What’s going on everybody? I hope things are well with you all! I thought this month I'd begin this series of blogs writing about knee injuries in our youth athletes. There is a lot that we could discuss about the subject in general, so I thought I’d write a bit about some findings in recent studies on the most common of youth sports injuries: the knee injury.

Let’s jump into some data on knee injuries: For one they are four-six times more common in pubertal females than males. This statistic is pretty astounding to me, until you start to examine some possible reasons. During puberty there is a rapid increase in both bone weight and size, causing a large increase in torsional forces. Perhaps the most dramatic example of this is in the femur and tibia. In addition there was found in multiple studies to be a profound imbalance in quadricep strength compared to glute strength. Generally it was found that Quadriceps were much stronger than glutes amongst athletes in this population. This imbalance adds to torsional forces and increases the strain on soft tissue in the knee, not only across the entirety of a season, but also during occasions of high impact.

While young men also experience this increase, the increase in bone mass and size is also occurring at the same time as muscle growth due to the increased production of testosterone. This, perhaps, can explain the difference in injury rate from female-male injuries, given it is easier for males to produce the necessary muscle mass to control the longer and heavier bones.

Thankfully, there are ways we can mitigate this increased chance of injury. In multiple studies it was found that an increase in the strength of the glutes and core musculature decreased pubertal female athletes acl/mcl injuries by increasing the control they had over their lower extremities. Both strength and plyometric(jumping) exercises were shown to have a marked improvement over control, and thus a mitigation of injury.

There are also easy ways we can test to see how we are doing: The LESS(Landing Error Scoring System) and Tuck Jump test. If you are concerned about your athlete, give us a shout and we can take them through an assessment. In addition, ensuring that we are taking the time to develop our musculature evenly is paramount to reduction of injury and increasing our ability to perform into adulthood.

If you are curious about these studies I will post a few(of the 18 I read) that I think are most useful. Let us know if you know anyone that might benefit from this information, we’d love to spread the word so that all of our youth athletes can be healthy and stronger!

Have a great month!

Nathan Payne

Sources:

1) Toth AP, Cordasco FA. Anterior cruciate ligament injuries in the female athlete. J Gend Specif Med. 2001; 4:25–34.

2) de Loes, M, et al.  A 7-year study on risks and costs of knee injuries in male and female youth participants in 12 sports. Scand J Med Sci Sports. 2000;10(2):90-97.

3) Myer, et al. 2008. Tuck Jump Assessment for Reducing Anterior Cruciate Ligament Injury Risk. Athl Ther Today. 2008 September 1; 13(5): 39–44.

12) Paterno, M, et al. Biomechanical Measures During Landing and Postural Stability Predict Second Anterior Cruciate Ligament Injury After Anterior Cruciate Ligament Reconstruction and Return to Sport. Am J Sports Med October 2010 vol. 38 no. 10 1968-1978.

14) Myer
, G, et al. 2008. Trunk and Hip Control Neuromuscular Training for the Prevention of Knee Joint Injury. Clin Sports Med 27:425–448.