Acl Tears Research Paper

The Terror of ACL Tears

If you walk into any high school at any time of year, you will most likely see several students on crutches and or wearing knee braces. Most often these injuries are a result of a torn anterior cruciate ligament, better known as ACL. This injury is very common and current research reports it “has steadily increased among 6- to 18-year-olds in the United States, rising more than 2 percent a year over the last two decades” (Reinberg). ACL dramatic rise among high school students injuries in the past twenty years is alarming, which should motivate parents, coaches, schools, and doctors need to re-examine adolescent athletic programs.

This injury, which has grown significantly in the past twenty years, may occur in any

sports that involve a lot of cutting or pivoting. Doctors report “such as soccer and basketball are the riskiest for ACL tears. And contact sports like football can further increase the risk. But ACL tears can occur in tennis and volleyball, too, the researchers noted” (Reinberg). These are the most common sports where injuries take place, but gymnasts, lacrosse, downhill ski, and rugby players are also vulnerable. Dr. Nicholas Beck an orthopedic surgery resident at the University of Minnesota, says these injuries peak in high school. One of the reasons for this occurrence is “the year-round sports specialization that is occurring in kids at an earlier age”(Jayanthi, et al. xx). Most high school students focus on one sport and play it all year, which does not allow them to vary their muscle use. Another reason for the increase of injuries in the past 20 years is “that children as athletes play with more intensity and force than 20 years ago, which may put the body at increased risk of injury”(Jayanthi, et al). Advances in technology, equipment, training, and high intensity coaching has turned sports into a more competitive, dangerous environment.
The Journal of the American Medical Association's recent study discusses the alarming rise in ACL injuries, “Among teenage athletes, the rate of ACL tears is rising, with the sharpest increase seen in females aged 13-17 who, over the last 13 years, have experienced a 59 percent increase in the number of required reconstruction procedures” (UNC School of Medicine).

These numbers should cause great concern among students, parents, coaches and doctors. While the injuries are noteworthy among both genders, the rate for girls is higher. The American Academy of Pediatricians explains, their study claiming “males had an overall increase of 2.2 percent per year and experienced peak rates of ACL tears at age 17. Females, meanwhile, saw an increase of 2.5 percent per year and experienced most ACL tears at age 16” (American Academy of Pediatricians). These numbers are frightening, especially for female athletes whose increased ACL tears over the past twenty years has increased in all age groups; males’ injuries, on the other hand, have only increased in the 15-16 year old group (American Academy of Pediatricians). Females not only have a greater risk of initial injury but also a greater risk of reinjury. Jeffrey Spang, MD, associate professor of orthopaedics at the UNC School of Medicine, explains “females have both a higher rate of re-tear and a higher rate of injury to the other knee,” Spang said. “More than 10 percent of adolescent females who undergo an ACL reconstruction will

require a second operation somewhere down the line” (UNC School of Medicine). Any athletic injury is traumatic, but when the chance of re-injuring or injuring the other knee is so high, it may lead to several negative consequences. One of these consequences is quitting sports; another, equally dramatic, is the possibility of developing arthritis as early as ten years from the injury. These statistics and facts merit further analysis to search for ways to prevent ACL injuries.
The rise of ACL injuries among young boys and girls needs to be addressed and prevented.

Marc A. Tompkins, MD, an assistant professor of orthopaedic surgery at the University of Minnesota, hopes the research done on ACL injuries "will help foster discussion both about how changes in pediatric athletic participation over the past 20 years may be impacting injury rates and how we can best develop youth injury prevention programs and athletic participation guidelines" (American Academy of Pediatricians) . One way to do this, according to Tompkins, is to create more preventative programs aimed at decreasing injuries. Stephen Swirsky, an orthopedic surgeon at Nicklaus Children’s Hospital in Miami, and his team have developed an injury prevention program to reduce ACL injuries. He states one of the best ways to reduce injuries is to “teach good running techniques, which will improve function and agility” (Jayanthi, et al). This program teaches safe jumping, landing, warm-ups, hamstring strengthening, balance, stretching, and plyometrics. Additionally, the program emphasizes the importance of flexibility and stretching as “the more flexible they are, the less likely they are to have an injury.”(Reinberg). These programs and techniques have shown decreases in ACL injuries. Another effective way to do this is by changing the ways teams address warming up. According to Sprang, there are specific warm up skills teams could and should use. He specifically supports the FIFA 11+ program

as “one of the most popular and well-studied injury prevention programs”. This program includes “ a 20-minute warm up routine originally created for the international soccer organization” (UNC School of Medicine). Prevention programs do not have to be as sophisticated as ones used by professional organizations; however, all teams should focus on warming up, flexibility, stretching, and learning appropriate/safe ways to move. Mackenzie Herzog, MPH, doctoral candidate in the department of epidemiology at the UNC Gillings School of Global Public Health, notes even though there are ways to prevent these injuries, “the continued high rate of injuries suggests that they are not being implemented across the board” (UNC School of Medicine). To implement programs and strategies requires educating all those involved.
ACL injuries are serious and increasing for both male and females during their teens and young adulthood. Tompkins discusses the severity of ACL injuries saying “ACL injuries are serious in the short term because they generally require six months’ to a year’s worth of hard recovery work before going back to sports. And even then it often takes longer to get back to pre-injury function,” (Reinberg). Even after surgery and weeks or months of physical therapy, the risk of reinjury is significant and the long term negative effects is daunting. While doctors and coaches have important roles to help find ways to decrease injuries or treat them once they happen, parents and school have an equally important role. One way to do this is to encourage families to limit the intensity of physical activity and discourage students from playing just one sport all year.