrees. “To avoid an injury,” he says, “you need strengthening, flexibility, and preparation. I always try to communicate to my patients that world-class athletes train for their sport and then cross train with activities like weightlifting, yoga, and so on. I also believe proper nutrition plays a part,” he adds. “It leads to good muscular development and appropriate weight.”
Here are additional tips for keeping your knees strong:
* Warm up before playing sports.
* Never push through fatigue.
* Wear appropriate shoes for the sport.
* Pay close attention to pain signals.
* Build up the hamstrings and quadriceps.
* Learn how to land properly.
* Do specific knee exercises.
If you already have been injured, don’t ignore it and hope it will go away. Dr. Stone says: “If you heard a pop and there’s swelling, there’s a 95 percent chance you have torn a crucial structure.” The next step is usually an examination and tests to determine the extent of the injury.
Hurting your knee is no small thing. But if it happens, Laura advises, “Take it in stride and deal with it. Things will get better!”
Exercises to Strengthen the Knees
Often the key to strong knees is doing regular knee exercises, Dr. Kevin Stone suggests the following:
* Quad sets: Leg straight out in front of you (either oil ground or seated on the edge of a chair), tighten thigh muscles focusing oil inner thigh just above kneecap and hold for 5 seconds. Repeat 10 times, three to five times a day.
* Adduction sets: sitting in a chair with knees bent to about 90 degrees and a pillow between knees, squeeze pillow evenly with both knees and hold for 5 seconds. Repeat 10 times, three to five times a day.
* Leg raise: Start with sets of 10 repetitions and work up to two sets of 25 reps.
Lying back on elbows with right knee bent and left leg out straight in front, tighten thigh muscle of left leg and actively lift leg in front to the level of the opposite knee and then lower.
Lying on right side with legs out straight, tighten thigh muscle of left leg and lift to the side, making sure to keep foot level with the ground.
Lying on stomach, tighten thigh muscle and lilt leg behind you a few inches off the floor, then lower, making sure to keep hips on floor.
Lying on left side with right leg bent and rigid foot on the floor in front of left leg, tighten thigh and lift leg toward the inside, keeping foot level with ground.