The knee to know - #lakewoodnews

Ponderosa junior Maddie Gabel has a vivid memory of last season's state playoff soccer game in which she tore the anterior cruciate ligament in her rightknee."I slid and blocked a shot, and once I made contact(with the ground),that's when I heard it pop," she said of the sound coming from her knee. "It took 10 months total for a full recovery."Gabel was far from alone in her plight on the sidelines.Numerous studies have concluded that girls and women are more susceptible to ACL injuries than boys and men, with most reports stating female athletes are four to eight times more likely to tear the knee ligament."There are more ACL injuries in women ... Younger women are more at risk, usually the adolescents, teenagers and up to the early 20s, in general," said Dr. Michele Wolcott, an associate professor in the University of Colorado Department of Orthopedics.In the Douglas County School District over the past five years, 42 ACL injuries in girls have been reported. Katherine West, head trainer for Jefferson County Public Schools, said there were 69 knee injuries among girls in Jeffco in the past six years, and 27 were ACL injuries.Why does it happen?Sports like soccer, basketball and volleyball that require one-step deceleration, changing direction and jumping put the most strain on athletes' ACLs, those of girls and women in particular, experts say.But why are female athletes more susceptible to the injury?"Obviously, there is a difference between females and males," said Dr. Mitchell Seemann, team physician for Regis University and D'Evelyn High School. "There have been a couple conferences over the past few years that have come together to try to figure out why (there are more ACL injuries among women). The most common reason for it is what we call neuromuscular factors."One factor includes less hamstring strength in female athletes than in their male counterparts, according to certified chiropractic sports physician Dr. Steven Horwitz, writing on the website MomsTeam, a resource for parents of athletes. Stronger hamstrings can help protect against ACL injuries, he said.Other factors, experts say, include ligaments that tend to have more give, a smaller ACL and tendency toward poor, flat-footed landings after jumping, which puts the knee in a positon to buckle and stress the ACL."We can address some factors," Wolcott said. "We can't change their skeleton or size, so we work on (what) we can, which is how you jump, land and control your landings."There are all sorts of jumps, landing drills, running around cones and doing some agility (drills), doing the cutting and pivoting things when you are not in a game situation so you are controlled and focused on doing it correctly."Trying to prevent injuriesSeemann and West attempted to establish a Jeffco districtwide ACL-injury prevention plan called the Cincinnati Sportsmetrics Program a few years ago."We did have to abandon it, and we learned something," Seemann said. "One, coaches don't want to take 15 or 20 minutes out of their practice to do this kind of stuff. The other factor is girls this age tend not to think this is going to happen to them."The major thing is it had to be done in a setting where you have perhaps one trainer and 30 kids on a soccer team. The key to the training is you have to make sure they are doing the training properly."Some area coaches are trying to take proactive measures.Horizon's softball team lost starting pitcher Kayla Kascak, who said she was hurt during a routine outfield drill in late August.Hawks softball coach Gary Mares is aware of the importance of hamstring training. He has his players do a variety of exercises to strengthen hamstrings and other lower-body muscles."It is very important to train both the front quads and back hamstrings while training the leg muscles," he said.Castle View's new girls soccer coach, Nichol Rodriguez, played college soccer for Notre Dame and the Puerto Rican national team and seven years in the Women's Premier Soccer League."We will be implementing ACL prevention once a week during the season at the end of practices," Rodriguez said of what's ahead this spring. "Also, all of the lifting that is done in the offseason seeks to strengthen all of the muscles and ligaments around the knee for a preventive measure."Former University of Utah and National Basketball Association standout Keith Van Horn is executive director of the Premier Basketball Club, which has locations in Evergreen, Parker and Grand Junction.He said the club puts a strong focus on ACL-prevention techniques."The teams that I coach at the beginning of every practice, with the girls, we implement a few warmup drills that incorporate the proper landing technique, knee positioning, hip strengthening and a number of different things in areas that tend to cause ACL injuries. We started working with an agility group that comes in and works with all of our kids."Arapahoe girls basketball coach Jerry Knafelc has had one athlete, a junior varsity player, go down with an ACL injury in the past six seasons. He said training in the summer, fall and during the season has helped mitigate the ACL injuries.Knafelc said the workouts include movement training, bleacher jumps, lifts with an emphasis on getting the glutes to activate, making sure the knees don't come in when jumping or landing, and having girls look in the mirror to make sure their posture is correct."We put a lot of time into it," he said. "That's the only way it can happen ... You have to have somebody with them to make sure they are doing it correctly."No such thing as prevention?Gabel, the Ponderosa soccer player, said she's not sure how much the drills and exercises help to prevent injuries like the one she sustained."Before I got hurt, I had done those exercises and after I got hurt, I have done a lot of them," Gabel said. "As a preventive measure, I don't really think it helps, but it's always good to strengthen your muscles and try to do anything you can."What it comes down to, if it's going to tear, it's going to tear."

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