The Herald, Sharon, Pa.

January 1, 2013

ACL tears are on the increase for female athletes

Proper training techniques can help avoid knee problems

By Lynn Saternow
Herald Sports Editor

MERCER COUNTY — This past year we celebrated the 40th anniversary of Title IX, the law that demanded equal participation in sports for girls and women. But with equality in sports, it also brought equality in another area related to athletics: Injuries!

Especially on the increase are injuries to the anterior cruciate ligaments, know more familiarly as ACLs.

“The main thing that can create ACL problems for girls is jumping,” said Dr. Keith Lustig, the director of the Sports Medicine Clinic for Sharon Regional Health System. “It’s the way they land when they jump. Because of the way girls are built, they land differently, with their feet out. This puts more pressure on the knees.”

But that’s not the only concern with females, there is also the difference in hormones to males. There are estrogen receptors on ACLs which determine the development of the ligaments, fiberous tissues that connect the upper and lower leg bones.

However, because of studies on women and ACL tears, Lustig said there are jumping and landing techniques which can be taught to help prevent these injuries as well as stretching and strengthening regimens which condition the knee areas.

Lustig, former Hickory High football and wrestling standout, has done ACL repairs on many boys and girls involved in high school sports locally since returning to the area a few years ago after years at Erie’s Hamot Medical Center. And he has considerable experience regarding knee injuries both as an orthopedic  surgeon and as a long-time scholastic and collegiate football coach.

“There are still a lot of studies being done on why ACL tears occur,” said Lustig. “But to help prevent them there has to be a combination of flexibility and strength training. It’s so hard to determine what went wrong when ACL injuries happen.”

Part of it could be the increased weight-lifting and strengthening of various leg muscles. And without proper flexibility, something has to give when great pressure is applied on the knee joint.

There are also outside contributors. At one time after artificial turf was developed, there seemed to an increase in non-contact ACL injuries in football and soccer. But because of better turf, those numbers are reduced today.

And while there seems to be a lot more ACL injuries than there were in the 1960s and ’70s, part of it is because of the ability to diagnose the problems, Lustig said. Before MRIs, it was hard to determine that a knee injury was with the ACL.

But while it is much easier to diagnose the ACL injuries today, it is also much faster to get athletes back to the field, gym, mats or tracks.

Lustig has studied many of the various surgical techniques developed for ACL injuries from some of the top clinics in the northern hemisphere and is highly regarded for his work.

“It used to be a year or more for recovery to return to a sport,” said Lustig, who heads sports medicine clinics in Hermitage and Hubbard for SRHS. “Now we don’t cast and we start rehabilitation right away. Some kids return to sports in under 4 months.

“Of course, a lot of if depends on the person and how hard they are willing to work at rehabilitation. We have a good team here. We have great trainers on site  who work with and push the athletes.

“But if you don’t rehab properly, it can create problems and may actually require more surgery.”

Lustig and the other staff at the sports clinic keep in close contact with area schools and can often be seen plying their trade at various high school games. But no matter how well athletes are trained today, Lustig admits that there will always be injuries in sports.

But the goal is to cut down on the number of ACL injuries as well as properly get athletes ready to return to their sports as soon as possible when ACL injuries occur.