Knee Care

LEARN HOW TO PROTECT YOUR BODY’S MOST VALUABLE JOINTS

ACL: the anterior cruciate ligament; the ligament that runs under the front of the kneecap and controls the pivoting motion of the knee joint.

Did you know that women are four to eight times more likely than our male counterparts to suffer an ACL injury?

Risk Factors:
SKELETAL STRUCTURE. Women’s hips and pelvic girdles are naturally wider than men’s to accommodate bearing children. Thus, our thighbones tilt in from the hip at a greater angle to meet the knee, making the knees more likely to rotate inward. This puts more pressure on the joints. Another anatomical difference: the groove through which the ACL passes tends to be narrower, and some believe that lateral and jumping movements may, over time, have a nasty shearing effect on the ACL.
HORMONES. The jury is still out, but some studies have shown that hormonal changes can affect the laxity of connective tissue throughout a woman’s menstrual cycle. While other studies suggest that joint looseness and cyclic risk vary greatly from woman to woman.
FLOORS AND FOOTWEAR. While studies have shown mixed results, it appear that sticky rubber floors and shoes with cleats – both of which cause the foot to catch in place when landing from a jump or making a quick movement – can boost the risk of injury.
NEUROMUSCULAR FACTORS.
· Connective-tissue properties: The ACL is a connective tissue that stores elastic energy like a rubber band – it helps put the spring in your steps and the height in your jumps. But how well it controls the joint depends on the speed and magnitude of the movement: Sudden, rapid motions, particularly lateral ones, can greatly increase the risk of a tear.
· Strength ratios: Women tend to have stronger quadriceps relative to their hamstrings, which may decrease the hamstrings’ ability to stabilize the knees. The general recommendation for a healthy hamstring-to-quad strength is for the hamstring to be at least 60% - and ideally closer to 80% - as strong as the quad.
· Fatigue: Tired muscles aren’t as good at absorbing impact, controlling the position of joints or responding quickly to sudden demands. They force connective tissues to work harder to manage the weight loads and to stabilize moving parts.

Ultimate lovers and wide-hipped girl take heart: you aren’t doomed to damaged knees! Recent research suggests that learning proper techniques early in your athletic career, such as jumping and landing properly, play a big role in maintaining healthy knees. With training, you can significantly reduce your risk of injury.
Because knee injuries are not the result of just one cause, there isn’t just one solution. Combine the ideas below to build your own prevention plan:
· Education and observation: Figure out how you move; study how you jump and land – especially noting whether your knees are collapsing inward toward each other. As training becomes more difficult and fatigue sets in, be vigilant and don’t allow your knees to cave in. Focus on proper alignment by engaging your hamstrings and hip abductors (the muscles that help you externally rotate the hip and pull your legs outward, away from the midline of your body).
· Plyometric drills (remember these?): Dynamic jumping movements strengthen connective tissue better than just about any other method. Example: tuck jumps (jumping and tucking the legs to the chest quickly, then re-extending the legs and landing softly with bent legs, trying to keep the knees from collapsing inward on both takeoff and landing). Also recommended are one-legged hops in various directions (front to back, side to side). Plyos should be done early in a workout before your legs get tired.
· Agility training: This helps you perfect fancy footwork and proper movement, such as pivoting and rapid changes in direction on the field. The more accustomed your body is to moving in certain ways, the more you can depend on it to move correctly when it counts.
· Resistance training: A well-balanced program includes strengthening the muscular link that runs from the lower back through the glutes, hips and hamstrings.
· Unilateral training: This helps to mimic the real-life conditions of playing Ultimate and also helps correct any asymmetries in strength. Try one-legged squats, lunges, dead lifts, and jumps both forward and backward and side to side. Balance training is good too (either some yoga poses or standing on one leg on a wobble board).
· Maintain a healthy body weight: Flat out, the heavier you are, the more force your joints have to manage – and the more damage you can do to your knees.

In short, being an athlete and female increases your risk of knee problems, but it isn’t a death sentence for your ACLs. By learning proper jumping and landing techniques, and maintaining strong muscles around the joints early on, you can keep your ligaments healthy for the long haul. If you feel you need extra work to keep your knees strong or want someone to watch if you collapse your knees while jumping or landing, please let me know! We will work together. After all, this is a topic that is near and dear to my heart.

Your friendly neighborhood coach,
Kelley

This article appeared as “Weak in the Knees” by Krista Scott-Dixon in Experience Life (Sep 2006)